Is Your Back Pain Sciatica?

What Is Sciatica?

Sciatica is a pain that radiates from the low back down a lower extremity; it is caused by irritation of the sciatic nerve. The sciatic nerve transmits sensation from the lower extremities and lumbar area of the low back. It is common for people to recover from sciatica without a surgical operation.

Sciatica Symptoms

Low back pain that radiates to the hip, buttock, and down a lower extremity is the most common symptom of sciatica. Sometimes sciatica pain worsens with bending at the waist, coughing, sitting, or sneezing. Sciatica can also cause tingling, numbness, or weakness of the leg. Sciatica symptoms can occur rapidly and persist for weeks.

Sciatica or Other Back Pain?

Back pain is extremely common. There are many causes of lower back pain that are not sciatica. Frequently, low back pain is caused by back strain of muscles and ligaments. The characteristic feature of sciatica is pain that radiates down the leg from the low back, often reaching the foot.

Who Is Likely to Get Sciatica?

Sciatica is common as we reach middle age. Pregnancy can lead to sciatica as a result of direct pressure on the sciatic nerve by the enlarging uterus. Other causes of sciatica are degenerative spinal arthritis and lumbar disk herniation.

Cause: Herniated Disk

Disk herniation is a common cause of sciatica. The disk cushions between the spinal vertebrae weaken and are more vulnerable to injury as we age. The weakened disk can herniate its gel-like center to cause direct pressure on the nerves in the spinal canal that form the sciatic nerve.

Cause: Spinal Stenosis

Degeneration of the vertebrae of the spine can lead to narrowing of the spinal canal; this is called spinal stenosis. This can lead to pressure on the spinal nerve roots that form the sciatic nerve. Sciatica can be a symptom of spinal stenosis.

Cause: Spinal Tumors

Tumors are rare causes of sciatica when they put direct pressure on the sciatic nerve or its nerve roots.

Cause: Piriformis Syndrome

The piriformis muscle in the buttock can sometimes lead to irritation of the sciatic nerve. This is referred to as piriformis syndrome.

A Fat Wallet Can Trigger Piriformis

A wallet or object that is in the back pocket during prolonged sitting can lead to piriformis syndrome and irritation of the sciatic nerve, causing sciatica. Placing the wallet in the front pocket instead can avoid the problem.

Cause: Infection or Injury

Rarely, sciatica can be caused by injury, fracture, infection, or inflammation. Any condition that leads to direct pressure or irritation of the sciatic nerve can cause sciatica. Sometimes, no specific cause of sciatica can be detected.

Diagnosing Sciatica: Exam

To detect the cause of sciatica, the doctor will ask about all the symptoms the patient is experiencing as well as their location and aggravating or relieving features. During the examination, the patient may be asked to do various maneuvers with the lower extremities.

Diagnosing Sciatica: Imaging

Various tests, such as MRI scans, CT scans, and others, may be used to help detect the cause of sciatica. With a precise diagnosis, the treatment program can be optimized.

Complications Related to Sciatica

When sciatica is complicated by uncontrolled loss of bowel or bladder control, it is considered an emergency. These symptoms are evaluated rapidly to consider whether or not an immediate surgical operation is necessary.

Sciatica Relief: Use Ice and Heat

Home remedies for new sciatica include heat-pad or ice-pack applications. Each can be applied for approximately 20 minutes every couple of hours. Some benefit from alternating heat and ice applications.

Sciatica Relief: Medication

Medications that are over the counter and are used for sciatica include nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (Tylenol). Cortisone injections into the spinal canal can be helpful for selected patients.

Sciatica Relief: Stretching

Strict bed rest is recommended less often than in the past. Physical therapists are experts at designing optimal exercise programs for sciatica. Brief walking can be helpful for certain people with sciatica.

Sciatica Relief: Injections

Spinal injection of cortisone medication (steroids) can be beneficial for severe sciatica. This medication rapidly reduces the inflammation around the nerves.

Sciatica Relief: Surgery

For persisting sciatica that does not respond to medical management, surgical operation can sometimes be required. Various operations differ depending on the exact condition causing the sciatica. Sometimes disk material and bone is actually removed to free up the adjacent irritated nerves.

Sciatica Rehab

After spinal surgery, there are often activity restrictions, as tissues must heal. Physical therapy is often prescribed to strengthen the back and promote healing by avoiding injury. The goal is eventual return to one's usual activities.

Complementary Therapies

Adjunctive therapies, such as massage, yoga, osteopathic & chiropractic care, and acupuncture, can sometimes be helpful for back pain.

Preventing Sciatica

Sciatica can recur. To minimize the chances of recurrence, people should exercise regularly, maintain proper posture, and protect the back by bending at the knees to lift heavier objects.

The Truth About Back Pain

Back pain is extremely common. In fact, 80% of people will have significant back pain at some point. Back pain symptoms vary from individual to individual. They can be sharp or dull. Myths regarding back pain are also common. Can you recognize the myths and facts that follow?

Myth: Always Sit Up Straight

We know slouching in chairs is bad for your back. However, sitting up too straight and still can also irritate the back.

For relief of back pain from prolonged sitting, intermittently try leaning back in your chair with your feet on the floor with a slight curve in the low back. Also, stand for part of the day when possible (for example, while on the phone or reading).

Myth: Don't Lift Heavy Objects

When lifting, it's the way you lift that is most important, not just the weight you are lifting. When lifting, try to be as close to the object as possible, squatting to make the lift. Use your legs to lift. Don't torque your body or bend during the lift.

Myth: Bed Rest Is the Best Cure

Bed rest can help an acute back strain or injury. But it is not true that you should stay in bed. Sometimes remaining immobile in bed can actually make back pain worse.

Myth: Pain Is Caused by Injury

Back pain can be caused by injuries, disk degeneration, infections, and conditions that are inherited, such as ankylosing spondylitis.

Fact: More Pounds, More Pain

Keeping fit is helpful in preventing or aggravating back pain. Back pain is more common in those who are unfit or overweight. Those who only exercise intermittently (the weekend warriors) are at increased risk for back injury.

Myth: Skinny Means Pain-Free

People who are too thin can also be at risk for back pain, especially those witheating disorders and osteoporosis.

Myth: Exercise Is Bad for Back Pain

Regular exercise is very good for preventing back pain. Actually, for those with an acute back injury, sometimes a guided, mild exercise program is recommended. This often begins with gentle exercises that gradually increase in intensity.

Fact: Chiropractic Care Can Help

Spinal manipulation and massage can be very helpful options for many forms of lower back pain.

Fact: Acupuncture May Ease Pain

Acupuncture can be helpful for relieving many types of back pain that do not respond to other treatments. Yoga, progressive relaxation, and cognitive behavioral therapy can also be beneficial

Myth: A Firm Bed Mattress Is Better

People differ in their response to mattress firmness. One study from Spain showed that those who slept on a medium-firm mattress (rated 5.6 on a 10 point hard-to-soft scale) had less back pain and disability than those who slept on a firm mattress (2.3 on the scale).

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