Sciatica, or sciatic nerve pain, can be extremely painful. This back and leg pain is widely experienced and may affect up to 40% of the population. For some, the pain may be slight, but others may suffer significantly from its debilitating effects.
It is important to understand the possible causes of sciatica, as well as the symptoms, so you can recognize them if they occur. You can also learn your risk factors for sciatica, and how you may be able to manage it through treatment and physical therapy.
What is sciatica?
Sciatica is a term that refers to pain of the sciatic nerve. Your two sciatic nerves are the largest in your body. They run from the lower spine down through the buttocks and into each leg, all the way to the foot.
Because of the extension of this nerve, sciatica might be experienced at several points in the body. You might feel pain in your back, buttocks or legs, or more than one area.
There are several possible causes for sciatica. However, the cause of a person’s sciatica is not always clear, even if they have been thoroughly tested.
Sciatica can be linked to another injury or condition. It is not a specific medical condition with a single cause, rather the experience of pain in the nerve. As a result, symptoms, complications, and treatment may vary.
Common sciatica symptoms
Although sciatica is considered a symptom rather than a condition, it has its own connected symptoms as well. The most recognizable sign of sciatica is a shooting pain that radiates from the lower spine, into the buttocks and through the back of the thigh and calf. This is generally felt on one side only.
The type of pain can vary. Some might experience it as a stabbing; others may feel a sharp burning, while others feel a shock. The level of pain can also be experienced differently. Some may only feel a slight ache, while others struggle to walk or stand with the pain.
Often, actions such as twisting or bending over can increase the pain. Coughing or sneezing could also affect it. As well as pain, sciatica can cause a feeling of numbness along the area of the nerve. You may experience a tingling sensation, similar to pins and needles.
If you experience sciatic pain as a result of a separate condition, you may have other symptoms as well.
While sciatica may simply be experienced as pain, some patients may also experience complications. The pain in the sciatic nerve is caused by pressure, and prolonged pressure can potentially cause damage.
You may lose feeling in the affected leg, or even experience weakness and an inability to control the limb. In extreme cases, permanent nerve damage could result from continued pressure. Some patients may experience a loss of bladder or bowel control.
The cause behind sciatica may also grow worse if left untreated. For example, slight damage to your spine may gradually worsen, causing further complications.
Common causes of sciatica
The most common cause of sciatica is a herniated disc. This means a disc in your spine has slipped out of position and is pressing or pinching the nerve. However, there are many other reasons your nerve might be compressed.
In some cases, a bone spur on one of your vertebrae can cause the compression. A tumor or epidural abscess could also have this effect if pressed against your spine. Nerve damage caused by a condition such as diabetes could result in pain in the sciatic nerve. Conditions that narrow the spine, such as spinal stenosis, may also be linked to sciatica.
Pressure on your spine from physical positioning can result in sciatica. Those who sit for long periods every day may develop sciatica as a result of poor posture.
Confusion with back pain
Sciatica is often confused with back pain. Sciatica may be felt around the lower back or pelvis, but it is not interchangeable with other forms of back pain. Some back pains may be muscular, while sciatica is specifically related to your nerves.
If you have sciatica, it will only affect the lowest part of your back. It is also likely to affect one of your legs, rather than only your back.
Also, the symptoms of sciatica are generally restricted to one of the sciatic nerves. You are unlikely to feel pain in both branches at the same time, although this is possible.
This condition is often confused with sciatica, as they share many of the same symptoms. Both result in pain of the sciatic nerve. However, piriformis syndrome is caused by pressure from the piriformis muscle, which if found in the buttocks.
While sciatica is not a specific diagnosis, there is a common understanding that it is related to pressure on the spine. Because of this, piriformis generally is treated as a separate condition. Your doctor may test to determine whether you have piriformis syndrome, rather than sciatica.
Some treatments used for sciatica, however, including physical therapy, massage, and stretching, can also help the piriformis muscle.
Health risk factors
Your age can affect the chances of sciatica. It most commonly affects those between the ages of 30 and 50. Those under 20 are unlikely to have sciatica unless it is the result of physical trauma. As you age, the underlying causes of sciatica such as bone spurs, become more likely.
