Sciatica, what is that? Are you also curious about it? Are you in pain and want to know more about it? In this article, I will provide you with all the information about this condition.
But Friends, before you know what is sciatica, you should know about the sciatic nerve. So, here I am explaining to you the sciatic nerve before providing you with complete information on sciatica.
The sciatic nerve is the huge nerve present in the body and is formed by the union of 5 nerve roots from the lower spine.
It is the longest as well as largest. The diameter of the sciatic nerve is 3 quarters of an inch. . This nerve starts at your lower back, continues to your hips, and your buttocks, going down each of your legs and bending at the knees.
The nerve develops in the sacral plexus which is a network of nerves present in the lumbosacral spine i.e. lower back.
The lumbosacral spine is the combination of the sacrum i.e. sacral and lumbar spine. The lumbosacral spine lies down at the base of your spine and above the tailbone i.e. coccyx.
The sciatic nerve leaves the sacrum through the sciatic foramen (a nerve passageway). Two branches namely muscular and articular branches are formed at the upper part of the sciatic nerve. The muscular branch goes to the leg muscles whereas the articular branch serves the hip joint.
The sciatic nerve has many smaller nerves that get divided from the main nerve. These smaller nerves enable motor and sensory functions, and movement in the thighs, calves, knees, ankles, feet, and toes.
What is Sciatica?
Sciatica, often confused with general back pain, is not just limited to the back; it causes pain, numbness, as well as tingling that radiates along the path of the sciatic nerve.
The sciatic nerve runs from your lower back through your hips and buttocks, and down each leg, ending just below the knee.
Sciatica is also known as sciatic neuralgia and is a common symptom of many spinal disorders. Though it’s not a dangerous condition, sciatica can seriously interfere with your daily life.
It’s characterized by the compression of the sciatic nerve. In some cases, it can irritate other nerves, particularly the spinal nerve which can leave a person paralyzed.
Sciatica usually occurs on one side of the body but can occur on both sides, more commonly than most people realize. It can be acute or chronic. A lot of people suffer from sciatica, but they don’t always know what sciatica is.
In this article, I am going to shed some light on the causes, symptoms, diagnosis, treatment, and complications of sciatica and by going through this you will know more about this condition.
What are The Causes of Sciatica?
Several conditions that involve your spine and affect the nerves running along your back can cause sciatica. It can also be caused by spinal or sciatic nerve tumors, or an injury, such as falling.
Below here I am describing common conditions that can cause sciatica:
Your vertebrae are separated by soft pads called discs that are made up of cartilage. This cartilage is also filled with a thick and clear material to ensure cushioning and flexibility while movement.
Herniated or slipped discs occur when a disc is pushed out of place, putting pressure on the sciatic nerve, resulting in lower limb pain and numbness. It is the most common cause of sciatica.
Degenerative Disc Disease
As you age, your vertebral discs may wear down. If the discs become too thin, the space between each vertebra becomes compressed and puts pressure on the sciatic nerve root, which can lead to pain. If the outer covering of the discs wears down, fluid from the disc may leak out and irritate the sciatic nerve.
The vertebrae in your back are designed to stack on top of one another for stability. The slippage of one vertebra in the lower back so that it is out of line with the one above it, (a condition called spondylolisthesis), can press down on the sciatic nerve.
Overgrowth of bone (osteophyte) on the vertebrae can also put pressure on the sciatic nerve roots. This happens often when osteoarthritis affects the vertebrae.
Trauma injury to the vertebra that forms a joint (pars interarticularis) in the lumbar region cracks or fractures, (a condition known as spondylolysis) can compress the sciatic nerve.
Spinal stenosis also called lumbar spinal stenosis is a condition characterized by the abnormal narrowing of your lower spinal canal. This narrowing reduces the available space for the spinal cord and sciatic nerve roots, causing compression. Spinal stenosis may be caused by aging or arthritis.
Piriformis syndrome is a condition when the piriformis muscle, a small muscle that lies on top of the sciatic nerve in the buttocks, compresses the sciatic nerve if the muscle involuntarily contracts or tightens. Symptoms of piriformis syndrome may get worse after walking upstairs, sitting for long periods, falling, running, or experiencing a car crash. It is an uncommon neuromuscular disorder.
The piriformis is a flat band-like muscle that connects the lower portion of your spine to your thighbones.
Tumors Within The Spine
Tumors in the lumbar spinal canal can compress the root of the sciatic nerve.
Cauda Equina Syndrome
Cauda equina syndrome is a rare condition that affects the bundle of nerves in the lower part of the spinal cord called the cauda equina. This syndrome causes pain down the leg, loss of bowel and bladder control, and numbness around the anus. It is a serious condition that requires immediate medical attention.
What are The Symptoms of Sciatica?
The main symptom of sciatica is moderate to severe pain anywhere along the route of the sciatic nerve; from the lower back, through the buttock, and down the back of your leg.
