Do you wake up in the morning with lower back pain? Do you experience tingling sensations or numbness that runs down the back of your leg? You may be one of the 3.7 million Aussies suffering from chronic back pain. Sciatica is one of the most common causes of chronic lower back or nerve leg pain and it can be extremely difficult or even debilitating for some people.
In this post, we’re going to talk about the causes of sciatica and how you can treat it.
Do you know what sciatica is?
The sciatic nerve is one of the larger nerves of the body, formed from nerve roots that originate in the spinal column. The sciatic nerve controls sensation and function in the legs and feet. The nerve passes between the discs of your spine and extends from the lower back, through the buttocks and down into both feet.
If the sciatic nerve receives pressure at any point on its pathway, it may cause pain. This pressure irritates the nerve and causes pain and stiffness. When the pain spreads to your hips, knee or feet, it is called referred pain. People suffering from sciatica may also feel pain when moving from standing to sitting position, sneezing or coughing, or during bowel movements.
What are the causes of sciatica?
Sciatica usually occurs when the nerve is irritated by pressure caused by bulging or ‘slipped’ discs in the spinal cord or by muscles that are too tight or too weak. In rare cases, the pressure could be caused by a bone spur or a tumour pressing on either the nerve or vertebrae.
The most common causes are:
- Tight or inflamed muscles in the glutes
- Degeneration of spinal discs due to age
- Added pressure on the spine due to obesity
- Career hazards like heavy lifting or long hours of sitting
- Nerve damage caused by chronic conditions like diabetes
- Spinal injury or trauma
- Bone spurs or other forms of growth
- Narrowing of the nerve tunnel between discs due to osteoarthritis
- Narrowing of the spinal canal
What are the symptoms of sciatica?
The most common symptoms of sciatica are:
- Pain in the lower spine or at any point along the sciatic nerve pathway
- Pain or spasms in the lower back when coughing or sneezing
- Numbness, tingling or muscle weakness in the foot or leg
- Pain in the muscles of the buttock
- Aches in the hamstring and calf
- Pain in the ankle and foot
- Constant sensation of pins and needles
- Increased pain or stiffness when lifting or straining
- Sudden loss of power and strength in the muscles of the leg and foot
When should I see a doctor?
Do keep in mind that some of the symptoms may be caused by something other than sciatica. If you aren’t sure, it is best to consult your GP.
In most cases of sciatica the symptoms tend to pass in a few days. If they persist for more than a week, medical care should be considered, particularly if you experience more serious symptoms like:
• Sudden or serve lower back pain, numbness or muscle weakness
• Traffic accidents that have resulted in back pain
• Bowels or bladder changes
To diagnose sciatica, the expert will take a medical history and examine your spine and legs. The doctor performs a physical examination to assess both muscle strength and reflexes, as well as a series of stretching and movement activities. Medical imaging tests may be required to identify herniated disks or bone spurs.
What is the treatment plan and outlook for sciatica?
Until recently, complete bed rest was recommended for sciatica treatment. However with recent research, it is believed that bed rest may offer only minimal improvement or may even worsen the condition. Sciatica therapies are centered around minimally invasive treatment like physiotherapy or treating symptoms with anti-inflammatory gels, heat treatment or medication.
The choice of sciatica therapies depends on the length of symptoms and severity of your condition. The initial treatments include the following:
- Lifestyle changes
- Pain-relieving or anti-inflammatory medication
- Manipulative therapies such as chiropractic or physiotherapy
Surgery or invasive treatments are only considered as a last resort for extremely severe cases and may include:
- Epidural injections – medication injected directly into the spine
- Chemonucleolysis – Injection of a special enzyme into the disk
Most cases of mild sciatica usually heal by themselves given time. Conservative treatments which include physical therapies can help expedite the process. When you first experience sciatica, bed rest for a day or two is recommended. However it is important to return to activity as soon as possible to help your spine stay strong.
In severe cases, treatments like steroid injections (in which pain medication is injected directly into the painful area to help reduce the inflammation) may help. Surgery is only recommended to people who are experiencing significant leg weakness and bowel/ bladder problems. The surgery for sciatica consists of removing the bone spur or some of the herniated disk but may not always totally relieve the pain.
You should see a medical practitioner again if the above measures do not prove to be effective. If your pain lasts longer than a week, is severe or becomes progressively worse. You could consider the following sciatica professionals:
- Your doctor
- Osteopathic practitioner
What self-care measures can I take for sciatica to manage nerve leg pain?
The discomfort of sciatica can be managed at home by the following:
- Rest but not prolonged bedrest
- Prescribed medication like mild painkillers or muscle relaxants
- Ice or heat treatment
- Improving posture
- Avoiding the exertion of bending, flexing or lifting heavy weights
- Warm baths
- Ergonomic mattress and furniture such as chairs with lumbar support
- Stretching or gentle strength building exercises to support the lower back
- Keeping weight under check
- Staying hydrated to keep muscles flexible
It is highly recommended to make a habit of these self-care methods to avoid reoccurrence. Staying active is the go-to option for sciatica, unless you have been otherwise instructed. Gentle exercises like yoga or swimming have proven to help with pain management.
Physical therapy for sciatica
Physiotherapy or chiropractic care are effective long-term solutions for managing sciatic pain. All the physical therapies involve improving mobility and posture, stabilizing and relaxing muscles, building strength, and reducing pain.
Most physical therapy requires a duration of supervised exercise so that you can learn the correct way to perform movements or exercise. After that you can add these therapeutic exercises to your routine to help improve pain and ward off future bouts of sciatica.
Remember that the effective reduction of your symptoms depends on the origin, history, diagnosis and professionally guided course of action for your specific condition. The biggest deciding factor when it comes to the speed of your sciatica recovery is YOU. You can increase the pace of recovery by maintaining regular physical activity and following the treatment plan that is tailored to your requirements.