Sciatica: What is Sciatica, Causes, Symptoms, Treatment Options

The Sciatica nerve is the largest in the body and is a combination of five nerve roots originating in the lower spine. Spanning down the buttocks and thighs to the soles, the main role of the sciatic nerve is to connect the spinal cord to skin and muscle in the lumbar spine area. It controls the muscles of the back of the knee and lower leg and provides sensation to the back of the thigh, part of the lower leg, the sole, and along the outer edge. 

What is sciatica?

Sciatica is nerve pain that occurs due to irritation of the sciatic nerve. The pain, which might feel like a bad leg cramp or 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. The distribution of the pain depends on which nerve root is affected. It is rarely due to irritation of the sciatic nerve itself.

Sciatica Causes:

Some causes of sciatica include:

• A herniated or slipped disc: This is the most common cause of sciatica. The herniated disc puts pressure on a nerve root resulting in pain.
• Spinal stenosis:  This results from the narrowing of the spinal canal, which puts pressure on the nerves.
• Spondylolisthesis:  It occurs when one vertebra slips out of place such that it is out of line with the one above it, narrowing the opening through which the sciatic nerve exits.
• Obesity: This can lead to sciatica because excess body weight can put stress on the spine.
• Piriformis syndrome: This occurs when the piriformis muscle, which lies deep in the buttocks, becomes tight and spasms, thus putting pressure on and irritating the sciatic nerve.

Sciatica Symptoms:

Below are symptoms that are often associated with sciatica:

• Pain from your lower back/spine into your butt and down the leg
• Mild aching to sharp, burning pain in the affected area
• Pain that worsens when coughing or sneezing
• Numbness
• Burning or tingling in the leg
• Muscle weakness
• Pain, generally on one side of the body

The severity of sciatica pain can vary widely. It can simply feel like a dull ache or intense shooting pains that are almost unbearable. A severe case of sciatica is often due to permanent damage to the sciatic nerve. The pain is often accompanied by symptoms observed in other areas of the body. These symptoms include:

1. Bowel or bladder changes
2. Sexual dysfunction
3. Symptoms occurring in both legs
4. Severe leg weakness that can hinder mobility

Sciatica Treatment: 

After discussing your medical history and your symptoms, the doctor will give you a physical examination which involves checking your reflexes and the strength of your muscles. For this, the doctor might ask you to lie down and raise your legs, walk on your toes, or stand up from a squatting position. They may also order one or more of the following imaging tests:

• X-ray
• MRI
• CT scan
• EMG

The choice of treatment for sciatica depends on the length of symptoms and severity of your condition. These include:

• Rest
• Physical therapies
• Medication treatment
• Lifestyle changes
• Surgery

Mild sciatic pain usually goes away in time. When you first experience sciatica, one or two days of bed rest may be needed. However, excessive bed rest is not recommended and it is important to return to activity as soon as possible, to help your spine and muscles stay strong.

Sciatica Prevention:

While sciatica may not be completely avoidable, there are some medically approved ways to protect your back from recurring pain: 

1. Regular Exercise
2. Maintain a Good Posture When You Sit
3. Be Mindful of Good Body Mechanics

If self-care measures fail to improve your pain, you should see a Spine Surgeon or Neurologist.  If your pain lasts longer than a week, is severe, or becomes progressively worse, visit Regency Hospital, (Tower -1) and consult expert Neurologists / Spine Surgeons.