Sciatica: Causes, Symptoms, and Treatment

Sciatica: Causes, Symptoms, and Treatment

Sciatic pain is due to irritation, swelling, pinching, or compression of the lower back of the nerve. A herniated or slipped disc that produces pressure on the nerve's root is the most typical reason. With patience and self-care, most persons with sciatica improve on their own.

What is Sciatica?

Sciatica is severe nerve pain that begins in the buttock/gluteal area and can result from any injury or sensitivity to the sciatic nerve. The sciatic nerve is the thickest and broadest (almost a finger's breadth) nerve in the body. It consists of five nerve roots: two from the lower back, known as the lumbar region, and from the sacrum, the last segment of the spine. A proper and left sciatic nerve is when the nerve roots come together. One sciatic nerve runs from your hips, buttocks, and leg, ending just beneath the knee on each side of your body. The sciatic nerve then splits into several nerves that run down your leg and into your foot and toes.

Although actual sciatic nerve injury is uncommon, the term "sciatica" often describes any discomfort that begins in the lower backbone and spreads down the leg. Damage to a nerve — irritation, inflammation, pinching, or compression of a nerve in your lower back — is what causes severe discomfort.

If you have "sciatica," you will feel pain anywhere along the sciatic nerve route, which runs from the back to hips, buttocks, and/or down your legs. Weak muscles of your leg and foot, numb leg, and stinging pins-and-needles experience in your ankle, foot, toes, etc., are all possible side effects.

What does Sciatica Pain Feel Like?

Depending on the origin of sciatica pain, people describe it in a variety of ways. Sharp, shooting, or jolting pain is how some people describe the discomfort. Many people suffering from sciatica describe it as "scorching," "electric," and "stabbing" by others.

The pain may be persistent or intermittent. In addition, the discomfort in your leg is frequently more intense than in your lower back. When you rest or stand for lengthy periods, stand up, or twist your upper body, the discomfort may worsen. Coughing or sneezing, which are both forced and quick body movements, might aggravate the pain.

Can Sciatica Occur Down Both Legs?

Typically, sciatica mainly affects one leg at a time. Sciatica can, however, strike both legs at the same time. It's just a question of where the nerve thrusts in the spinal column.

Is Sciatica a Sudden Occurrence, or Does it Evolve?

Sciatica can strike suddenly or develop over time. It is conditional on the cause. A disc herniation can result in excruciating discomfort. Arthritis of the spine occurs gradually over time.

What is the Prevalence of Sciatica?

Sciatica is a highly prevalent ailment. Sciatica affects about 40% of people in the United States at some point in their lives. Back pain is the third most prevalent reason for seeing a chiropractor.

What Causes Sciatica?

Sciatica can be a result of several medical severities, including:

  • A nerve root feels pressure by a herniated or slipped disc. This most commonly causes sciatica. A slipped disc affects about 1% to 5% of all persons in the United States at some point in their life. The cushioning pads within each vertebra of the spine are known as discs. The gel-like center of a disc can expand (herniate) through a weakness in its outer wall due to pressure from vertebrae. A herniated disc can press the sciatic nerve in the lower back vertebrae.
  • Degenerative disc disease is natural wear and tear of the discs between the vertebrae of the spine. As the discs wear out, their height decreases, and the nerve passages become more dangerous (spinal stenosis). As the sciatic nerve leaves the spine, spinal stenosis might squeeze them.
  • Spinal stenosis: The space for the spinal cord and nerves will reduce due to this narrowing.
  • Spondylolisthesis is the misalignment of one vertebra with the one above it, narrowing the aperture through which the nerve leaves. The stretched spinal bone can pinch the sciatic nerve.
  • Osteoarthritis. In aged spines, bone spurs (jagged edges of bone) can occur and pressure lower back nerves.

Tumors in the lumbar spinal canal pressure the sciatic nerve, causing lumbar spine or sciatic nerve trauma.

  • Piriformis syndrome happens when the piriformis muscle, a tiny muscle deep in the buttocks or spasms. This can hurt and press on the sciatic nerve. Piriformis syndrome is a rare neuromuscular condition.
  • Cauda equina syndrome is an uncommon but deadly disorder affecting the cauda equina, a bundle of nerves near the edge of the spinal cord. This syndrome produces leg pain, numbness around the anus, and bowel and bladder control problems.

What are the Symptoms of Sciatica?

The symptoms of sciatica include:

  • Moderate to harsh pain in the back, buttock, and leg
  • Numbness or weakness
  • Movement pain that worsens
  • Movement loss
  • Poking needles feeling in legs, or entire feet
  • Loss of bowel and bladder control

How is Sciatica Diagnosed?

Your chiropractor will start by reviewing your medical history and then will ask about the symptoms.

Your chiropractor will ask you to walk during your physical exam so that your chiropractor can assess how your spine supports your weight. To test the health of your calf muscles, a walk test on your toes and heels will be a mandate. Your doctor may also perform a straight leg raise test. You'll be asked to lie back with your legs straight for this test. Slowly elevate each leg and record the point where your pain starts. This test pinpoints the nerves that are affected and determine if one of your discs is damaged. Furthermore, the chiropractor will request stretches and actions to localize pain and check muscular flexibility and strength.

