What is Sciatica?
Sciatica is a symptom. It consists of leg pain, which might feel like a bad leg cramp, or it can be excruciating, shooting pain that makes standing or sitting nearly impossible.
The pain might be worse when you sit, sneeze, or cough. Sciatica can occur suddenly or it can develop gradually. You might also feel weakness, numbness, or a burning or tingling (“pins and needles”) sensation down your leg, possibly even in your toes. Less common symptoms might include the inability to bend your knee or move your foot and toes.
What causes sciatica?
Sciatica might be a 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 into the leg.
Conditions that cause sciatica:
- A herniated or slipped disc that causes pressure on a nerve root — This is the most common cause of sciatica.
- Piriformis syndrome — This develops when the piriformis muscle, a small muscle that lies deep in the buttocks, becomes tight or spasms, which can put pressure on and irritate the sciatic nerve.
- Spinal stenosis — This condition results from narrowing of the spinal canal with pressure on the nerves.
- Spondylolisthesis — This is a slippage of one vertebra so that it is out of line with the one above it, narrowing the opening through which the nerve exits.
5 test to check for sciatic pain
These are not sure signs that you have sciatica but if any are positive then I strongly recommend seeing a doctor.
Well, actually just one knee—and it runs throughout the entire leg. The sciatic nerve—the one that gets pinched and causes sciatica—is the largest single nerve in the entire body, running from the lower spine all the way down to the foot. When that nerve is pinched, its function is disrupted, resulting in all kinds of unwanted sensations, such as pain, weakness, and tingling. And while pain is pretty common (and oftentimes hard to diagnose), pain and weakness in a single leg acts like a red flag for doctors.
Your a walker not a runner
If you’re not training for your next marathon or logging hours on the treadmill, there’s a good chance your leg pain is sciatica caused by a herniated disc, not the less-common piriformis syndrome, which mainly affects athletes. The funny thing is that piriformis syndrome presents itself almost exactly like sciatica: pain, tingling, numbness starting in the buttocks and extending down the leg. But instead of a slipped disc causing the issues, your piriformis muscle (found in the butt near the top of your hip joint) is pressing on that touchy nerve.
You can’t summon your pain
Sometimes the pain you think is sciatica isn’t actually nerve-induced pain at all, but rather, something muscular. So how do you find out? Use your thumb, suggests Jacob Teitelbaum, MD, author of Real Cause, Real Cure. “Push around on the muscles in your lower back and see if you can find spots that affect your pain,” says Teitelbaum. If you can trigger pain by a push—not a gentle push, you want to exert at least 5 to 10 pounds of pressure—your pain is most likely muscular and the result of a shortened, tightened muscle. “When a muscle gets stuck in the shortened position, it gets thicker and doesn’t get the blood or nutrients that it needs,” says Teitelbaum. And when you press on those tightened muscles—especially on the small, tender knot in the center—it can send pain throughout the body.
Slipped disk test
It’s the main test docs use to diagnose sciatica caused by a slipped disc, and it starts with you lying down with your feet stretched out. The examiner then raises your straight leg between 30 and 70 degrees. Pain from this test—the kind that radiates down your entire leg, below your knee, and possibly even down to your toes—indicates sciatica. This is because when you stretch the affected leg, you’re also stretching the entire sciatic nerve, and if the nerve root is pinched, you’ll feel it through the stretching movement.
You have to go a lot more
We’re not talking about getting up a few extra times each night, but rather, totally losing control of your bowel and bladder movements. When paired with the typical sciatica pain, doctors treat this as a “surgical emergency,” according to Alan Hilibrand, MD, spokesperson for the American Academy of Orthopaedic Surgeons. It’s extremely rare, but if the spinal column is putting that much pressure on the nerve, it can lead to permanent damage to bowel and bladder function, so be sure to see a doctor immediately.
5 Treatments for Sciatica
The goal of treatment is to decrease pain and increase mobility. Treatment most often includes limited rest (on a firm mattress or on the floor), physical therapy/massage therapy, and the use of medicine to treat pain and inflammation. A customized physical therapy exercise program might be developed.
Pain medicines and anti-inflammatory drugs help to temporarily relieve pain and stiffness, allowing for increased mobility and exercise. There are many common over-the-counter medicines called non-steroidal anti-inflammatory drugs (NSAIDs). They include aspirin, ibuprofen (Motrin, Advil), and naproxen (Naprosyn, Aleve). Muscle relaxants, such as cyclobenzaprine (Flexeril), might be prescribed to relieve the discomfort associated with muscle spasms. However, these medicines will not solve the issue just help decrease some pain. They also might cause confusion in older people. Depending on the level of pain, prescription pain medicines might be used in the initial period of treatment.
Physical Therapy –
The goal of physical therapy is to find exercise movements that decrease sciatic pain by reducing pressure on the nerve. A program of exercise often includes stretching exercises to improve flexibility of tight muscles and aerobic exercise, such as walking.
The therapist might also recommend exercises to strengthen the muscles of your back, abdomen, and legs.
Spinal injections –
An injection of a cortisone-like anti-inflammatory medicine into the lower back might help reduce swelling and inflammation of the nerve roots, allowing for increased mobility.
Surgery might be needed for people who do not respond to conservative treatment, who have progressing symptoms, and are experiencing severe pain.
Surgical options include:
Microdiscectomy — This is a procedure used to remove fragments of a herniated disc.
Laminectomy — The bone that curves around and covers the spinal cord (lamina), and the tissue that is causing pressure on the sciatic nerve are removed.
Many people believe that yoga or acupuncture can improve sciatica. Massage can significantly help muscle spasms that often occur along with sciatica. Biofeedback is an option to help manage pain and relieve stress, which can affect your ability to cope with pain. These are referred to as alternative therapies.