• Sciatica: Symptoms, Causes, and Treatment

    Sciatica

    refers to back pain that radiates from the lower back to the leg. The pain is a result of a problem with the sciatic nerve, a nerve that branches from the lower back down to your buttocks, hips and the back of both legs.

    Sciatica commonly results when a bone spur, herniated disk or narrowing of the spine (spinal stenosis) compresses part of the nerve leading to discomfort, inflammation, and often numbness in the affected leg. Naturally, sciatica will only affect one side of your body.

    Although the discomfort resulting from this condition can be severe, most cases can be treated without surgery. In fact, 90% of people get pain relief from sciatica after a few weeks with non-operative treatments.

    Signs and symptoms

    One of the most common symptoms is lower back pain that radiates down to the affected leg. While the discomfort can be felt anywhere along the nerve canal, sciatica pain radiates explicitly from your lower back to your buttock, hip, and calf.

    Sciatica pain varies greatly, from mild to excruciating or a sharp, burning sensation which tends to worsen after prolonged sitting or even just sneezing. Other symptoms include muscle weakness, tingling, numbness in the affected leg and in severe cases, problems controlling your bowels.

    Causes

    The most common cause of sciatica results from a lumbar disc herniation directly pushing against the sciatic nerve, but any form of irritation or inflammation can cause discomfort resulting in symptoms of sciatica.

    Besides a pinched nerve from a disc or irritation of the sciatic nerve due to pregnancy, other causes include:

    • Spinal stenosis
    • Cauda equina syndrome
    • Internal bleeding
    • Infections in or around the lumbar spine
    • Nerve irritation caused by adjacent bones, tumors or muscles
    • osteophyte

    Treatment

    Typically, sciatica is diagnosed through physical exams and medical history. The symptoms and tests done will help the health care professional to diagnose the condition. In some cases, X-rays, CT scans, MRI scans, Nerve Conduction Velocity and electromyogram are done to rule out some underlying conditions such as tumors.
    Treatment varies depending on the intensity of the problem (acute or chronic) and the underlying condition.

    Acute sciatica treatment responds well to self-care procedures such as:

    • Over the counter (OTC) medication such as painkillers, muscle relaxants, anti-depressant, and anti-inflammatories. Individuals should seek medical advice and review options with their doctor before taking any medicines to avoid severe effects.
    • Regular exercise, such as light stretching or walking. Sciatic nerve targeting exercises alleviate pressure on the nerve, provide pain relief, and reduces the need to take medications.
    • Hot or cold compression provide pain relief and should be used interchangeably.

    Chronic sciatica treatment consists of a combination of self-care and medical treatment procedures, which include:

    • Medication
    • Physical therapy
    • Cognitive-behavioral therapy (CBT) which trains individuals on pain management and coping mechanisms, enabling them to react differently to pain.
    • Surgery may be considered if symptoms fail to respond to other treatments. Depending on the cause, the surgeon will guide you through the risks and benefits of surgery and suggest the best option.

    Prognosis

    Depending on the causes of sciatica and duration of the symptoms, the recovery outlook ranges from positive to lasting chronic symptoms. Although, the sooner the treatment process begins, the better the outcome.

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