Sciatica

Sciatica health facts

  • Sciatica refers to pain in the back caused by a problem with the sciatic nerve, a large nerve extending from the lower back down the back of each leg.
  • According to the American Academy of Orthopedic Surgeons, people are most likely to get sciatica between the ages of 30 to 50.
  • Sciatica is most commonly caused by a herniated disc but can be caused by a range of other matters such as infection, obesity and medical conditions.
  • Treatments range from at home options to surgery.
  • However, up to 90% of people recover from sciatica without surgery.

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What is sciatica nerve pain?

Sciatica refers to a pain that radiates along the sciatic nerve, which starts in the lower back and branches out through the hips, buttocks and down each leg, ending just before the knee. The sciatic nerve is the widest and longest nerve in the human body.

People between the ages of 30 and 50 are most likely to get sciatica. Most of the time sciatica only affects one side of the body.

Causes of sciatica

The most common cause of sciatica is a herniated disc in the spine. This disc acts as a cushion between the vertebrae, the small bones forming the backbone. The discs can get weaker as a person ages and become more vulnerable to injury.

At times the gel-like center of a disc pushes through its outer lining onto the roots of the sciatic nerve. About 1 in 50 people will get a herniated disc during their lifetime. Of those affected, around a quarter will have symptoms that last more than six weeks.

Other possible causes of sciatica

  • Spinal stenosis. This narrowing of the spinal canal that in turn puts pressure on the nerve is more common in adults over 60.
  • Spinal tumors. These compress the root of the sciatic nerve.
  • Piriformis syndrome. Caused by spasms in the piriformis muscle, a small muscle deep in the buttocks, this affects the sciatic nerve by putting pressure on it and irritating it. This is common in women, runners, athletes and men who have a large wallet in the back pocket.
  • Sacroiliac joint dysfunction or sacroiliitis. Irritation or inflammation of the sacroiliac joint, located at the bottom of the spine.
  • Injury or infection. In general any condition, such as these, that compresses or irritates the sciatic nerve can trigger symptoms.
  • Spondylolisthesis. A condition in which a small stress fracture causes one vertebra to slip forward over another below it. This narrows the opening through which the nerve exits.
  • Pregnancy. Women may be more likely to develop the problem during pregnancy due to pressure on the sciatic nerve from the developing uterus.
  • Obesity. The increased weight adds stress to the spine and can contribute to spinal changes.
  • Lifestyle and professional choices. A job or hobby that causes a person to twist the back, carry heavy loads or drive for long periods of time may all play a role in sciatica.
  • Diabetes. This condition affects the way the body uses blood sugar, which can increase the risk of nerve damage.

Sciatica symptoms

The most common symptom associated with sciatica is pain in the lower back that extends through the buttocks, hip and down one leg. This pain frequently gets worse when a person sneezes, coughs or sits for a prolonged period of time. The leg or foot may also feel weak, numb or tingly at times.

These symptoms can appear suddenly and can last for days or weeks. The pain can vary widely from a mild ache to excruciating pain.

Not all lower back pain involves the sciatic nerve. In many cases pain could be caused by straining or overextending the muscles in the lower back. What sets sciatica apart is when the pain radiates down the leg and into the foot.

As mentioned before, there can be other nerves that cause similar symptoms. Our team is able to determine if the pain is caused by the sciatic nerve or another nerve.

When to see a doctor

Not all cases of sciatica require that a patient see a doctor. People in pain can try the at-home treatments listed below. But when those at-home measures fail to ease the symptoms or if the pain lasts longer than a week in a person, he or she should see a doctor.

If patients experience any of the following, they should seek immediate medical care:

  • Pain that follows a violent injury, such as a car accident.
  • Having trouble controlling bowel or bladder movements.
  • Sudden and severe pain in the lower back or leg and numbness or muscle weakness in the leg.
  • Loss of feeling in the affected leg.

The appointment

The healthcare provider will ask how the pain started and where exactly it is located to determine if sciatica is causing the pain. The patient may also be asked to squat, raise the leg without bending the knee, and walk on the toes or heels. The doctor is looking to see if the sciatic nerve is irritated, as the pain usually worsens during these activities.

The doctor may also order an imaging test, including an MRI, CT, EMG or X-ray. This will help to get more information about the cause and location of the irritated nerve.

Sciatica pain treatment

A person suffering from sciatica pain has a range of treatment options. Learn about the at-home and medical options below.

Ice and heat therapy

A mix of ice and heat can be helpful. Each person will see different relief from the ice and the heat. Apply the heat or ice for around 20 minutes every 2 hours. It can also be beneficial to alternate between the two temperatures.

Medication

Another at-home option for short-term relief is over-the-counter pain relievers. A doctor could also prescribe additional medications including muscle relaxants, narcotics, anti-seizure medication and tricyclic antidepressants.

Movement and physical therapy

While sciatica is healing, it is important to remain active. Motion can help reduce inflammation and pain. A physical therapist can show patients how to stretch the lower back and hamstrings. Yoga or tai chi may also be used to stabilize the affected area and strengthen the core. Another activity that can be beneficial is short walks.

Osteopathic manipulation treatment

Dr. Carla Page is trained to perform osteopathic manipulation treatment. This manipulation is a hands-on way to diagnose, treat, and prevent illness and injury. There are many manipulation techniques for sciatica that Dr. Page can use, and the technique will depend on the cause of the pain.

Alternative medicine

The HealthFit providers may also refer patients to be seen by an acupuncturist or a massage therapist. The goal of these alternative therapies is to restore movement and reduce pain.

Sports medicine specialists

There could be nerves other than the sciatic nerve that cause similar symptoms. Dr. Kiyoshi Yamazaki, HealthFit Family Medicine’s sports medicine provider, can identify the cause as sciatic nerve pain or another cause.

Dr. Yamazaki offers steroid injections to reduce inflammation around the irritated nerve. This is a good short-term solution, but the steroid injection’s effects wear off after a few months.

After a patient receives an injection, Dr. Yamazaki will work with him or her to understand the cause of the pain, which can result in long-term relief.

Surgery

If the sciatica is due to a herniated disc and still causing severe pain after four to six weeks, the doctors may recommend surgery. At HealthFit Family Medicine, we work with our patients to find a surgeon who will meet their needs.

The surgeon will remove a portion of the herniated disc to relieve the pressure on the sciatic nerve. Surgery can also be performed to relieve sciatica caused by spinal stenosis.

After surgery the patient will need to start physical therapy that helps strengthen the muscles in the back. We recommend that patients not lift, drive or bend forward for about a month after surgery.

Prevention

If a person has had sciatica before, there is a high chance it will return. Patients can reduce the chance of sciatica returning if they exercise regularly, maintain a good posture and bend at the knees when lifting heavy objects.

Take the next steps at HealthFit

If it is suspected that you or a loved one may have sciatica or other nerve pain and need medical help, contact our practice. HealthFit providers can find the best treatment option that fits your needs, using exercise and stretching as a primary treatment option.

Request Appointment or call (303) 218-7774