Sciatica

Sciatica

Sciatica: Everything you need to know

Sciatica is health condition that stems from the sciatic nerve in the body. Sciatica can be a profoundly painful condition for many who suffer from it. Often characterised as low back pain and pain in the legs or buttocks, these symptoms can last anywhere from a few days or weeks through to a number of years, and can even become chronic. Sciatica is a highly variable condition, and not everyone experiences the same symptoms, which can make it slightly more challenging to diagnose. It is named after the sciatic nerve, which has five nerve roots, two from the lumbar spine and three from the sacrum. Usually, people find their symptoms ease after 4 to 6 weeks, although symptoms may take longer to clear for some.

What is sciatica?

Sciatica is a specific condition that is defined by nerve pain in the legs or buttocks. Often referred to as the lower extremities, this pain is usually of the radiating kind, from the lumbar area or lower back through to the thighs. In some cases, it can stretch as far as the back of the knee. In particularly rare cases, it may radiate even further, though this is far less common. Sciatica can usually be readily diagnosed by a doctor, thanks to its distinct set of symptoms which we discuss at length in the ‘sciatica symptoms’ section below. If you feel like you have this condition, it is always best to consult a medical professional before trying a treatment.

Sciatica is named after the cause of this painful condition – irritation or compression of the sciatic nerve in the body. The sciatic nerve is one of the largest in the body. It is made up of five nerve roots: two from the lower back region known as the lumbar spine and three from the final section of the spine, known as the sacrum. These nerve roots come together and form the left and right sciatic nerve, which runs through your hips and buttocks, right down the leg, stopping just below your knee. This then branches into other nerves that go all the way down to your toes.

Irritation can occur in several different ways, but most commonly damaged discs within the lumbar region result in this specific condition. As mentioned above, sciatica doesn’t feel the same for every person. For one individual, it may be a dull pain or ache that becomes chronic. For others, it may be short-term but more extreme levels of pain.

Sciatic nerve pain will always originate from the lumbar, or lower back, area. However, the pain itself may travel on the front, back or even the inside of the leg. In some cases, sciatica pain is described as a shooting pain. In the vast majority of sciatica cases, only one side of the body is affected. This means any pain or sensation is experienced only down one leg, a classic symptom of the condition. Numbness and weakness can also be seen in those with sciatica.

How to check if you have sciatica

Checking if you have sciatica is relatively easy, though it’s always recommended that you consult a professional when it comes to getting a formal diagnosis. Typically, if you have a risk factor that makes you more susceptible to this condition, and you experience any of the symptoms listed below, then it may be likely you have sciatica. Risk factors for this condition include degenerative arthritis that affects the lumbar, disc disease in the lumbar, herniated discs or trauma and injury directly to the lumbar area. Should you meet one or more of these risk factors, and you’re struggling with pain in the leg, buttocks or lower back, then speaking to a doctor should be a priority.

Beyond those risk factors, if you’re displaying any of the symptoms below, checking if you have sciatica is as easy as going to the doctors. If you are suffering from any form of prolonged back, leg or buttocks pain, especially if it is shooting or intense, then consulting a medical professional should be done as swiftly as possible. In the case of sciatica, this may be caused by injury or a herniated disc, which in some cases will need attention to manage or fix.

For those struggling with severe pain, particularly when bending or walking, these are classic signs of sciatica when it presents in a more severe form. In some cases, individuals can reduce the level of pain or even numbness by lying or sitting in certain positions. In many cases, to completely confirm a diagnosis of sciatica, an x-ray, CT scan or MRI may be needed both to examine the cause and confirm final diagnosis.

Sciatica Symptoms

A series of localised symptoms typically characterise sciatica, but it is worth noting that many people struggling with this condition do not have the same symptoms as each other. This is in part due to the difference in the way the sciatic nerve can be damaged, and also due to personal pain levels and factors such as level of activity or existing injury and illness.

However, typical symptoms to watch out for that may indicate sciatica include:

  • Sensations of numbness, tingling or pain in the lumbar area of the lower back
  • Sensations of numbness, tingling or pain in the buttocks and back of the pelvis
  • Sensations of numbness, tingling or pain in the thighs, on the front, back or side
  • Sensations of numbness, tingling or pain in the feet and lower legs
  • Localised feet or lower leg weakness
  • Difficulty with walking, either immediately or after a short period
  • Difficulty achieving a standing position after sitting, especially after a more extended period
  • Difficulty raising one leg, or bending the leg
  • Muscle spasms throughout the legs, low back and buttocks
  • A feeling of relief from pain when lying down
  • An increase in pain when bending or walking, particularly around the lower back

While all of these symptoms can be directly related to sciatica, it is also possible they are symptoms of other diseases or illnesses. As such, consulting a doctor is the ideal way to ensure your symptoms do indicate sciatica so you can be treated effectively. As mentioned above, sciatica does not always present in the same way. For example, someone who has leg pain but no pain in the low back may still have sciatica.