Other common symptoms of sciatica include:
1) Tingling sensation (feeling of pins and needles) in your feet, toes, or legs.
2) Loss of movement or pain that becomes worse with movement.
3) Weakness or numbness in your feet, leg, buttock, or lower back.
4) This pain may be aggravated by sitting for long periods.
5) Loss of bowel and bladder control, is a symptom of cauda equine syndrome and needs immediate emergency attention
How to Diagnose Sciatica?
The diagnosis of sciatica is done based on 3 important factors and that are medical history, physical examination, and clinical tests. So, let’s now understand each of the factors of diagnosis.
In medical history, the doctor or health care provider will ask you to provide a detailed report of the following:
- Decreased leg strength.
- The incidence of muscle cramps or spasms in the pelvic region
- Injury or trauma to the hip or back area
- The occurrence of pain and other related symptoms.
- Duration, nature, and type of pain.
In physical examination, the doctor or health care provider will examine for the following:
- Any kind of pain in the leg, thigh, buttock, and lower back region.
- Your response to certain stimuli, such as pressing the calf region or toes gently.
- Your response to leg movements such as straightening of legs etc.
Your doctor may also conduct some clinical tests to check for sciatica. The clinical tests include the following:
This test is performed in the following steps,
1) Firstly, the patient is seated upright with hands behind the back.
2) Then the patient is bent forward at the hip.
3) Afterwards, the neck is bent down with the chin touching the chest and one knee is extended to a possible degree.
If the pain occurs, the problem is possibly sciatica.
Straight Leg Raise (SLR) Test
For the test, the patient is made to lie on their back. Then, the doctor lifts one of his/her legs while keeping the other leg bent at the knee or flat. The same is then repeated for the other leg. If the pain occurs while doing it on any of the legs, then it is usually the indication of sciatica.
Medical Imaging Tests for Sciatica
Sometimes the doctors ask for a medical imaging test, in case sciatica is suspected. The aim of these tests is to confirm the cause of sciatica. The imaging test includes X-ray, MRI, CT scan, and electromyography (EMG).
Spinal X-rays look for spinal fractures, disk problems, infections, tumors, and bone spurs.
Computed Tomography (CT) Scan
It combines a series of X-rays to get a better glance at your spinal cord and spinal nerves
Magnetic resonance imaging (MRI)
MRIs use radio waves and magnets to create pictures to get a detailed look at the bone and soft tissues of the back. An MRI can show disk herniation, pressure on a nerve, and any arthritic condition that might be pressing on a nerve. MRIs are used generally ordered to confirm the diagnosis of sciatica.
Nerve conduction velocity studies/Electromyography (EMG)
Nerve conduction velocity studies/Electromyography is used to examine how well electrical impulses travel through the sciatic nerve and the response of muscles.
A myelogram is used to determine if a vertebra or disk is causing the pain.
Prevention For Sciatica
Although some sources of sciatica can’t be preventable such as sciatica due to pregnancy or degenerative disk disease. But there are some measures that can help in the protection of the back and it may also lower your risk. So, here is what you can do for sciatica prevention:
Maintain proper posture
Maintain good and proper posture while sitting, sleeping, lifting objects, and standing. This will help in relieving pressure on your lower back. If you start to experience stiffness or soreness, then you should adjust your posture.
To keep your back strong, you must pay special attention to your core muscles — the muscles in your abdomen and lower back. Exercise regularly to strengthen your core muscles, as these muscles work to support your spine. You can also ask your doctor to recommend specific activities.
Choose physical activities that don’t hurt your back
Do physical activities which have rare possibilities to hurt the back, which may include tai chi, yoga, walking, or swimming.
Maintain a healthy weight
Extra weight or obesity is associated with inflammation and pain throughout your body. The closer you are to your healthy or ideal body weight the lesser strain you put on your spine.
Keep yourself safe from falls
You should follow measures to keep yourself safe from falls, like
- Wear shoes that fit properly
- Make sure that your rooms are well-lighted
- There must be rails on stairways and grab bars in bathrooms.
- Use good body mechanics
When you lift a heavy object, let your lower extremities do the work i.e. move straight up and down. Try to keep your back straight and bend only at the knees. You must hold the heavy object close to your body. Find a lifting partner while lifting the heavy or awkward object.
Avoid smoking as nicotine reduces the blood supply to your bones. Thus, it weakens your spine and vertebral disks, leading to back and spine problems.
Risk Factors For Sciatica
The risk factors for sciatica include:
The nicotine present in tobacco may lead to the weakening of bones, damaging of spinal tissues, and speeding the wearing down of vertebral disks.
Leading An Inactive Lifestyle
An inactive lifestyle such as sitting idle for long, not doing any exercises, and not moving the muscles and keeping them untoned and inflexible may increase the risk of developing sciatica.
This condition may lead to damage to the spine and increases the risk of injury to the nerves.
