Sciatica is a condition when we suddenly start feeling pain in our lower back or hip radiating to the back of our thigh and into our leg, we may have a herniated disk in your spinal column that is pressing on the nerve roots in the lumbar spine. Sciatica pain is very painful in nature and it can hinder in normal lifestyle.
The largest single nerve in the body which is made up of individual nerve roots that start by branching out from the spine in the lower back is a sciatic nerve. It starts typically in lumbar segment 3 (L3). At each level of the lower spine a nerve root exits from the inside of the spinal canal, and each of these respective nerve roots then come together to form the large sciatic nerve. It runs from the lower back, through the buttock, and down the back of each leg. Portions of the sciatic nerve then branch out in each leg to innervate certain parts of the leg—the thigh, calf, foot, and toes.
Characteristics of sciatica pain:
- Constant pain in only one side of the buttock or leg (rarely in both legs)
- Pain worsens during sitting
- Burning, searing or tingling leg pain.
- Difficulty moving the leg, foot, and/or toes due to weakness.
- Difficulty walking or stand up due to a sharp pain.
- Radiating pain down the leg and possibly into the foot and toes. (it rarely occurs only in the foot)
Risk Factors of Sciatica pain
1. Age: Due to age related changes in spine, like osteoporosis, herniated disks etcetera. Degeneration usually starts at age of 30, so the risk of sciatica begins from that age. In short, people of age 30-50 are at risk of sciatica because people of this group are very active in sports, work, and social activities in comparison to other group increasing the likelihood of causing damage.
2. A sedentary lifestyle: Sitting for long period of time in same position, working at a computer, frequent and long hour driving are major factors for causing sciatica pain. A sitting or working for long hour compresses the spine and discs which may compress the nerves and irritates it. In addition, sitting will put direct pressure on the sciatic nerve.
3. Occupation related: Frequent lifting of weight or heavy lifting of weight might twist the spine leading to disc herniation. Another work related sciatica may be caused by operation of vibration machine ie. Jackhammer.
4. Walkers and runners: Repeated contraction of the piriformis muscle would lead to sciatica pain, the walker and runners are at risk. Extended period of walking and running tightens the piriformis muscle, causing irritation to the nerve. Spinal journal in 2002 Finish study shows the association of walking with onset of sciatica symtoms and jogging with a continuation of symptoms.
5. Pregnant woman and diabetic: Diabetic patient are prone to nerve damage due to not able to utilize the sugar in their blood leading likelihood of getting sciatica pain. In the pregnant ladies due to hormonal changes and position of baby, the likelihood of sciatica pain increases.
6. Obesity: Obese people would have more pressure on the spine, and excess bodyweight would contribute to the spinal changes leading to sciatica.
7. Piriformis syndrome: When piriformis muscle in the thigh compress the nerve, it irritates the nerve causing sciatica. Fat purse in the back can press the piriformis muscle leading to irritation of nerve.
How is sciatica diagnosed?
1. Physical exam
2. X ray
3. CT scan
4. MRI
5. Electromyelogram
What are treatment options for sciatica?
1. Bed rest of 12 weeks (an traditional method)
2. Physical therapy
3. Transcutaneous nerve stimulators (TENS units)
4. Stretching exercises and Yoga.
5. Acupuncture
6. Drugs: Pain killer, muscle relaxants, anti-inflammatories, and antidepressnts. Other medications of help would be Neurontin and Cymbalta. Cortisone medications, given orally or by local injection (epidural injection), can sometimes be helpful in relieving sciatica.
7. Hot and cold compress in the muscles and to the lower back.
8. Surgery: Last but not the least surgical procedure to relieve the nerve compression would also be helpful in case of severe cases.
How long does sciatica last?
Duration depends on the cause may last from days to weeks. Each can cause chronic condition lasting months. Sometimes degeneration of the lumbar spine and discs can cause chronic sciatica that persists unless a surgical intervention is performed.
Complications Related to Sciatica
Uncontrolled loss of bowel or bladder control, it is considered an emergency.
Paralysis.
Excruciating pain.
Sciatica facts
- Sciatica is pain due to irritation of sciatic nerve. The sciatic nerve is the largest nerve in the body beginning from nerve roots in the spinal cord in the low back and extends through the buttock area to send nerve endings down the lower limb.
- Obese people, sedentary lifestyle, prolong sitting, injury or infection of spine, piriformis syndrome, age-related changes are major cause of sciatica.
- Sciatic pain is typically felt from the low back to behind the thigh and radiating down below the knee and usually felt in one side of the body.
- Treatments for sciatica depend on the underlying cause and the severity of the pain
- Sciatica is diagnosed by physical exam and radiation exam.
- Treatment of sciatica is basically done by bed rest, drugs (muscle relaxant, antidepressant, pain killers, cortisone), yoga and stretching exercise, acupuncture, hot and cold compress, and surgery.
- Sciatica can be prevented if yoga and stretching exercise are done regularly and sitting position is maintained and fat purses are not kept in back pocket.
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