Sciatic Pain

True sciatica is formed when the sciatic nerve gets pinched or irritated, causing inflammation of the nerve. The most common site of irritation is your lower back and pelvis. The inflammation causes tremendous pain to occur anywhere along the path of the sciatic nerve.


Sciatica is most frequently experienced by people between 30 and 50 years of age because it tends to develop as a result of general wear and tear on the lower spine rather than being caused by a particular injury.

The clinical diagnosis and medical term used for sciatica is radiculopathy. It means that a disc has protruded from its normal position in the vertebral column and is putting pressure on the radicular nerve, situated in the lower back. Radiculopathy or sciatica is broadly used to describe a form of pain that radiates into your leg. Pain running down the back of your leg is symptomatic to sciatica, but pain running in the front of your leg, or general lower back and leg pain is technically not true symptoms of sciatica.

Sciatic pain can be identified by its definite pattern, usually starting in your buttocks, but can also start from the lower back. A feeling of pain and tenderness is then extended down the back of your thigh and into the lower part of your leg, sometimes the pain even reaches the soles of your feet. This is a gnawing pain that tends to spasm.

Sciatica is a set of symptoms that irritate the root of the nerve and causes pain to occur. Sciatica usually only affects one side of the body, often starting at your lower back through the back of your thigh and down one of your legs. Pain may also extend to your foot or even your toes, depending on where the sciatic nerve is affected. The pain is sometimes replaced by a feeling of numbness or weakness of the muscles in the lower leg.
In the beginning sciatic pain can be infrequent and only irritating, but usually gets worse if not treated. Immediate medical attention is advised for people with any symptoms of progressive lower extremity weakness or loss of control over your bladder or bowel.

Common Symptoms

• A shooting pain down the leg, making it difficult to stand after sitting or lying down


• Constant pain on one side of your buttocks


• A feeling of weakness and numbness in one leg or foot


• Difficulty moving the affected leg or foot


• A burning or tingling sensation running down your leg


• A pain in your buttocks or leg that worsens when sitting for some time.

Symptoms that Require Medical Attention

You are advised to consult a doctor if you develop sciatica, especially if you are unable to control the pain with painkillers or anti-inflammatory medicine and the pain carries on for two weeks or more.

See a doctor immediately when experiencing any sciatic symptoms if:

• You are younger than 20 or older than 55 when experiencing sciatica for the first time


• You experience constant pain that gets worse


• Your pain extends to the back of your chest


• Your pain follows a violent injury like an accident


• You recently lost a lot of weight over a short period of time


• You have great difficulty to bend forward

Doctors call these bullet-points, mentioned above, Red Flags. The Red Flags helps them to estimate the severity of your sciatica case and highlights the need to act more quickly.

Most causes of sciatica include problems with the intervertebral disc and the sciatic nerve. The intervertrabral disc has a tough and fibrous ring around the outside that acts as a shock absorber or cushion and allows some flexibility between the bones of the spine.

The sciatic nerve has many functions like transmitting messages around the body. The sciatic nerve's main task is making your muscles in your leg contract when you walk. Damage to the sciatic nerve causes malfunctioning, pain or numbness of your limbs.

• The most common cause of true sciatica is Spondylolisthesis or a prolapsed intervertebral disc (PID), more commonly known as a "slipped disc". Slipped disc is when one vertebrae slips forward over another one.


• Degenerative Disc Disease occurs when the intervertebral discs break down or degenerates.


• Sciatica is also commonly caused by Piriformis Syndrome. The piriformis is a muscle in the buttocks that runs closely underneath or sometimes through the sciatic nerve. When the piriformis muscle tightens or gets inflamed, it irritates and puts pressure on the sciatic nerve, causing sciatica.


• Damage or inflammation of your Sacroiliac Joint, situated at the base of your spine, can cause sciatica. This type of sciatica mainly occurs due to old age and wear and tear of your joints and spine.


• Lumbar Spinal Stenosis is the narrowing of the spinal canal in the lower-back area and can put a lot of pressure on the sciatic nerve. Spinal Stenosis is usually caused by pregnancy or old age.