During your physical examination, imaging, and another testing, depending on what your chiropractor discovers. These could include:

  • Spinal X-rays: This helps in determining spinal fractures, disk problems, or infections. It can also detect intense issues such as tumors and bone spurs.
  • MRI or CT (Magnetic resonance imaging and computed tomography) scans: Used primarily to check and find detailed bone images or soft tissues of the back. An MRI can indicate nerve pressure, disc herniation, and any arthritis that can push the nerve. The diagnosis of sciatica usually is ordered by MRIs.
  • Nerve conductivity/electric velocity investigations: Used to study how well electric pulses pass through the sciatic nerve and muscle reaction.
  • Myelogram: it is used to determine if a vertebra or disk is causing the pain.

How Long Should I Try Treatments for My Sciatica Before Seeing my Chiropractor?

Every person who suffers from sciatica is unique. The type of pain, the degree of the pain, and the reason for the pain are all variables to consider. Chiropractors may try More aggressive treatment first in some cases. However, suppose a six-week trial of conservative self-care methods has failed to offer relief, such as ice, heat, stretching, and over-the-counter medications. In that case, it's time to see a chiropractor and explore additional treatment choices.

Other sciatic treatments according to chiropractors options include:

Prescription medications: Muscular relaxants, such as cyclobenzaprine (Amrix®, Flexeril®), may be prescribed by your chiropractor to alleviate the pain of muscle spasms. Tricyclic antidepressants and anti-seizure medicines are two further pain-relieving treatments to consider. Prescription pain medications may be used early in your treatment plan, depending on your level of pain.

Physical therapy: Physical therapy's purpose is to find exercise movements that relieve sciatica by lessening nerve pressure. Stretching exercises to promote muscle flexibility and cardiovascular exercises should be included in every workout regimen (such as walking, swimming, water aerobics). Your chiropractor can refer you to a physical therapist who will work with you to create a stretching and aerobic exercise program tailored to your specific needs and offer other exercises to strengthen muscles in the lower back, stomach, and legs.

Spinal injections: An injection of corticosteroid, an anti-inflammatory drug, into the lower back may relieve discomfort and swell around the damaged nerve roots. Injections provide pain relief for a brief period (usually up to three months) which are then administered as an outpatient procedure under local anesthetic. After the injection, you may feel some pressure, as well as a burning or stinging sensation. Discuss with your chiropractor the number of injections you may have and the hazards associated with injections.

Alternative therapies: Alternative therapies are increasingly popular to treat and manage various types of pain. Spinal manipulation by a competent chiropractor, yoga, or acupuncture is all option for relieving sciatic discomfort. Massage may help with muscle spasms, which are familiar with sciatica. Biofeedback is a technique that you can use to manage pain and stress.

When Should One Consider Surgery?

Suppose alternative treatment options, such as stretching and medication, have failed. In that case, your pain is escalating, you have severe weakness in your lower extremities muscles, or you have no bladder or bowel control; spinal surgery is usually not indicated.

The source of your sciatica determines the timing of surgery. A chiropractic expert will only recommend surgery within a year of persistent problems. Suppose your pain is severe and unrelenting, prohibiting you from standing or working, and you might have to take admission to the hospital. In that case, you'll need more aggressive therapy and surgery sooner. If the chiropractor diagnoses the cause of the loss of bladder or bowel control to be equina cauda syndrome, you might need surgery.

Spinal surgery for sciatica aims to relieve pressure on pinched nerves while also ensuring that the spine is stable.

Surgical options for sciatica relief include:

  • Microdiscectomy is a minimally invasive treatment for removing herniated disc parts that are compressing the nerve.
  • The lamina or part of the vertebral bone, the ceiling of the spinal canal, is the nerve that pressures on the sciatic nerve releases in this technique.

Should I Rest If I Have Sciatica?

You may require rest and a change in your activities and degree of exercise. Too much rest, bed rest, and physical inactivity, on the other hand, might aggravate your pain and hinder the healing process. 

See your chiropractor or a spine specialist for a proper diagnosis before starting your exercise program. This chiropractor will send you to a physical therapist or another certified exercise or body mechanics specialist to develop the appropriate exercise and muscle strengthening program for you.

A Final Word About Sciatica

The majority of sciatica patients do not need surgery. All that is usually required is time and self-care therapy. However, if basic self-care methods do not reduce your discomfort, you should seek medical help. If necessary, your healthcare practitioner can determine the source of your pain, provide other treatments, and/or send you to additional spine health professionals.

When Should I Contact My Chiropractor?

If you have sciatica and experience these symptoms, you need to seek medical attention immediately:

  • Intense unbearable pain in your leg that lasts for more than an hour.
  • Numb or weakening muscle of the same leg.
  • Lost control of bowel and bladder can primarily be due to the cauda equina syndrome/ condition. Remember that the same situation affects the nerve bundles at the end of the spine.

Regardless of your condition and symptoms, if you are worried that you might develop the issue, you must visit your chiropractor and get checked at Realign Spine

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