Sciatica is the pain that radiates along your sciatic nerve. The sciatic nerve is the one branching from your lower back, through your hips and butt and then down each of your legs. In most cases, the condition of sciatica will only affect one side of your body.
Most often, sciatica is the result of a bone spur on the spine, herniated disk, or spinal stenosis causing the nerve to become compressed. This compression results in pain, numbness in the leg, and inflammation.
Though the pain of sciatica can be excruciating, most of the time, it will resolve without surgery within just a few weeks.
Individuals who have severe cases of sciatica associated with weakness in the legs and changes in bowel and/or bladder functioning may need to speak with their physician about surgery.
Symptoms of Sciatica
The very first indication that you may be suffering from sciatica is pain radiating from your lower spine through your buttock, down the back of your leg.
You may feel some discomfort anywhere along the pathway of the nerve, but most of the time, it follows the path from your lower back down to your calf.
The pain and discomfort varies widely from a very mild ache to an excruciating, sharp, burning pain. In some cases, it may feel like an electric shock or jolt. When coughing or sneezing, the pain and discomfort can intensify.
Sitting for very long periods of time can cause the symptoms to be worse. In most cases, only one side of your body will be affected.
Some individuals will also experience tingling and/or numbness as well as muscle weakness in the leg- or even the foot- that is affected. In addition, you may notice that you have pain in one area of your leg/foot and numbness in another.
When Should You See Your Physician?
Typically, a mild case of sciatica will dissipate over time. However, if you notice that your symptoms last more than one week or self-care measures are not easing the signs and symptoms, you should see your physician.
Also, if the pain and discomfort is extreme, or becomes worse over time, it’s time to seek medical attention. Here are some keys to tell whether you should see your physician:
- Sudden, severe pain in lower back and/or leg, as well as muscle weakness and numbness in your leg.
- You experience pain following a significant injury such as an accident.
- You have loss of bowel and/or bladder control and/or functioning.
Causes of Sciatica
Sciatica is the result of the sciatic nerve becoming pinched. Typically, this is due to a herniated disk or a bone spur on your spine. In rare cases, the sciatic nerve can become damaged by a disease such as diabetes or compressed because of a tumor.
Risk Factors for Sciatica
There are several risk factors for this condition, including the following:
Age: as you age, your spine changes and you may develop herniated disks and/or bone spurs. These are the most common causes of the condition of sciatica.
Obesity: individuals who are obese increase the amount of stress being placed on their spine- which can trigger the changes in the spine that can be a trigger for sciatica.
Occupation: if your job requires that you carry heavy loads, twist your back, or even drive for long periods of time, this could be causing or contributing to your sciatica, but there’s no clear evidence of this particular link.
Prolonged Sitting: individuals who sit for long periods of time or have a more sedentary lifestyle are much more likely to develop this condition than those who are more active.
Diabetes: this condition increases your risk of developing nerve damage because it affects the way your body processes blood sugars.
Complications Related to Sciatica
Though in most cases, individuals will fully recover from this condition, without being treated, there are some complications that can result such as permanent nerve damage. If you experience any of the following, you should see immediate medical attention:
- Weakness in the leg that is affected
- Loss of feeling in the leg that is affected
- Loss of bowel function/control
- Loss of bladder function/control
Getting Ready to See Your Physician
Since this condition will most often correct itself on its own without medical treatment, it’s not always necessary. However, if you do have symptoms that are very severe or last for over one month, you should definitely see your physician as soon as possible to make sure that there is nothing more serious going on.
Things to Do
If you do end up needing to see your physician, there are a few things you will need to do in order to prepare for your appointment. They are as follows:
Record your symptoms: take the time to record the symptoms you are experiencing, how long they last, the severity of them, and when they first started.
Record other medical information: take the time to write down any other conditions you have been diagnosed with, as well as any medications you are taking (OTC, prescription, supplements, herbal treatments)
Write down recent injuries and/or accidents: these could play a role in your symptoms, so make sure that you let your physician know if you were recently in an accident or experienced an injury.
Bring a friend or family member along: often, appointments are rushed because physicians are so busy- bringing someone else along with you will help you to remember what was said and what may have been overlooked for the next appointment.
Write down your own questions: many times, patients think that they shouldn’t ask questions to take up their physician’s time.
However, it’s necessary to make the most of your time with him/her and ask questions that you’re not clear on. Here are some of the basic questions:
- What could possibly be causing my back pain?
- Are there any other things possibly causing it?
- Will I need further testing?
- What is your first-line treatment for this condition?
- What are the side effects to medications you’re suggesting (if he/she prescribes a medication)?
- How long will I be taking this medication?
- Is surgery an option? Why or why not?
- Should I be following any specific restrictions on activity?
- Are there any self-care treatments I can use?
- Is there anything at all I can do to prevent symptoms from flaring back up again?
If any other questions come up during the appointment, make note of them and be sure to ask them either before the appointment is over of at your next one.
In addition to any questions that you have, your physician will be asking you questions during your appointment, including the following:
- Are you experiencing numbness in your legs?
- Are you experiencing any weakness in your legs?
- Are there specific positions that cause pain to be worse?
- Are there specific positions that cause your pain to be better?
- Does your pain limit your activity?
- Does your work require heavy physical activity?
- Do you exercise on a regular basis? If so, what do you do?
- Are there any treatments, including self-care, that you have tried and does anything help?
These questions, and others that he/she may ask will help determine the next step in treating your condition.
Testing for and Diagnosing Sciatica
When testing you for sciatica, your physician will start with a physical exam, in which he/she will test your reflexes and muscle strength. You will likely be asked to walk on your heels or your toes, rise up from a squatting position, and lie on your back, lifting your legs one at a time. Sciatica pain will typically get worse when performing these activities.
