Sciatic Nerve Pain: Understanding Sciatica

If you’ve been suffering from nagging low back pain you know exactly how debilitating it can be. There are many forms of low back; mechanical low back pain, disc bulges, facer irritation, and degenerative causes to name a few. However, many people are affected by sciatica and this can take a major toll on their lives. It is very important to truly understand what sciatica is and what it causes are to find a long term solution.

What is Sciatica?

Sciatica is pain that is found along the path of your sciatic nerve which travels from your back, through your hip/ gluteal region and runs down the back of your leg. Sciatica is an irritation along the path of this nerve. The Sciatic nerve is actually the longest nerve in your body. It is very important to understand that sciatica is not an actual diagnosis, it is a way of describing your symptoms. That means that if you are having pain down the back of your leg that can be described as sciatic pain, but it does not address the reason you are actually getting the pain.

What does Sciatic pain feel like?

Sciatic pain is usually shooting pain that is felt in the lower back, through the buttocks and down the back of your leg. If you are feeling a pain traveling from your lower back and down the back of your legs it is most likely caused by irritation to the sciatic nerve. Along with feeling a shooting pain, you may also feel numbness and tingling along the distribution of the sciatic nerve. Sciatic pain is usually one-sided. It is also important to understand that depending on where the irritation or impingement occurs there may be different areas affected. The pain that most people use to describe sciatica is sharp or shooting not dull or achy.

What cause sciatica?

Once again it is important to understand that if you have sciatica there is an underlying reason for that. Some of the most common causes of Sciatica are listed below;

Disc herniation:

A disc herniation is when the discs between your vertebrae become damaged and the soft inner part of your disc pushes on the outer edge of the disc and it causes irritation of your nerves. Your nerves are very sensitive so even a small amount of pressure can cause severe symptoms. In the case of sciatica, the disc herniation puts pressure on your sciatic nerve and this, in turn, gives you pain along the sciatic nerve distribution.

Piriformis syndrome:

The sciatic nerve in most people usually passes under your piriformis muscle, however, in some instances it can pass over or even through your piriformis muscle. Your piriformis muscle can possibly impinge or irritate your sciatic nerve which will lead to sciatica.

Degenerative Disc Disease:

As you get older there is more wear and tear that occurs on your intervertebral discs. As they continue to wear down the now degenerated disc can start to pressure on your nerves and cause irritation of your sciatic nerve.

Lumbar Spinal Stenosis:

Lumbar spinal stenosis is narrowing of the spinal canal. When spinal stenosis occurs it can also cause irritation of your sciatic nerve pain.

What is the treatment for Sciatica?

The treatment for sciatica is dependent on the cause of sciatica. The matter of the fact is that we are not treating sciatica we are treating what is causing sciatica. So the most important part of treatment is making sure that you get an accurate diagnosis from your doctor. For argument's sake, if you have been diagnosed with any of the above conditions, treatment will usually consist of some form of the following;

Acute Sciatic (Pain is present from 1-3 months)

-Usually, if the pain is been present and is fairly new, you will be prescribed with a form of an anti-inflammatory medication from your doctor.

- It is definitely important to ice the area using the 10-10-10 method (Ice for 10 mins, take office for 10 mins and re-ice for 10 mins).

- Starting some form of physical therapy

Sub acute/Chronic Sciatic pain (3 months+)

-You may be prescribed pain killers from your family doctor to cope with the pain

-You may continue in physical therapy to help address the physical component of your pain

-You may be referred to Cognitive Behavioural Therapy(CBT) to learn different ways to cope with pain

If you still do not respond to therapy and continue to have pain, a surgical consult may be warranted

When should I see my Doctor?

If you are having mild sciatic symptoms, it is best to try self-care methods before going to the doctor. However, if the pain becomes more severe or doesn’t subside within a week it is advised you go and see a qualified health professional. It is also important to keep an eye out for red flags such as losing control of your bowel or bladder and sudden or severe pain or weakness if you have any of these symptoms you should go to the emergency room immediately.

What are the risk factors for Sciatica?

Certain things may predispose you to acquire sciatic symptoms, some of the risk factors are listed below;

1) Being overweight: Those who are overweight or obese create more pressure to be applied to the lower back and in turn, can cause some of the injuries that lead to sciatica

2) Work activities: If your job is demanding, physical and involves a lot of bending and twisting you are more predisposed to injuring your back and causing sciatic type symptoms

3) Sedentary lifestyle: People who are less active and those who tend to sit for prolonged periods of time are more susceptible to getting an injury that would cause sciatic pain

When Should I Consider Surgery?

In general, if you have tried all forms of treatment and have been in constant contact with your doctor and physical therapists and your pain continues to be very severe a surgical consult may be recommended. It is always important to always follow up with your doctor and surgeon to become aware of the advantages and disadvantages of surgery.

Summary

Sciatica can be a very serious and painful ordeal. As with any form of injury, it is imperative that you find the source of the pain (IE disc herniation, piriformis syndrome, etc.). Once you have a confirmed diagnosis the next step in your treatment should be finding a quality physical therapist or health professional who has experience in dealing with muscle, joint and nerve pain. If you are proactive and take the right steps there is no reason that you should not be able to lower your pain levels and even eradicate the pain altogether.

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