• Sciatic pain can be worsened by being overweight, not exercising on a regular basis, wearing the wrong shoes or sleeping on a bed with a soft mattress and then again, old age.

The vast majority of people who experience sciatica find pain relief without any surgical treatment, mostly recovering spontaneously, depending on the symptoms they have. Recovery or the healing process commonly takes place within a few days or weeks. Patients are medically advised to rest for a short period; are limited from some activities and anti-inflammatory medication is prescribed.

• Non-Surgical Sciatica Treatment

Non-surgical treatments of Sciatica are usually a combination of one or more medical treatment with one or more non-medical treatment (alternative treatment). Non-surgical treatments almost always include some form of stretching and strengthening exercise with its goal to relief sciatic pain and prevent the symptoms of reoccurring.

Pilates
The most generally used stretching and strengthening exercise is Pilates, a treatment that is often prescribed by physiotherapists. Pilates is stretching exercises that focuses on strengthening of the core muscles in your back and your stomach, relieving the symptoms and pain caused by sciatica. Strengthening of these muscles does not only avoid and reduce back pain and strain; it also improves your posture. A good posture is plays a very important role in maintaining a healthy back.

Sciatica Pain Medications
Prescription or over-the-counter medications can be very helpful in the relieving process of sciatic pain. The medication will reduce the inflammation that causes Sciatica.

Epidural Steroid Injections
For severe cases of Sciatica, epidural steroid injections are given to reduce inflammation. The steroids are injected directly into the affected and painful area, temporarily relieving the patient from the pain. Temporary pain relieve often allows the patient to progress with an exercise program for more long-term pain relief.

Spine Care Professionals
There are many different spine care professionals who specialises in treating sciatica, non-surgically. These professionals include physical therapists, chiropractors and physiatrists. They will help you to relief the pain and prevent sciatica from reoccurring.

• Alternative Treatments

There are several alternative treatment options available nowadays. Some of these alternative treatments have been known to provide effective sciatic pain relief for many patients. The most commonly used options of alternative care are acupuncture and massage therapy.

Acupuncture
Hair-thin needles are inserted into the skin at the area where pain is felt. The needles are then left in place for a short while (from a few minutes to over half an hour). The needles positively influence the flow of energy via that specific pathway in the body.

Massage therapy
Massage therapy's benefits include muscle relaxation for spasms, increased blood circulation and an increase in the release of endorphins (body's natural pain-killers)

• Surgical Sciatica Treatment

Patients who have pain that is associated with muscle weakness or a progressive neurological deficit are most likely to improve after surgery. Surgery techniques like lumbar laminectomy and discectomy are the removal of the part of the disc that irritates the sciatic nerve. By doing this, the nerve is relieved from the pressure and the inflammation that causes sciatica.

New, modern surgical techniques, called microdiscectomy or microsurgery have been developed. Microsurgery also involves the removal of disk fragments, but the surgery is performed without cutting through the skin and by only using needles. The recovery period after the surgery is much shorter than with the usual lumbar laminectomy and discectomy, but unfortunately not all sciatica patients are suitable for this type of surgery.

• Stay active and keep on working if possible


• Bed-rest is not bad, but try to limit it to not more than a week at a time.


• Avoid any activities that put strain on your back


• Try taking your usual pain-killers like paracetamol and see if it helps


• Consult your doctor if the pain stays for more than a few days or you notice any of the symptoms that require medical attention, mentioned above.

The good news for most people is that sciatic pain will get better on its own and the healing process normally only takes a few days. The most important thing for a sciatic patient to remember, whether severe or minor, is that exercise is vital for recovery and management of sciatica. Patients who engage in a regular program of strengthening and stretching exercises will recover more quickly from sciatica and it will help to prevent future flares of sciatic pain.

I did my best to make sure the information in this lens pertaining Sciatica and Sciatic Pain is correct and accurate at the time of publication. I accept no responsibility for any errors or omissions and can not be held liable for any loss or damaged caused due to the reliance of the information in my lens. Treatment and advice of medical professionals is still advised.