If you have a herniated disk or bone spurs, you may not be experiencing symptoms- but they will show up on x-rays. However, unless your pain is severe or does not improve within a specified period of time, imaging tests will not be ordered.
X-ray: a spinal x-ray will reveal a bone spur that could be pressing on the nerve, causing your sciatica.
MRI: in this test, radio waves and a powerful magnet will be used to produce cross-sectional images of your back. This will create detailed images of your bones as well as soft tissues, including herniated disks. You will lie down on a table that will be moved into the MRI machine.
CT Scan: contrast dye will be injected into your spinal canal before a CT scan will be performed. The dye will circulate around your spinal nerves/cord and will appear white on the scan- which will reveal any damage that has been done.
Electromyography: this particular test will measure electrical impulses that are produced by your nerves and your muscle response. This will confirm whether or not your nerve compression is due to spinal stenosis or a herniated disk.
Treatments and Medications for Sciatica
In most cases, sciatica will improve on its own. However, if it does not improve through self-care treatments, your physician will likely suggest that you try some of the following:
Medications: There are several different medications that your physician may prescribe to treat the pain associated with your sciatica, including the following:
- Tricyclic antidepressants
- Muscle relaxers
- Anti-seizure medications
Physical Therapy to Treat Sciatica
Once the acute pain of your sciatica has improved a little, your physician and/or a physical therapist will work with you to design a rehab program that can prevent you from becoming injured and aggravating the condition in the future.
Basically, this typically includes exercises that will help to make corrections to your typical posture, strengthen the muscles that support your back and also improving your level of flexibility.
Steroid Injections to Treat Sciatica
Some physicians will recommend that you receive injections of corticosteroid medications into the area around the nerve root that is involved in your sciatica pain.
These are effective for helping reduce pain because they actually suppress the inflammation around the nerve that is irritated.
However, the problem with the steroid injections is that they are not a long-term treatment, they typically wear off within a few short months.
Since the side effects will increase with repeated treatments, the amount of steroid injections you can get is very limited.
Surgery to Treat Sciatica
This is a very serious option that is typically reserved for when sciatica is very severe.
If there is a significant loss of weakness, loss of bladder function & control, loss of bowel function & control, or the pain gets worse over time and you see no improvement with other options, your physician may recommend surgery to treat your sciatica.
In surgery, a surgeon will go in and remove the bone spur or part of the herniated disk that is placing pressure on the pinched nerve- which should correct the sciatica. However, you must keep in mind that surgery always comes with risks.
Lifestyle and Home Remedies for Treating Sciatica
The good news is that in most cases, sciatica actually responds quite well to self-care treatments.
Still, remember that while resting a couple of days may offer some relief of sciatica pain, prolonged periods of time inactive will actually cause the signs and symptoms of your condition to become much worse.
Some self-care treatments used to treat sciatica include the following:
Cold Packs: you may be able to get some relief by placing a cold pack on the affected area for up to twenty minutes at a time several times during the day. You’ll want to use an ice pack or a package of frozen veggies (peas are recommended) wrapped in a clean, dry towel.
Hot Packs: two to three days following your sciatica flare or injury, you can begin to apply heat to the affected areas. You can use a hot pack, a heating pad on the lowest setting, or a heat lamp. If your pain and discomfort continues, you can alternate warm and cold packs.
Stretching: carefully stretching your lower back can be quite effective for helping you to feel better and may relieve some of the nerve compression.
However, you must avoid any twisting, jerking, or bouncing motions while you are stretching- these should be very gentle. Try to hold your stretch for at least thirty seconds.
OTC Medications: over the counter pain relievers such as naproxen sodium or ibuprofen are often effective for treating the pain and inflammation of sciatica pain.
Using Alternative Treatments for Sciatica
These days, many people are leaning more towards the more natural, alternative therapies for treating their conditions.
Some of the alternative therapies that seem to be effective for treating sciatica include the following:
For this therapy, the practitioner will insert very thin needles into your skin at certain points on your body.
Some studies have revealed this therapy to be very effective at relieving the pain and discomfort of sciatica pain and discomfort, while others have revealed that there is no benefit at all.
If you do decide that you would like to try this therapy, make sure that you select a licensed practitioner so that you can be sure he or she has had the proper training.
Having your spine adjusted/manipulated is one of the forms of therapy that are used by chiropractors for treating restricted mobility of the spine.
The primary goal of this therapy is to restore movement of the spine, and therefore decrease pain and improve overall functioning.
Spinal manipulation seems to be just as effective and safe as regular treatments for pain in your lower back, but may not be good for pain that radiates.
You must keep in mind that it is not always possible to prevent this condition and it sometimes may recur.
However, the following things can actually play a role in helping to protect your back from becoming injured or inflamed:
Get exercise on a regular basis
In order to keep your back strong, you must focus on your core muscles that are critical for helping you maintain proper alignment and posture. Speak with your physician or a personal trainer about some specific exercises you can be doing.
When sitting, maintain proper posture
When choosing a seat, you should choose one that has great support for your lower back, a swivel base, and armrests.
In order to maintain the natural curve in your back, consider placing a rolled towel or pillow in the small of your back. Always keep your hips and knees level.
Use good mechanics
If you are usually standing for a long time, try resting one foot on a small box or stool every now and then. When you’re lifting heavy items, allow your lower extremities to do the work instead of your back.
Lift using an up and down motion, keeping your back straight. Only allow your knees to bend. Make sure that you’re holding the load close to your body and avoid lifting and twisting at the same time. If the load is awkward or extra-heavy, make sure you have someone to help you.
Sciatica is a very common, but very treatable condition. Do what you can to properly take care of your body and try to avoid becoming injured or aggravating the condition if you have already experienced it.