Sciatica

What is Sciatica?

Sciatica refers to pain that travels down the back of the leg, usually from the lower back or buttock and all the way to the foot due to irritation or injury of the Sciatic nerve. Sciatica pain typically follows the path of this nerve starting at the lower back through the hips, buttocks and down each leg.  It commonly presents as lower back pain and knee pain.

The term ‘Sciatica’ specifically refers to a collective symptom of leg pain, a tingling sensation, numbness or leg weakness. The pain originates in the lower back, moves through the lower buttock and then down the back of each leg.

What is the Sciatic Nerve?

The Sciatic nerve is a large nerve that originates at the lower back (by combining nerve roots from the spine), runs along each buttock and down the thigh and leg respectively.

The Sciatic nerve controls the sensation and function of each foot and leg. In Sciatica, problems with your spine and its surroundings can put pressure on the nerve and therefore lead to severe pain, difficulty in certain movements and strange sensations, such as pins and needles.  Herniated disc (disc herniations) and protrusion can cause lower back and knee pain down the leg.

What Causes Sciatica?

Sciatica in itself is not a medical diagnosis, but rather a symptom caused by an underlying condition such as a herniated lumbar disc, degenerative disc disease, spondylosis or spinal stenosis. The symptoms are due to the nerve being compressed or entrapped against your spine leading to inflammation, pain, and numbness.

Aside from a pinched nerve by a disc, other sciaticacauses of include irritation of the nerve from adjacent bone, tumors, muscle, internal bleeding, infections involving the spine and injury relating to your spine.

What are the risk factors of Sciatica?

• Degenerative arthritis of the lower spine (Osteoporosis)
• Lower spinal disease (Arthritis)
• Slipped or herniated disc
• Injury or trauma to your lower back and its surroundings
• Age: Age-related changes in the spine such as bone spurs or herniated disks are the most common causes of sciatica
• Obesity: Due to increased stress on your spine by excess body weight can trigger sciatica
• Occupation: Physical demanding jobs such as heavy lifting, driving for long periods at a time or twisting your lower back can all lead to sciatica
• Diabetes: This condition increases your risk of nerve damage which can lead to sciatica.

Sciatica Symptoms

• Pins and needles in your lower back, thigh, and leg
• Pain in your lower back, thigh, and leg
• Pain in your ankle or foot
• Difficulty in moving your leg
• Increased pain with moving
• Difficulty walking

The pain from sciatica can vary from a mild aching pain,  sharp burning sensation or to an excruciating pain. It tends to worsen with coughing or sneezing and after prolonged sitting. Usually, these symptoms only occur on one side of your body. (For example your right buttock, thigh, and leg).

How is Sciatica diagnosed?

Your physician usually diagnoses Sciatica by taking a medical history and doing a thorough physical examination. The medical history can include questions on recent trauma or injury, motor vehicle accidents, family history, recent surgeries, and chronic medical conditions. The physician will extensively ask about the symptoms that you are experiencing to diagnose Sciatica and at the same time rule out other medical conditions.

Sometimes investigations such as X-rays, CT or MRI scans can be requested to diagnose and find the cause of your Sciatica while also ruling out other conditions.

Complications:

Usually, most people recover from sciatica within 4 to 6 weeks, some even without treatment. Sciatica, however, can potentially cause severe nerve damage and affect your day-to-day life. Therefore, it is very important to seek immediate medical attention if you experience any of the following:

• Weakness on one or both sides of your body, mostly your leg(upper thigh).
• Pins and needles on one or both sides of your body (involving mostly your buttock thigh and leg).
• Loss of feeling (sensation) in your one leg, thigh, and buttock.
• Loss of bladder or bowel function
• Difficulty in maintaining an erection

How can I prevent sciatica from happening?

Although Sciatica cannot be prevented, some noticeable factors can greatly reduce your risk:

• Regular exercise: Keeping your lower back muscles strong is the key to proper posture, alignment and ultimately preventing conditions like Sciatica. Yoga and Pilates are great examples of maintaining a strong core.
• Maintaining proper posture: If you sit at a desk for long hours a day, it is important to sit on a proper chair (ergonomic) with a good lower back support, armrests, and a swivel base.

What can I do once I have Sciatica?

• Rest your back, but do not rest on your bed for long hours at a time.
• Place ice packs on your back every 4 hours for 20-minute intervals.
• Refrain from unnecessary bending, flexing or heavy lifting.
• Sleep on a proper mattress (not too soft or too hard).
• Furniture with proper support.
• Maintain a proper posture.
• Gentle exercises to strengthen your lower back.
• Analgesia such as NSAIDS.

Who can I approach once I have Sciatica?

Although many physicians are familiar with sciatic, Elite Pain Management has specialists that work on spine specific disorders.   They would provide you with appropriate pain relief and advice. It is important to remember that treating Sciatica takes time and patience. If your symptoms are not starting to subside within 4 weeks, you should seek Elite Pain Management to start a multi-disciplinary approach.

Sciatica Treatment

• Medication such as pain-relievers and anti-inflammatories.
• Manipulative therapies such as chiropractic.
• Epidural injections (pain relief or ant-inflammatory).
• Physiotherapy such as electrical stimulation.
• Treating the underlying cause (such as obesity, poor posture, sedentary lifestyle, osteoporosis)
• Weight loss and lifestyle modification
• Acupuncture.
• Surgery: Surgery should be a last resort. Surgery will usually only be an option if the sciatica is caused by a ruptured or slipped disc.

Important facts to remember:

• Sciatica is pain experienced in the lower back, buttock, and leg, caused by pressure on nerves in the lower back.
• Sciatica can be caused by slipped discs, pinched nerves, and injuries.
• Options for treatment can include rest, painkillers and surgery.

Sciatica treatment options for sciatic leg pain is best achieved through a combination of injection in conjunction with graded rehabilitative exercise.  Individual programs may include a cortisone shot, regenerative medicine, PRP injection, PRP treatment or stem cell therapy which boosts the body’s natural ability to heal.

If your pain does not resolve after a brief period, contact us so that we may help diagnose the problem and treat the underlying cause.  Do not let pain persist or else it may become chronic.