Pain is often your body’s way of letting you know that something is not quite right. Read on to learn more about sciatica: The Sciatica nerve is the longest and widest nerve in the human body. It runs from the lower back, through the buttocks, and down the legs, ending just below the knees. This nerve enables muscles in the lower legs to feel and to move. The pain caused by any irritation of the sciatic nerve is called Sciatica.
Sciatica pain can be described as a tingling, numbness or weakness that radiates from your lower back right down to your calves. There is a certain amount of discomfort that is felt almost all along the nerve pathway. The most pain though can be felt at in the things and the calves. The pain could be a mild ache or even a sharp burning sensation. For some it can be erratic and more of an irritant. For others, it could even be incapacitating. Sciatica itself is not a medical condition. It is a symptom of an underlying medical condition. It is for this reason that Sciatica should only be treated by a professional. Trying home remedies may make the situation worse for the patient.
Sciatica is not hereditary. It is most likely to develop between the ages of 40-50 years. It could happen due to age-related wear and tear in the spine such as arthritis or degenerating discs. Or it could occur due to a wide range of common lower back problems such as a slipped disc, lumbar spinal stenosis etc. Lifestyle related issues such as prolonged sitting and obesity can also be risk factors.
In most cases, the patient will experience both back and leg pain. However, there are rare scenarios where the patient could experience only one of the pains. If for example you have a prolonged pain in the leg that doesn’t seem to be improving, get it checked for Sciatica.
Sciatica can be difficult to diagnose. Diagnosis for it begins with the doctor understanding the symptoms and medical history of the patient followed by a physical examination. Here the doctor may ask the patient to perform various physical tests such as raising a straight leg or walking on toes. Through these s/he tries to pinpoint the source of the nerve irritation. In some cases, the doctor may require further tests like an x-ray, in order to confirm the diagnoses. Occasionally, laboratory tests are done in order to rule out infection.
It is a common myth that sciatica can only be treated with surgery. On the contrary, most doctors will attempt to treat it non-surgically at first. This may include epidural injections, physiotherapy, medication etc. Only when these methods do not work will the doctor recommend surgery. Most often, the surgical procedures are minimally invasive.
In most cases, sciatica can be treated within a couple of weeks. And more often than not surgery is not required. Sciatica can also be prevented to some extent. Exercising regularly, being aware of your posture through the day and learning to lift things correctly can help reduce the risk of sciatica.
Know the Symptoms of Sciatica: Your lower back has been hurting off and on for a while now and you just can seem to figure out what the problem is. Is it a regular back pain or is it something more? Since the Sciatica nerve is quite long, there could be different symptoms depending on where the nerve is affected. There could also be a combination of symptoms. And to make matters worse, Sciatica shares symptoms with other conditions such as arthritis. This makes Sciatica difficult to diagnose. So, don’t try to do it yourself. These are a few distinct symptoms of Sciatica to help you understand if there is a chance you may be affected by it and to seek medical help accordingly.
Description of the Pain: The hallmark of Sciatica is that the pain radiates from the lower back down to the legs. Though discomfort can be felt anywhere along the nerve path, the pain is most likely to follow the entire path. These are some ways in which the pain can be described.
• Stabbing or sharp pain in the lower back or hip radiating down the leg
• Dull or sharp pains in the thigh
• Hot pain in the buttocks
• Aching in the buttock, back of the thigh (hamstring) and calf
• A painful tingling/ ‘pins and needles’ sensation in the toes or feet
• Numbness on the back, side of the hip, and down the back of the leg
• Weakness in the legs as a result of numbness
• Electric shock like sensation
• Dull, aching pain throughout the leg, calf or foot
• Localized lower back pain
• Cramping or muscle spasms
• Pain in the ankle, foot or the big toe
• Muscle tightness in the calf or back of the thigh – This could occur due to a muscle reaction or even the psychological anticipation of pain.
Manner of Pain and How It Affects You: Sciatica usually occurs one side of the body at a time, although it can occur on both sides as well. The symptoms develop gradually. For some, they are intermittent and infrequent for others they could be more incapacitating.
• The pain increases with sudden movements like sneezing and coughing
• Patients may find it difficult to walk, stand or sit for prolonged periods of time. The longer you do these activities, the stronger the pain gets.
• The persons reflexes maybe diminished
• The muscles in the leg and foot feel weak
• In severe cases bladder incontinence could occur
• Hip pain – This can occur on both sides of the body. When one side is in pain, the patient tends to compensate by shifting their weight to the other side. This leads to pain on both sides.
If you suspect that you might be suffering from Sciatica, start making detailed notes of your symptoms before you meet the doctor. Notice if you have any inflammation or swelling as well. In general, if you have recently had some sort of injury, it is advisable to check with your doctor for sciatica symptoms. Though Sciatica is painful, it can be treated non-surgically over a couple of weeks. Don’t ignore it. Come to our Spinalogy Clinic for a consultation.
Know the Most Common Causes: Sciatica is caused when the sciatica nerve is irritated. The cause of irritation could be a wide range of reasons. Here are a few of the more common causes of sciatica.
1. Slipped Disc: To put it simply, a slipped disc occurs when the cushioning of tissues between the bones in your spine begin to bulge outwards. These tissues have a strong outer layer made of cartilage and a soft gelatinous centre. They act as shock absorbers. When they become weak, they begin to bulge out. In this process they could put pressure on the root of the sciatic nerve causing inflammation, pain and numbness. This condition is also known as a herniated disc, bulging disc or pinched nerve. A slipped disc could be caused by lifting heavy objects, leading a sedentary lifestyle and age amongst other factors.
2. Lumbar Spinal Stenosis: This is the narrowing of the spinal canal in the lower back. When the spinal canal narrows, the nerves have less space to pass through. This results in strain and pain and could affect the sciatic nerve. People who suffer from spinal stenosis tend to have regular back pains and suffer more pain while walking or standing. Spinal stenosis tends to affect older people more and is related to natural ageing.
3. Spondylolisthesis: This is when one of the bones is your spine slips out of position and slides over the bone beneath it. This is not the same as a slipped disc. Slipped disc is related to the tissue in the spine and not the bone. Spondylolisthesis most commonly occurs in the lower back, directly straining the sciatica nerve. It could be caused by an injury, infection, arthritis or may even be something a person is born with.
4. Piriformis Syndrome: Piriformis is the muscle is located in the lower part of the spine near the hip joint, connecting to the thighbone. It assists in hip rotation, maintaining balance and walking. The sciatic nerve runs beneath the piriformis muscle. Sometimes the piriformis muscle becomes tight, goes into spasm, or swells. When this happens it compresses the sciatic nerve. This is known as piriformis syndrome. Athletes are especially susceptible to this.
5. Bone Spurs: A bone spur is a projection that develops on the surface of a normal bone. These can occur for a number of reasons. One reason is friction. When bones rub against each other, calcium deposits are formed. These deposits are called bone spurs or osteophytes. Bone spurs themselves are not painful. Often people have them and don’t even realize. It’s only when these spurs rub against nerves such as the sciatica, do they cause discomfort.
Apart from these causes, there are a number of lifestyle factors that could make you more prone to sciatica. These include leading a sedentary lifestyle, smoking cigarettes and excessively consuming alcohol, physical activities that involve heavy lifting or twisting of the back (e.g. – golf) and diabetes. Things like wearing high heels or sleeping on a mattress that is too hard or too soft could make the condition worse. Being aware of these causes will help prevent Sciatica.