Sciatica

 

Sciatica is pain, tingling, or numbness produced by an irritation of the nerve roots that lead to the sciatic nerve. The sciatic nerve is formed by the nerve roots coming out of the spinal cord into the lower back. It goes down through the buttock, then its branches extend down the back of the leg to the ankle and foot.

What causes sciatica?

The most common cause of sciatica is a bulging or ruptured disc (herniated disc) in the spine pressing against the nerve roots that lead to the sciatic nerve. But sciatica also can be a symptom of other conditions that affect the spine, such as narrowing of the spinal canal (spinal stenosis), bone spurs (small, bony growths that form along joints) caused by arthritis, or nerve root compression (pinched nerve) caused by injury, piriformis syndrome, muscular problems (strains and sprains).

What are the symptoms?

Symptoms of sciatica include pain that begins in your back or buttock and moves down your leg and may move into your foot.  The type of pain can vary it may be sharp, feel like electric shocks, discomfort or numbness.  Weakness, tingling, or numbness in the leg may also occur.

  • Sitting, standing for a long time, and movements that cause the spine to flex (such as knee-to-chest exercises) may make symptoms worse.
  • The pain may be worsened by certain movements like coughing or sneezing (these movements increase the intra-abdominal pressure).
  • Walking, lying down, and movements that extend the spine (such as press-ups) may relieve symptoms.

How is sciatica diagnosed?

Sciatica is diagnosed with a medical history and physical assessment. Sometimes X-rays and other tests such as magnetic resonance imaging (MRI) are done to help find the cause of the sciatica.

How is it treated?

In many cases, sciatica will improve and go away with time. Initial treatment usually focuses on medicines and exercises to relieve pain. You can help relieve pain by:

  • Avoiding sitting (unless it is more comfortable than standing).
  • Alternating lying down with short walks. Increase your walking distance as you are able to without pain.
  • Using a heating pad on a low or medium setting for 15 to 20 minutes every 2 or 3 hours. Try a warm shower in place of one session with the heating pad. You can also buy single-use heat wraps that last up to 8 hours. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours. There is not strong evidence that either heat or ice will help, but you can try them to see if they help you.
  • Perform some gentle back and leg stretches to maintain flexibility in your tissues and encourage your body’s natural healing and recovery process.
  • Strengthening exercises will help to prevent your back from getting weaker and can reduce your chances of experiencing a recurrence in the future.
  • Try to link your exercises to activities you do regularly and perform these exercises regularly and gently. Pain is normal and to be expected so don’t worry if some of the exercises are comfortable.  Just do what you can.
  • You may need to shorten the amount of activity you do at first such as walking or swimming, but these activities can be built up gradually over time. If you are taking medication, it is important to take these regularly.  Do not feel like they are masking your symptoms, as they will help you to stay active and strong.  Perform some gentle back stretches to maintain flexibility in your spine and reduce constant pressure on your nerves and discs.

If your symptoms are not settling after six weeks you should seek advice from a healthcare professional.

If you experience any of the following symptoms contact your clinician urgently:

  • An inability to pass urine when you feel that you need to go.
  • Loss of control of your bowels.
  • Numbness around your genital area.
  • Inability to get an erection.
  • Worsening weakness in both legs.

Be patient with your mind and body. The long term outlook is good.

 

Sources:

Physitrack

Healthwise: Copyrighted material adapted with permission from Healthwise Incorporated.