Sciatica – What Is It And How To Manage It?
Sciatica is very common. It is characterized by the pain that is felt along the path covered by the sciatic nerve, a nerve that extends from the lower back down to the back of each leg. The sciatic nerve is the largest in the body and one of the most important ones too.
This nerve has a direct effect on the control and feel of one’s legs. When this nerve is irritated, you experience sciatica. Sciatica can manifest itself into moderate to severe pain in the back, bottom and legs. If you experience any such discomfort that can either mean that there is an underlying injury to the sciatic nerve or there is a problem in any area that affects the nerve such as your vertebrae.
Signs of Sciatica
Almost forty percent of people experience this pain at some point in their life. It is more common and frequent as the age advances. Many signs can help you identify whether the pain you are experiencing is sciatica or something else. Most of the time, any pain that is felt in buttocks and then into your legs is Sciatica. You can be sure if you feel anything like:
- The pain gets worse with the movement.
- You may experience pain or numbness in your feet or legs, mainly in the sciatic nerve pathway.
- There might be a sensation of needles and pins, which also feels like a tingling pain in the feet and toes.
- In severe cases, people may experience incontinence, inability to control the bladder or bowels. This is also one of the rare symptoms of CES (cauda equina syndrome), the condition where a herniated disc presses the nerve that is in control of bladder and bowel movements.
What can cause Sciatica?
There are many medical conditions, that can involve the spine or the nerves, thereby leading to sciatica. This can also be the result of a fall, or a tumor in sciatic nerve or spine. Some common conditions that can cause sciatica are:
Spinal Stenosis
Also known as lumbar spinal stenosis, this condition is characterized by an abnormal narrowing of the lower spinal canal. This puts pressure on the spinal cord and also on the sciatic nerve roots, hence causing sciatica.
Herniated disks
Our vertebrae are separated by pieces of cartilage. This cartilage is filled with clear and thick material that ensures cushioning and flexibility whenever we move around. A herniated disk can occur whenever any layer of this cartilage rips.
The substance inside the cartilage compresses the sciatic nerve and results in limb pain and numbness. An estimate tells us that about 1-5 percent of the population experiences back pain at some point in their life due to slipped disks.
Piriformis syndrome
This rare neuromuscular disorder causes the involuntary contraction or tightening of the piriformis muscle, causing sciatica. The piriformis muscle connects the lower portion of our spine with our thighbones. Any tightening puts pressure on sciatica, hence the pain. This syndrome worsens if a person experiences a crash or sits for a longer period.
Spondylolisthesis
This is one of the associated conditions of the degenerative disk disorder. The vertebrae extend over another causing the spinal cord to pinch the nerves that make up the sciatic nerve, hence the pain.
How to diagnose Sciatica?
The symptoms of sciatica vary from person to person. To evaluate and diagnose the actual problem, it is necessary to consult a doctor and discuss the full medical history. That might include enquiring about any recent injuries, the location, and intensity of pain, etc. A physical examination can help the doctor determine the exact cause.
This includes testing muscle strength and reflexes. You might be recommended some stretching and moving activities that can help determine the activities that intensify the pain.
Some imaging tests can also help determine any abnormalities. X-rays, Ct Scans and MRI’s are the most commonly recommended medical tests.
Treatment options for sciatica
A consultation will doctor will help you determine a good path for recovery. The doctor might recommend some tips and exercises that can help you get better. Sciatica can get better if you continue your routine activities. Too much resting or staying in bed does not help this condition. Here are the most common treatment options:
Cold packs
This is the first step, to begin with. You can use ice packs or frozen vegetable packages. All you have to is wrap the cold pack in a towel and apply it on the affected area for at least 20 minutes each day, several times. The first few days need rigorous cold treatment until you find reduced swelling and the pain eases a bit.
Hot packs
This is usually recommended after two to three days of cold pack treatment. Once the swelling settles and the pain eases, you can switch to hot packs. If the pain is still persistent, try switching the hot and ice therapy alternatively.
OTC medication
If the pain is not tolerable, you can take aspirin or ibuprofen. This will ease the pain and also settle the inflammation. (Note: Self-medication is not recommended and is unsafe. It is better and safe to consult your doctor for any kind of medication.)
Stretching and exercise
You can start by gently stretching your lower back. A proper therapist can help you figure out which stretching exercise can help you overcome your condition. Also, the more you stay active, the more your body releases the endorphins. Endorphins are natural pain relievers in the body. Stick to low impact activities at first. Swimming and stationary bicycling are a good start.
Alternative treatments
If the condition does not improve, surgery can be recommended. This includes discectomy and microdiscectomy. Some other alternative remedies include consultation with an acupuncturist, a chiropractor, massage therapist, etc.
Lifestyle changes that can help prevent sciatica
Change your shoes
Always wear shoes that fit. A shoe too tight, too big or too wide can throw off the intricate body balance and worsen sciatica. There are many shoes out there that provide good arch support. Always wear the right shoes for the right activity and make sure that there is ample space around the toes and most important- shoes should always be comfortable.
Exercise often
You can always strengthen your back, core and stomach muscles by exercising appropriately. This can keep you back healthy and prevent sciatica.
Mind the posture
Whenever you sit for long working hours, make sure the chair is offering proper support to your back. Always place the feet on the floor while seated and use the armrests.
