Definition & Overview

Simply defined, sciatica refers to pain in the back, hip, and outer side of the leg. This pain often occurs when a spinal nerve root, found in the lower back, are compressed, often due to the deterioration of the intervertebral disk.

The general term “sciatica” is actually a set of pain symptoms involving the sciatic nerve, which can be irritated or compressed. One of the most common sites of sciatica is the lower back, which could extend to pain, weakness, and numbness in the lower parts of the body, such as the legs and the feet.

Though the condition is relatively straightforward, many people misunderstand the term. Sciatica is a set of symptoms, and not a diagnosis or an explanation for what causes the pain.

Cause of condition

There are many causes of sciatica, and one of the most common is the spinal disc herniation. Ninety per cent of patients suffering from sciatica are found to have this condition, which presses on one of the sacral or lumbar nerve. The pressure of the herniation on the nerves is often accompanied by swelling in the surrounding tissue, which results in pain in the lower back.

Another cause of sciatica is lumbar spinal stenosis, a condition in which the spaces where the spinal cord passes through, or the spinal canal, compresses the sciatic nerve roots, the cauda equina, or the spinal cord. There are many factors that cause this condition, including inflammation in the spinal canal, bone spurs, a herniated disc, or spondylolisthesis. All of these can significantly narrow down the spinal canal, which can irritate or pinch the roots of the sciatic nerves.

Pregnancy can cause sciatica, too. The weight of the foetus can press on the sciatic nerve, most often when the female patient is sitting down. Sciatica caused by pregnancy, of course, does not normally harm the mother or the foetus, but the mother might experience numbness in the legs. The numbness in the legs can cause a loss of balance, and increase the risk of the mother falling over or getting into a serious accident.

One of the rarer causes of sciatica is piriformis syndrome, which could cause lower back or buttock pain. People suffering from piriformis syndrome have their sciatic nerves running under or through the piriformis muscle, instead of underneath this muscle. When this muscle contracts or shortens (due to overuse or trauma), the sciatic nerve becomes compressed.

Key Symptoms

There are many symptoms of sciatica, but most of them are just confined to one part of the body. Lower back pain is the most common, which could be compounded by a constant pain in one side of the buttocks or a shooting pain in the lower back area that makes it difficult for one to stand up after sitting or lying down. Lower back pain can also be accompanied by a tingling or burning sensation that runs through the leg, or pain that becomes aggravated when sitting down or bending over.

Symptoms can vary depending on which sciatic nerve is pinched, irritated, or compressed. In some cases, a patient may feel pain or a consistent tingling or burning sensation in the toes, feet, or lower legs.

Depending on the gravity of the compression, pinching, or irritation, the symptoms of sciatica can be inconvenient and of an episodic nature, or extremely painful and constant. When left untreated, lower back pain caused by compression, irritation, or pinching of the sciatic nerve can lead to progressive weakness of the lower extremity, numbness of the upper thighs, and significantly decreased bowel or bladder control.

The amount of pain felt varies greatly with sciatica. Patients can experience mild, tingling aches, or a sharp burning sensation, or even excruciating pain that can go beyond uncomfortable. Coughing, sneezing, sitting for longer periods of time, lying down in an uncomfortable position, can trigger the pain.

Who to See & Types of Treatments Available

When you observe the symptoms described above, it is best to see a doctor at the soonest possible time. Many doctors, however, will recommend pain medication or self-administered management methods for mild sciatica. However, if the pain in the lower back persists for more than a week or so, set an appointment and consult with a medical professional right away. A doctor's appointment is also highly recommended if the symptoms grow progressively worse.

Medical professionals recommend seeing a doctor right away if you feel sudden and severe pain in the lower back area or the upper thighs. Muscle weakness and numbness in the legs or feet are also known causes for concern. If the symptoms of sciatica occur right after violent injuries, such as a traffic accident or assault, see a doctor right away. Sciatica can also cause an inability to control the bladder and the bowels, so it is best to consult with a medical professional should these symptoms occur.

Pain medication can be prescribed to a patient suffering from sciatica to manage the symptoms. Over-the-counter painkillers, such as ibuprofen, aspirin, ketoprofen, acetaminophen, and naproxen, can also be taken to manage the pain. In the case of tingling sensations and muscle spasms, relaxants can be prescribed. Chronic lower back pain can warrant the prescription of antidepressants, while stronger pain medication available only through a physician's prescription, can be prescribed.

In the case of more severe pain that lasts for over six weeks, your physician can refer you to a nerve specialist. Surgery can be an option to relieve the sciatic nerve of the pressure, pinching, or irritation. If, for example, a patient's herniated disc is the source of pressure on the nerve, then surgery to correct the herniation is the best option.

Physical therapy is also an option for those suffering from sciatica in order to train the patient to move in certain ways that will not put more pressure on the sciatic nerve and not trigger the conditions causing the pain.

References:

  • Sciatica, American Academy of Orthopaedic Surgeons
  • Sciatica: More than Just Back Pain, Beth Israel Deaconess Medical Centre
  • Symptoms and Causes of Sciatica, Hospital for Special Surgery
  • Sciatica Exercises for Sciatica Pain Relief, Spine-Health
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