Sciatica is a sensation that can arise as moderate to severe pain in the back, buttocks and legs. The sciatic nerve starts at the spinal cord, travels via the hips and buttocks and branches down in every leg. It typically occurs among individuals between the ages of 30-50 years of age.
It can also be accompanied by numbness or weakness in these areas. Sciatica is a symptom brought about by an underlying injury to the sciatic nerve or a region that disrupts the nerve such as the vertebrae.
What are the indications?
Sciatica is considered as distinct type of symptom. If the individual experiences pain that radiates from the lower back via the buttock region and into the lower limbs, it is likely sciatica.
The pain is usually due to damage to the sciatic nerve; thus, it is accompanied by other symptoms of nerve damage.
Other symptoms that might be present include:
- Pain that worsens with movement
- Weakness or numbness in the feet or legs that can be felt throughout the pathway of the sciatic nerve. In severe cases, there is also loss of sensation or movement.
- Sensation of pins and needles that involves sore tingling in the feet or toes.
- Incontinence or inability to control the bowels or bladder
What are the causes?
Sciatica can be triggered by various conditions that affect the spine and even affect the nerves travelling throughout the back.
The common conditions that can cause sciatica include:
- Herniated discs – this occurs if the first layer of cartilage in between the vertebrae is torn.
- Spinal stenosis – this is characterized by abnormal narrowing of the lower spinal canal which places pressure on the spinal cord and sciatic nerve roots.
- Piriformis syndrome – characterized by involuntary contraction or tightening of the piriformis muscle
- Spondylolisthesis – occurs if one of the spinal bones or vertebra radiates forward over another which can pinch on the sciatic nerve
Management of sciatica
Some of the commonly used home treatment options include:
- Cold – an ice pack is applied on the affected area for 20 minutes per day at several times during the initial days of pain to reduce the pain and swelling.
- Heat – a heating pad or hot pack can be applied after 2 or 3 days after using cold initially. If the pain persists, you can alternate between cold and heat
- Stretching – perform gentle stretching in the lower back
- Over-the-counter medications – this includes aspirin or ibuprofen to ease the pain, swelling and inflammation
- Regular exercise – being physically active releases more endorphins which are natural painkillers produced by the body. Start with low-impact activities and as the pain reduces and endurance improves, the regimen should include aerobics, core stability and strength training.
In case home treatments fail to effectively reduce the pain, the doctor might prescribe the following measures:
- Physical therapy – the exercises can improve posture and strengthen the back muscles
- Prescription medications – these include muscle relaxants, narcotics or antidepressants.
- Epidural steroids – corticosteroids are injected into the epidural space which is the canal surrounding the spinal cord
- Surgery – surgical approach is required if there is significant pain or instances where the individual lost control over the bowel and bladder or developed weakness in certain muscle groups in the lower extremity.