What Is Sciatica?
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SLIDESHOW
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Is Your Back Pain
Sciatica? ( medicinenet.com )
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Sciatica pain
radiates from the lower back toward the feet. Learn about causes, exercises,
treatments, and pain relief.
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Sciatica is a pain that
radiates from the low back down a lower extremity; it is caused by irritation
of the sciatic nerve. The sciatic nerve transmits sensation from the lower
extremities and lumbar area of the low back. It is common for people to recover
from sciatica without a surgical operation.
Sciatica Symptoms
Low back pain
that radiates to the hip, buttock, and down a lower extremity is the most
common symptom of sciatica. Sometimes sciatica pain worsens with bending at the
waist, coughing, sitting, or sneezing. Sciatica can also cause tingling,
numbness, or weakness of the leg. Sciatica symptoms can occur rapidly and
persist for weeks.
Sciatica or Other Back Pain?
Back pain is
extremely common. There are many causes of lower back pain that are not sciatica.
Frequently, low back pain is caused by back strain of muscles and ligaments.
The characteristic feature of sciatica is pain that radiates down the leg from
the low back, often reaching the foot.
Who Is Likely to Get Sciatica?
Sciatica is
common as we reach middle age. Pregnancy can lead to sciatica as a result of
direct pressure on the sciatic nerve by the enlarging uterus. Other causes of
sciatica are degenerative spinal arthritis and lumbar disk herniation.
Cause: Herniated Disk
Disk herniation
is a common cause of sciatica. The disk cushions between the spinal vertebrae
weaken and are more vulnerable to injury as we age. The weakened disk can
herniate its gel-like center to cause direct pressure on the nerves in the
spinal canal that form the sciatic nerve.
Cause: Spinal Stenosis
Degeneration of
the vertebrae of the spine can lead to narrowing of the spinal canal; this is
called spinal stenosis. This can lead to pressure on the spinal nerve roots
that form the sciatic nerve. Sciatica can be a symptom of spinal stenosis.
Cause: Spinal Tumors
Tumors are rare
causes of sciatica when they put direct pressure on the sciatic nerve or its
nerve roots.
Cause: Piriformis Syndrome
The piriformis
muscle in the buttock can sometimes lead to irritation of the sciatic nerve.
This is referred to as piriformis syndrome.
A Fat Wallet Can Trigger Piriformis
A wallet or
object that is in the back pocket during prolonged sitting can lead to piriformis
syndrome and irritation of the sciatic nerve, causing sciatica. Placing the
wallet in the front pocket instead can avoid the problem.
Cause: Infection or Injury
Rarely,
sciatica can be caused by injury, fracture, infection, or inflammation. Any condition
that leads to direct pressure or irritation of the sciatic nerve can cause
sciatica. Sometimes, no specific cause of sciatica can be detected.
Diagnosing Sciatica: Exam
To detect the
cause of sciatica, the doctor will ask about all the symptoms the patient is
experiencing as well as their location and aggravating or relieving features.
During the examination, the patient may be asked to do various maneuvers with
the lower extremities.
Diagnosing Sciatica: Imaging
Various tests,
such as MRI scans, CT scans, and others, may be used to help detect the cause
of sciatica. With a precise diagnosis, the treatment program can be optimized.
Complications Related to Sciatica
When sciatica
is complicated by uncontrolled loss of bowel or bladder control, it is considered
an emergency. These symptoms are evaluated rapidly to consider whether or not
an immediate surgical operation is necessary.
Sciatica Relief: Use Ice and Heat
Home remedies
for new sciatica include heat-pad or ice-pack applications. Each can be applied
for approximately 20 minutes every couple of hours. Some benefit from
alternating heat and ice applications.
Sciatica Relief: Medication
Medications
that are over the counter and are used for sciatica include nonsteroidal
anti-inflammatory drugs (NSAIDs) and acetaminophen (Tylenol). Cortisone
injections into the spinal canal can be helpful for selected patients.
Sciatica Relief: Stretching
Strict bed rest
is recommended less often than in the past. Physical therapists are experts at
designing optimal exercise programs for sciatica. Brief walking can be helpful
for certain people with sciatica.
Sciatica Relief: Injections
Spinal
injection of cortisone medication (steroids) can be beneficial for severe
sciatica. This medication rapidly reduces the inflammation around the nerves.
Sciatica Relief: Surgery
For persisting
sciatica that does not respond to medical management, surgical operation can
sometimes be required. Various operations differ depending on the exact
condition causing the sciatica. Sometimes disk material and bone is actually
removed to free up the adjacent irritated nerves.
Sciatica Rehab
After spinal
surgery, there are often activity restrictions, as tissues must heal. Physical
therapy is often prescribed to strengthen the back and promote healing by
avoiding injury. The goal is eventual return to one’s usual activities.
Complementary Therapies
Adjunctive
therapies, such as massage, yoga, osteopathic & chiropractic care, and
acupuncture, can sometimes be helpful for back pain.
Preventing Sciatica
Sciatica can
recur. To minimize the chances of recurrence, people should exercise regularly,
maintain proper posture, and protect the back by bending at the knees to lift
heavier objects.
Reviewed by Joseph Carcione, DO on Tuesday,
May 03, 2016
Sciatica Symptoms, Causes,
Treatments
This tool does not
provide medical advice.
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