Diabetes affects the way that your body uses blood sugar which eventually increases the risk of nerve damage and may result in sciatica.
Lacking proper posture in the weight room
After being physically active and fit too, the person can still have sciatica, in case of not following the right body posture during strength training exercises such as weight lifting, etc.
If you have a job that requires you to sit for long or heavy weight lifting leads to an increased risk of low back problems.
Lacking a strong core
The muscles of the back and abdomen are known as core muscles. These muscles are the only support to the lower back and the lack of a strong core leads to weaker support to the lower back.
An overweight body can lead to spinal changes and increase the stress on the spine. It may lead to sciatica.
The changes in the spine due to age, like bone spurs and herniated disks, might increase the risk of sciatica.
Having injury previously or at present
If you have an injury to the spine or lower back, then you might be at a higher risk of developing sciatica.
What is the Treatment Of Sciatica?
The main goal of sciatica treatment is to pacify the pain in the affected area and increase your mobility. The treatment of sciatica may consist of self-care treatment, prescription medications, physical therapy, spinal injections, alternative therapies, and surgery. The mode and number of treatments effective for the particular case depend upon the symptoms and intensity of the injury. So, let’s have a look at how different sciatica treatment works.
Self Treatments Of Sciatica
Ice and/or Hot Packs Application
The very first thing that you need to do at home when you feel that you have sciatica pain is to apply ice packs to the affected area. You can also use a bag of frozen vegetables for this. This helps to reduce inflammation and pain. It can be applied several times a day, each for 20 minutes. Also, you can try using the heating pad or hot pack after the first several days. Or switch between the cold and the hot to analyze which one helps in reducing the pain and relieving the discomfort.
Perform Gentle Stretches
Learn and perform the stretches which help in reducing the lower back pain. You can also perform aerobic exercises, core muscle strengthening, and other general strengthening.
Take Over-The-Counter (OTCs) Medicines
Take the medicines which help in reducing pain, swelling, and inflammation. Some commonly used over-the-counter (OTCs) medicines include naproxen, ibuprofen, aspirin, etc.
But it’s better to consult your healthcare provider before taking any over-the-counter medicines.
Other Treatment Options For Sciatica
The self-care treatment is a 6-week trial process and if it does not work to provide relief then it’s time to consult with your healthcare provider and try other treatment options. Here, let’s dig into what are the other options of treatment available for sciatica.
Prescription Medications For Sciatica
Your health care provider or doctor after analyzing your condition and your level of pain may prescribe some drugs such as pain relievers, muscle relaxants, and tricyclic antidepressants. These medications may include cyclobenzaprine, etc.
Physical Therapy For Sciatica
Physical therapy helps in decreasing the pressure on the nerve which results in lowering the impact of sciatica. The physical therapist may suggest which exercise program or therapy would be better according to your particular condition. Some of the exercises include stretching exercises, aerobic exercises (such as water aerobics, swimming, walking, etc.), and other exercises which help in strengthening the legs, abdomen, and back.
Spinal Injections For Sciatica
An injection filled with Corticosteroid medications helps to reduce inflammation on and around the affected nerve root. These injections provide short-time relief majorly for 3 months. The health care provider may suggest the number of recommended doses of this injection. Long-term use of this may also lead to some severe side effects.
Alternative Therapies For Sciatica
These days alternative therapies are becoming more popular to treat and manage sciatic pain. These therapies include spine manipulation by a licensed chiropractor. Also, biofeedback therapy, massage, acupuncture, yoga, etc. are other alternative methods to improve sciatic pain.
Surgery For Sciatica
Surgery is the last option when nothing works to treat the illness. The surgery is done by removing the part of herniated disk or bone spur. It is usually suggested by your doctor when the pain increases continuously and worsens with time, loss of bladder or bowel control, significant weakness, and no other mode of treatment is providing relief.
What Are The Complications Of Sciatica?
While in most cases, people fully recover from sciatica. But in some cases, it might create certain complications when the pressure in the nerve is not released.
The complications in such cases may include:
- Increased pain.
- Permanent nerve damage.
- Loss of bladder or bowel function.
- Loss of feeling or weakness in the affected leg.
- A slipped or herniated disc.
What Is The Outlook For Individuals With Sciatica?
The overall outlook of Sciatica is good and is curable in most cases. It requires some self-care treatments and goes off on its own with time. Along with a healthy lifestyle, some pain relief, exercise, and self-care work the best to get relief from sciatic pain. Almost 80 to 90% of people do not require surgery to get better from this illness. Most people fully recover from an episode of sciatica within 6 weeks.
Hope you have got all the understanding about sciatica or sciatic nerve pain. If you are suffering from this pain then there is no need to panic as it can be cured completely with time. Also, I always advise you to consult your healthcare provider in case of any confusion.
Disclaimer: This article is intended for informational purposes only. Any information associated with this article should not be considered as a substitute for prescriptions suggested by local health care professionals.