Sciatica is one of the most common types of pain along the path of the sciatic nerve. The sciatic nerve is your body’s longest nerve and one of the most important ones which branches from your lower back through your hips and buttocks and down each leg. It has a direct effect on your ability to control and feel your legs. The pain begins in the lower spine, passes through the buttock, down the back and side of the leg, and into the foot and toes. Typically, sciatica affects only one side of your body. You may also feel weakness or numbness in these areas. Almost 40% of people will get it during their lifetime and it affect people in their 40s-50s of age especially overweight people.
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Symptoms of Sciatica:
Usually, sciatica affects only one side of your body at a time. The symptoms radiate from the lower back or buttock to the thigh and down the leg. Sciatica may cause pain in the front, back, and/or sides of the thigh and leg. A few common symptoms of Sciatica are:
- Pain: – Pain is the first symptom of Sciatica. It may be a constant burning sensation, so you can’t find any comfortable position. Sometime it may come and go as a sharp shooting pain just like an electric shock. The pain is usually more severe in the calf region (below the knee) as compared to the back. It may occur on the entire leg and/or feet and on the thigh and back area.
- Numbness: – Numbness, tingling or muscle weakness in the affected leg or foot may be felt at the back of the leg and sometimes it feels pins-and-needles sensations. Some people also have a feeling of heaviness in the affected leg.
- Body posture induced symptoms: – Change in body posture may aggravate or relieve Sciatica pain. Sciatica pain may feel worse while sitting, trying to stand up, standing for a long time, bending the spine forward, twisting the spine, and/or while coughing.
- One-sided symptoms: – Sciatica typically affects one leg. The condition often results in a feeling of heaviness in the affected leg. Rarely both legs may be affected together. The pain may be relieved while walking, applying a heat pack to the rear pelvic area, or doing pelvic exercises. Pain may increase or remain constant while lying down. Lying on the back with the knees slightly elevated and propped up with a pillow, or lying on the side with a pillow between the legs, may help relieve the pain in such cases.
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Common Causes of Sciatica:
The sciatic nerve is formed by the combination of 5 nerve roots: L4, L5, S1, S2, and S3 and Sciatica pain most commonly occur when a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses part of the nerve. Sciatica can be caused by an injury, for example from falling, or spinal or sciatic nerve tumors. Common causes of sciatica include:
- Lumbar Herniated Disc: – The spinal discs are pads that serve as cushions and each disc is designed like a jelly donut with a central softer component (nucleus pulposus). Research suggests that up to 90% of sciatica is caused by abnormal rupture of the central portion of the disc which is referred to as a Lumbar Herniated Disc. The herniated disc typically compresses one or more spinal nerve roots (L4-S3) that form the sciatic nerve, resulting in lower limb pain and numbness. It is estimated that 1 to 5 percent of all people will have back pain caused by a slipped disk at some point in their lives. Bilateral sciatica may also be caused by two adjacent segments discs herniating on either side, although this possibility is rare.
- Lumbar Spinal Stenosis: – Lumbar Spinal Stenosis is the narrowing of the lower spinal canal. This narrowing puts pressure on your spinal cord and your sciatic nerve roots. Research suggests that lateral recess stenosis may be common in causing sciatica in the elderly population.
- Degeneration: – Degeneration of tissues, Degeneration of the facet joints, Degeneration of vertebral bone and Degenerated of intervertebral discs may cause inflammation of the sciatic nerve.
- Spondylolisthesis: – Spondylolisthesis occurs when a small stress fracture causes one vertebral body to slip forward on another. For example, the L5 vertebra may slip forward over the S1 vertebra. Sciatica may result from nerve compression following the disc space collapse, fracture, and forward slipping of the vertebral body. Spondylolisthesis may cause bilateral sciatica and is more common in younger adults.
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Risk factors for developing Sciatica:
Certain behaviors or factors can raise your risk of developing sciatica. The most common factors for developing sciatica include the following:
- Age: – As your body ages, the changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica.
- Occupation: – Certain careers place a lot of strain on your back, especially those that involve lifting heavy objects, sitting for extended periods, or twisting movements.
- Diabetes: – Having diabetes can increase your risk of nerve damage.
- Smoking: – Smoking can cause the outer layer of your spinal disks to break down.
- Obesity: – By increasing the stress on your spine, excess body weight can contribute to the spinal changes that trigger sciatica.
Treatment of Sciatica:
Sciatica treatment may include both nonsurgical and surgical methods. In half of the people with sciatica, the pain goes away without treatment within 4 weeks; fewer than 5% to 10% of people with sciatica require back surgery. Surgery may be indicated when the underlying cause is severe and/or progressive neurological deficits such as leg weakness occurs. Treatment of sciatica usually also involves self-care measures. Some commonly suggested at-home treatments are described below:
- Hot or cold compression packs help to reduce pain. Apply it to the affected area for 20 minutes per day, several times per day, during the first few days of pain. This will help to reduce swelling and ease the pain. You can try alternating between ice and heat therapy.
- Do exercises such as walking or light stretching (under supervision); stretching exercises that stretch your lower back may offer relief by easing pressure on the nerve.
- Physical therapy can also strengthen your muscles and lumbar spine.
- Start Yoga also if possible as Yoga can give benefits in many ways.
- If you are overweight, losing weight can help relieve sciatica a lot.
- To correct your body posture can also, ease sciatica.
- Do not forget to take rest. Taking rest is also equally important. Do all your daily routine work as much as possible and avoid prolonged periods of physical inactiveness or bed rest.
If home remedies don’t work, your doctor will probably prescribe stronger medication. If your pain lasts for more than 6 months, it might be time for surgery. See your doctor immediately if your sciatica causes severe pain and weakness, numbness, and loss of bladder or bowel function.
Surgical options include:
There are surgical procedures also available and these are:
Lumbar Laminectomy: – Widening of the spinal cord in the lower back to reduce pressure on the nerves.
Discectomy: – Partial or entire removal of a herniated disk.