Sciatica is a common low back condition that affects 40% of the population at some time in their lives. It most frequently affects men between the ages of 40-50 years old. Onset is usually sudden and can radiate from the low back to one or both of the lower extremities with pain, numbness and tingling in some cases. Causes can range from performing activities like lifting or repetitive bending to twisting and pulling motions. The main source of the pain is the sciatic nerve. Damage or compression of this nerve is what causes the myriad of symptoms associated with this disorder. In this article, we will answer the most common questions related to this condition and help you to gain a better understanding of how it is treated and managed.
What is Sciatica?
As stated above, this condition is characterized by pain that radiates from the low back down into the legs. The pain can be accompanied by feelings of numbness and tingling that can travel to the front of the thigh, to the side of the leg, or in some cases, down the back of the leg all the way to the foot. The pain can sometimes shoot down the lower extremity in a sharp fashion or may present as an aching feeling with weakness. Severe cases are debilitating and can lead to an inability to bear weight on the affected leg due to the intense pain.
What Causes Sciatica?
Sciatica is caused by compression of the nerve that gave the condition its name. The sciatic nerve is actually made up of a collection of nerve roots that stem from the low back and is the longest and largest of all the nerves in the body. Specifically, the sciatic nerve is made up of five nerve roots from the lower back region. Compression on any one of the nerve roots or anywhere along the nerve pathway, which travels down both legs to the feet, can cause the telltale symptoms of Sciatica.
How Do Nerves Get Damaged or Compressed?
Nerves are the communication superhighway for the body. This complex wiring system travels from our brain down our spine and out to all the different body organs and systems. Damage or compression to any one of these delicate nerves can cause interruption of this system and registers as pain. 90% of all sciatica is caused by a disc herniation at one of the spinal levels in the low back, the resulting inflammation and swelling causes pressure on the nerves. Another cause is called spinal stenosis, which is narrowing of the holes where the nerve passes through to get to the body. This may happen with age-related degeneration of the spine, inflammation or a disc bulge. Any of these conditions can pinch the nerve as it makes its way through the area. Piriformis syndrome can also cause compression of the sciatic nerve as the nerve passes directly underneath it. This gluteal muscle can spasm which causes irritation and compression of the underlying nerve.
How is Sciatica Treated?
Most cases of sciatica do not need surgery, are resolved with over the counter anti-inflammatory medication, or with measures like stretching, ice, or heat. More stubborn or severe presentations may require a step up in care. Second level treatments may include conservative management like chiropractic manipulation and acupuncture, or more invasive treatment like epidural injections. A medically supervised injection can quickly decrease the inflammation locally around the nerve. Chiropractic treatment aligns the spinal joints and has been shown to decrease pain and create a better environment for healing. Acupuncture is another non-surgical natural treatment which uses very fine needles to stimulate your natural healing pathways and speed recovery without drugs.
Can Sciatica Be Prevented?
Preventative measures for sciatica are aimed at strengthening and stretching the muscles around the low back and the lower extremities. This includes the core muscles and gluteal muscles like the piriformis muscle.
Now that you have a good understanding of sciatica, its causes and treatment options, hopefully you will carry on a regular program of strength and conditioning. Staying in motion and actively working on flexibility will go a long way to keeping this condition from affecting you in the long run.
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