In general, sciatica can either be a condition that disappears overtime when the lower back and nerve has healed, or it can be chronic. For some people, sciatica may come and go over their lifetime, and it can last anything from several weeks to months or even years. Sciatica generally falls into one of two categories; either existing illness or health conditions cause it, or it is caused by accident or injury.

What causes Sciatica?

As a general condition that describes all forms of sciatic nerve irritation, there is no single cause for sciatica. Instead, there is a wide range of different factors that may result in this condition. However, what we do know is that sciatica is caused by damaged discs in the lumbar, which is what leads to nerve irritation. These discs are what hold together the vertebrae in your spine, but whether due to incident or health, these discs can become damaged and ‘bulge’. This medical issue is often called a slipped disc, also known as a herniated disc.

Once a disc has ‘slipped’, it then presses on the sciatic nerve, leading to irritation and pain. This is also what can cause numbness as part of the symptoms of sciatica. But what can cause this condition in the first place? These are some of the most common causes:

  • Age
  • Poor posture in sitting and carrying
  • Smoking
  • Obesity or being overweight
  • Accidental injury
  • Wearing down from sports
  • Childbirth and pregnancy

Alongside these more typical causes of sciatica, many of which can potentially be resolved over time, some medical conditions can directly cause this condition. These specific medical causes include:

  • Spondylolisthesis
  • Bone spurs anywhere along the spinal cord
  • Spinal infection and injury
  • Spinal tumour
  • Spinal stenosis (narrowing of the spinal canal)
  • Cauda equina syndrome

Sciatica Treatment

As a condition that causes pain for many, accessing treatment for sciatica is a key concern for many of those who suffer from it. Speaking to a doctor is the first step to gaining access to that care following diagnosis. Typically, doctors may prescribe or suggest the following in the first instance of sciatica:

 

While in the past doctors may have suggested lying down for long periods, or even bed rest, for back conditions like sciatica, we now understand that moving and doing low impact sciatica specific exercises can significantly reduce recovery time and improve the patient’s overall outlook. Should the first round of treatment not affect your sciatica, the doctor may then move on to offering stronger painkillers, antidepressants that can ease nerve pain, diazepam to reduce any spasms in the muscles and evil corticosteroids via epidural.

Beyond these treatments, in very rare cases surgery may be required to improve the symptoms of sciatica, especially in cases where lumbar injury or damage is the cause. This is rarely used as a solution due to the severity of a discectomy, but it may be an option for those that suffer from severe, prolonged sciatica.

In the vast majority of cases, with advice from their doctor, patients can be treated for sciatica quickly and effectively, reducing their pain and allowing them to return to their day-to-day routines with as little disruption as possible.

FAQ

How do I relieve sciatic nerve pain?

You should speak to your doctor, who will provide medical advice, diagnosis or treatment for any issues with your sciatic nerve. They will be able to advise and recommend the most effective treatment to help the problem get better.

A doctor may prescribe or recommend various treatments to help ease pain in your sciatic nerve.

Common treatments for sciatica include:

  • Maintaining a good level of activity to encourage muscle movement
  • Physical therapy treatment
  • Cold and hot therapy with ice and heat packs
  • Anti-inflammatory medications, such as Naproxen and Ibuprofen either taken by mouth or used topically

What triggers sciatica?

Sciatica is caused by one or more discs in the lumbar region becoming damaged. This results in the sciatic nerve becoming irritated, which can lead you to develop sciatica. These discs hold your the vertebrae in your spine together, and they can become damaged and bulge.

The common causes of sciatica include:

  • Age
  • Poor posture in sitting and carrying
  • Smoking
  • Obesity or being overweight
  • Accidental injury
  • Wearing down from sports
  • Childbirth and pregnancy

Another common cause of sciatica symptoms can be certain medical conditions. If you develop any of the below, or have a medical history of any of these, you may also experience sciatica:

  • Spondylolisthesis
  • Bone spurs anywhere along the spinal cord
  • Spinal infection and injury
  • Spinal tumour
  • Spinal stenosis (narrowing of the spinal canal)
  • Cauda equina syndrome

Whatever the cause it is important that people get their symptoms medically reviewed by a health professional.

Is walking good for sciatica?

Although it may feel counterintuitive, as sciatica pain may cause leg muscle weakness, walking is a very effective way to relieve the symptoms of sciatic nerve problems.

While it is important to not over-exert yourself, taking regular walks will release pain-fighting endorphins and also help to reduce inflammation.

How long does sciatica last?

People who suffer from sciatica will normally get better within 4 to 6 weeks. However, the symptoms may last for longer than this period.

If you do suffer with sciatic nerve problems for an extended period, it is very important that you seek medical attention. Your doctor will be able to provide medical advice, diagnosis or treatment recommendations.

In very rare instances, surgery may be required to ease your problem.



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