Your sciatic nerve begins at your spinal cord, goes through your hips and buttocks, and then branches down each leg. This nerve is the bodyâs longest nerve and one of the most important ones, as it has a direct effect on your ability to control and feel your legs. When this nerve is irritated, you will experience sciatica.
Sciatica is a sensation that can manifest itself as a moderate to excruciating pain that you feel in your back, buttocks, and legs. You may also feel weakness or numbness in these areas. Sciatica is a symptom caused by an underlying injury to the nerve or to an area that impacts the nerve, such as your vertebrae (the bones in the neck and back).
According to the American Academy of Orthopaedic Surgeons, sciatica is most likely to occur to those between 30 and 50 years old. (AAOS, 2007)
Sciatica can be caused by a number of conditions that involve the spine and that can affect the nerves running along your back. Other times, the cause is an injury, such as falling or spinal/sciatic nerve tumors.
Common conditions that can cause sciatica are described below.
Your vertebrae, or spinal bones, are separated by pieces of cartilage. Cartilage is filled with a thick, clear material to ensure flexibility and cushioning while you move around. Herniated disks occur when the first layer of the cartilage rips. The substance inside can extrude and compress the sciatic nerve, resulting in lower limb pain and numbness. It is estimated that one in every 50 people will experience a herniated disk in their lifetime, according to the American Academy of Orthopaedic Surgeons. (AAOS, 2007)
Also called lumbar spinal stenosis, this condition is characterized by the abnormal narrowing of the upper or lower spinal canal. This narrowing puts pressure on the spinal cord and the sciatic nerve roots.
This is one of the associated conditions of degenerative disk disorder. When one spinal bone (vertebra) extends forward over another, the extended spinal bone can pinch your sciatic nerve.
Piriformis syndrome is a rare neuromuscular disorder in which the piriformis muscle (the muscle that connects the lower portion of your spine to your thighbones) involuntarily contracts or tightens, causing sciatica. The sciatica occurs because of the pressure the tightening places on the sciatic nerve. Piriformis syndrome can worsen as the result of such commonplace events as sitting for long periods of time, falling, or being involved in a fender-bender.
Sciatica is a very distinct type of symptom. If you are experiencing pain that flows from your lower back through your buttock area and into your lower limbs, it is typically sciatica.
Sciatica is the result of damage or injury to the sciatic nerve, so other symptoms of nerve damage are usually present with the pain. Other symptoms of sciatica may include:
Seek immediate medical attention in the case of the following symptoms:
This is a rare disorder that can cause paralysis, chronic bladder and bowel issues, and decreased sexual sensation if left untreated. Because this disorder often develops slowly, when symptoms appear, it is important to make an appointment with your doctor immediately.
Symptoms of this disorder include:
Since sciatica is, itself, a symptom that can vary from condition to condition and person to person, your doctor will first want to get your full medical background. This includes whether or not you have had any recent injuries, where you feel the pain, and how the pain feels. The next step is a physical exam that will include testing your muscle strength and reflexes. Your doctor might also have you do some stretching and moving exercises to determine which ones bring about more pain.
The next round of diagnosis is for individuals who have dealt with sciatica for longer than a month or have a major illness such as cancer. Nerve tests will allow your doctor to examine the way nerve impulses are being conducted by the nerve and see if there are any abnormalities. Imaging tests will allow a doctor to get a look at your spine, which will help him or her to determine the sciaticaâs cause. The most common imaging tests used to diagnose sciatica and to find its cause are:
Upon first diagnosis of sciatica, your doctor will often give you tips for treating your sciatica pain. One of the most important things to remember is to keep your daily activities going as much as possible, as lying in bed or avoiding activity can create a worse situation than you started with.
Some commonly suggested at-home treatments are described below.
You can purchase ice packs or even use a package of frozen vegetables. Wrap the ice pack or frozen vegetables in a towel and then apply to the affected area for 20 minutes a day, several times a day during the first few days of pain. This will help to reduce swelling and ease pain.
You can also purchase hot packs or a heating pad. It is recommended that you use ice the first couple of days. After two or three days, switch to heat. If you continue to have pain, try alternating between ice and heat therapy.
Gentle stretching of the lower back can also be helpful. A good way to do quality stretching is to get personal, one-on-one physical therapy or even yoga instruction from a physical therapist or instructor who is aware of and trained in dealing with your injury.
Over-the-counter medications, such as aspirin and ibuprofen, can also help with pain, inflammation and swelling. Be careful using aspirin excessively due to its potential complications, which include stomach bleeding and ulcers.
The more you stay active, the more endorphins your body releases. Endorphins are painkillers made by the body. Keep to low-impact activities at first, such as swimming and stationary bicycling. As your pain decreases and your endurance improves, create an exercise regimen that includes aerobics, core stability, and strength training. A regimen with these components can decrease the risk of future back problems. (Mayo, 2010)
If at-home treatments fail to treat your pain effectively, the doctor might suggest that you take further measures, including:
Certain behaviors or factors can make sciatica more likely. The most common factors for developing sciatica include:
The world of alternative medicine is growing in popularity. There are a number of alternative remedies for sciatica. These include:
The following steps can assist you in preventing sciatica or from keeping it from reoccurring: