Sciatica

Sciatica

This article has been medically reviewed and update byHussain Abdeh MPharm: 2211840

Updated on: 15/06/2021

 

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 several 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 is named after 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 does not 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.

Sciatica Diagnosis

It is estimated that between 5-10% of patients with lower backpain have sciatica. Although how sciatica is diagnosed varies greatly from country to country.

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, many patients will report a radiating pain in the leg, drawings may be used to show the distribution of the pain. Sciatica is usually categorised by a pain that follows a dermatomal pattern.  Patients with sciatica will usually report lower back pain, although this is usually less severe than the leg pain.

A physical examination such as a leg raising test will usually be performed under the analysis of a doctor or trained healthcare professional.

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 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.

Typical symptoms of sciatica 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, lower 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 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.

What causes Sciatica?

There are a number of personal and occupational risk factors for Sciatica such as:

  • Age
  • Poor posture in sitting and carrying
  • Height
  • Smoking
  • Obesity or being overweight
  • Accidental injury
  • Mental stress
  • Wearing down from sports
  • Childbirth and pregnancy
  • Occupational factors such as driving a vibrating vehicle

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

Most people with sciatica will generally recover within a few weeks. If the pain is bad enough to stop you from carrying out daily tasks, as a starting point; your doctor may suggest a combination of things such as, light exercise, stretching, rest, over the counter pain medicines. 

If you find that the pain is not easing, your doctor may suggest different sciatica treatments such as prescription medicine, or refer you to a specialist physio.

Typically, once diagnosed; doctors may prescribe or suggest the following in the first instance of sciatica:

  • 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

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.

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.

Exercises for Sciatica

Simple stretches and exercises can help reduce the pain and discomfort associated with sciatica. Exercises should be completed daily if sciatica persists, and pain should start to subside within two weeks. If pain is still ongoing after a few weeks, contact your doctor for examination. If you experience severe pain completing any of these exercises, do not continue; instead, seek the advice of a health care professional.

1. Knee to chest stretch

Begin by lying on a mat or carpet. Place a cushion under your head for support. Bend your knees and make sure your feet are kept hip-width apart.

Bend one knee towards your chest and hold it with your hands. Stay in this position for 20-30 seconds and take deep, relaxing breaths.

Repeat up to three times, ensuring that you alternate legs. Make sure you don’t tense your head, shoulders or neck.

2. Sciatic mobilising stretch

Begin by lying on mat or carpet and place a flat pillow under your head. Bend your knees and keep feet on the floor, hip-width apart.

Bend one knee up towards your chest. Hold the back of your upper leg and slowly straighten the leg upwards. Remember to only stretch if it is comfortable. The exercise should not hurt.

Hold this position for 20-30 seconds and then return your leg to starting the position and repeat with the other leg.

3. Standing hamstring stretch

Begin by standing up and raising one leg on to a stable object like a step. Keep the supported leg straight and toes pointing skyward.

Bend forward as you keep your back straight. Hold for 20-30 seconds. Remember that your lower back shouldn’t arch, and you should remain comfortable.

4. Sitting spinal stretch

Begin by sitting on the floor with both legs extended straight out and your toes pointing upwards.

Bend your right knee and place your foot on the floor outside of your opposite knee. Then place your elbow on the outside of your right knee and gently turn right.

Hold this position for 20-30 sections before switching sides and repeating up to 3 times.

Prevention of sciatica

The best way to prevent sciatica is to reduce the strain placed on your back and spine. You can do this by retaining good posture while sitting, sleeping, and standing. It is easy, in our technological age, to spend hours sitting at a computer desk. So, resist the urge to slouch by investing in an ergonomic chair and taking regular breaks from work where you can stretch and exercise.

Exercise is also a useful tool in preventing sciatica as it helps strengthen the muscles in your back and stomach area, which support your spine.

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.

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 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.



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