What is sciatica?
The sciatic nerve is the largest nerve in the body and sciatica is nerve pain which occurs due to irritation of the sciatic nerve. The pain which might feel like a bad leg cramp, or can be a shooting pain that makes standing or sitting nearly impossible, is typically felt from the lower back to behind the thigh and radiates down below the knee. If you have sciatica you might experience weakness, numbness, or a burning or tingling sensation down your leg, or even in your toes. You may also experience an inability to bend your knee or move your foot and toes. Sciatica can occur suddenly or it can develop gradually.
What are the causes of sciatica?
Sciatica is usually the symptom of a 'pinched nerve' affecting one or more of the lower spinal nerves. The nerve might be pinched inside or outside of the spinal canal as it passes through the leg.
Some causes of sciatica include:
- A herniated or slipped disc: which is the most common cause of sciatica that causes pressure on a nerve root.
- Piriformis syndrome: which occurs when the small piriformis muscle, which lies deep in the buttocks, becomes tight and spasms, thus putting pressure on and irritating the sciatic nerve.
- Spinal stenosis: that results from narrowing of the spinal canal which puts pressure on the nerves.
- Spondylolisthesis: that occurs when one vertebra slips, so that it is out of line with the one above it, narrowing the opening through which the sciatic nerve exits.
What are the risk factors of sciatica?
The risk factors for sciatica include:
- changes in the spine due to advancing age, such as herniated disks and bone spurs
- being obese which stresses the spine
- sitting for prolonged periods
- leading a sedentary lifestyle
- jobs which require you to carry heavy loads, drive for long periods, repeatedly twist your back etc.
What are the symptoms of sciatica? How is sciatica diagnosed?
Common symptoms of sciatica include:
- lower back pain
- pain in the rear or leg that is worse when sitting
- hip pain
- burning or tingling in the leg
- weakness, numbness, or difficulty moving the leg or foot
- a constant pain on one side of the rear
- a shooting pain that makes it difficult to stand up
If you suffer from the symptoms of sciatica you need to visit a general physician. The general physician, in turn, might refer you to an osteopathic physician or a chiropractor based on your condition.
The doctor will ask you about your medical history, your profession, your daily activities and questions related to your pain such as :
- Where do you feel pain?
- Is it all the way down your leg? Is it in both legs? Does it stop at your knee?
- Rate your pain on a scale of 1-10 with 10 being the worst.
- Are you experiencing weakness or tingling in your legs and/or feet?
- What activities did you recently do?
- What reduces the pain or makes it worse?
Your doctor will also perform physical and will advise you to undergo a neurological exam. In the physical exam, the doctor will check your posture, range of motion, and your spine.
During the neurological exam, the doctor will test your reflexes, muscle strength, and other nerve changes. He may further advise you to take imaging tests, x-ray, CAT scan and an MRI test.
All these tests will give a complete picture to your doctor.
What are the complications of sciatica?
Complications due to sciatica are rare. If they do occur they can include:
- permanent nerve damage
- loss of feeling in the affected leg
- weakness in the affected leg
- loss of bowel or bladder function
What is the treatment for sciatica?
Medical Treatment for Sciatica
Physical therapy is often prescribed for sciatica. Your doctor may recommend that you perform a few back exercises and stretches. If there is no improvement you can ask the doctor about alternative therapies since many people get relief by visiting physical therapists, osteopaths, and chiropractors.
For cases of persistent sciatica, the doctor may recommend epidural injections which are steroid injections.
For severe cases, the doctor may recommend surgery.
Sciatica exercises usually focus on strengthening and stretching the spinal column and muscles and tendons. Yoga and pilates are good forms of exercises along with swimming and walking. Before you decide on an exercise regimen it is advisable to consult with your doctor to find out which form of exercise will suit you the best. It is also advisable to perform the exercises under supervision, till you feel confident.
Questions answered by trusted doctors
Did you know?
Occurrence of sciatica in India
Sciatica has been reported to occur in 1 to 10% of the population, most commonly in people age 25 to 45 years.
Men affected more
Men are more frequently affected than women by sciatica.
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