The term sciatica is a medical term used to describe symptoms of leg pain and tingling or weakness that travels from the low back, through the buttocks and down the large nerve in the back of the leg. The majority of people who suffer from sciatica will usually get better with time and find there is no need for surgical intervention. For some however, the pain can be severe and debilitating.
After evaluation and diagnosis, the physician will use the clinical term radiculopathy which basically means that a disc has moved from its normal place in the spinal column and put pressure on the nerve in the lower back. It is important to note that sciatica is a symptom of another problem and not a problem itself. This is an important distinction to make if there is to be any significant successful treatment. In other words, you must treat the underlying condition in order to relieve the pain over the sciatic nerve.
The sciatic nerve pain often occurs in people between ages 30 and 50. It is a development over time and not the results of one particular event or injury. Individuals complain that pain will radiate down the back of the leg and they may feel discomfort anywhere along that pathway from buttocks to calf. The pain can very from a mild ache to a sharp burning sensation and may even feel like jolts of electricity. Usually, only one lower extremity is affected.
Depending upon the severity of the underlying medical condition, individuals can also suffer from numbness or weakness. In some cases individuals report they have pain in one part of the leg but numbness in another. Unfortunately, there is another rare, but serious condition, loss of bladder or bowel control. This is a sign of cauda equina syndrome when the nerves to the bowel and bladder are disrupted. This is a medical emergency and requires immediate medical and possible surgical attention.
In many cases physicians are able to determine an underlying cause, such as a ruptured intervertebral dis, spinal stenosis or pelvic fracture. However, in some cases no cause will ever be identified. The disc is a pad of cartilage that separates the bones in the spinal column and acts as a shock absorber when you move. They keep this spine flexible and reduce shock and pain to the bones.
As we grow older these discs may dry out, become flatter or more brittle. Eventually tiny little tearscause the jellylike substance at the center of the disc to leak out, called a herniation or a rupture. This then puts pressure on the nerve root that then causes the pain in the leg.
A herniated disc is the most common cause of sciatic nerve pain but it can also be triggered by a lumbar spinal stenosis, spondylolisthesis (degenerative disc disease), piriformis syndrome (spasm of the piriformis muscle), spinal tumors, trauma or sciatica nerve tumor or injury.
Treatment for this condition is usually nonsurgical and will combine several medical treatments or alternative medicine treatments. Almost always patients will be seen and evaluated by a physical therapists who will recommend stretching and exercises to strengthen the area and hold the spinal column in place. The goal is to relieve pain and prevent any future symptoms.
On more rare occasions a surgical option will be recommended to remove a portion of the disc that is irritating the nerve root. This surgery goal is to relieve pressure and inflammation and will be warranted if pain is severe or not relieved with other manual or medical treatments.
Prior to surgical treatment doctors may evaluate the efficacy of epidural steroid injections to the affected area. The goal of this is to relieve pain. However, the usefulness in the case of sciatica nerve problems is a matter that is debated among physicians. Some research points to short-term relief but this is not a long-term solution.
It isn’t always possible to prevent sciatica pain from occurring but there are methods of decreasing the risk as well as preventing further attacks. Individuals should exercise regularly and pay special attention to core muscles, those in the abdomen and lower back which are essential for proper posture. Using a good chair while seated that keeps your back in proper alignment will also help to decrease the risk of degenerative disc disease. Work with your feet flat on the floor in your arms on your desk.
Use good body mechanics when you stand, lift and even when you sleep. Keeping your back healthy will go a long way towards decreasing your risk of developing pressure over the nerve roots.
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