Those who lead less active lifestyles may be at a greater risk for sciatica. Obesity means additional weight and pressure on your spine. If you have diabetes, there is an added risk of nerve damage leading to sciatica.
Those with more active lifestyles are more likely to have well developed core strength. Core strength supports your spine, relieving the pressure that could cause sciatica.
Mechanical risk factors
Poor posture dramatically increases your risk for sciatica. This is a particular risk for those with sedentary lifestyles and desk jobs. However, in a more active job, there may be some risk of sciatica as well. If you have a job that requires heavy lifting, or actions such as turning or twisting, a lack of correct posture could result in sciatica.
Consider speaking to a chiropractor
If you have tried a number of home treatment options, and sciatica has continued, you may need to speak with a chiropractor. It is particularly important to do this if your symptoms are worsening, or if you have developed a fever.
Even if your symptoms are not growing worse, it may be advisable to seek help if the sciatica is preventing you from completing everyday tasks.
Seek treatment immediately
Some of the more severe sciatica symptoms require treatment as soon as possible. This includes a loss of bowel or bladder control, which can indicate nerve damage.
If you experience pain, weakness, or numbness in your legs, seek treatment soon. Experiencing pain on both sides can also require treatment. If your sciatica was treated successfully and then returned, you should seek treatment.
If you have previously had cancer, it is advisable to seek treatment as soon as you experience any significant back or leg pain.
Your chiropractor will take a history to determine the cause of your sciatica. This may include giving information about your lifestyle or work environment. The type of pain or numbness you have experienced, as well as its location, will affect the diagnosis.
You must inform your chiropractor if you have had any recent injuries, as these may have caused sciatica. He or she will ask about your recent symptoms, and whether you have experienced significant issues such as loss of bowel control.
Recent weight loss, or a history of cancer, should be considered when the doctor diagnoses you.
Generally, your chiropractor can diagnose sciatica based on your symptoms. However, he or she might also wish to perform a physical examination. You may be asked to perform actions such as a squat or to walk on your heels or toes. Any pain experienced during these actions can help the diagnosis.
A common diagnostic tool for sciatica is the straight leg raise test. This involves lying flat on your back and lifting one leg at a time. The leg is kept straight and lifted from the hip. Often, those with a herniated disk will experience pain when their leg is between a 30 and a 70-degree angle. This is also known as Lasègue’s sign.
Although common, the straight leg raise is not enough to diagnose sciatica on its own. Your chiropractor will need additional information before making a decision.
In some cases, your chiropractor may wish to use imaging tests to determine the cause of your pain. An x-ray may be used to see whether any abnormalities of the spine could be causing sciatica.
You might also have an MRI test. This allows the doctor to look at your internal organs and body structures. Other tests might be administered to assess your leg or lower back muscles.
These tests are only called for if other treatment has not worked after the pain has continued for a prolonged period.
Average duration of sciatica
In general, sciatica will only last for a few weeks. While the symptoms can go away on their own, you can still use various treatment options to relieve the pain. You can also obtain advice on how to prevent any future occurrences. If the symptoms persist, and your self-care has not worked, it is advisable to seek medical help.
Chiropractic therapy with lower back pain exercises can be one of the best ways to manage the pain of sciatica. By stretching and rotating your spine and legs, you can provide relief on the affected points.
Recommended stretches are often those that involve the hamstring, or hip rotation. For example, lying on your back and raising your knee to your chest is sometimes suggested, as are standing hamstring stretches. You may also find relief in stretches that involve crossing one leg over the other.
It can be particularly helpful to have a professional help you with these stretches. A professional can ensure you are performing the stretches correctly, preventing the risk of further injury. He or she can develop a routine for you to follow at home.
You could also combine your therapy with the benefits of massage.
While some rest can be beneficial, remaining immobile in a seated or prone position might make your symptoms worse.
Your chiropractor might advise you to rest after you first experience sciatic pain. However, this will only be for a short while, after which exercise is generally recommended.
Gentle, exercise is advisable after the pain of an initial sciatica flare-up has dissipated. This can include aerobics, swimming, cycling on a stationary bike, and yoga. Low-impact exercise limits the risk of injury while allowing you to build strength.
It is particularly important to develop an exercise routine during the recovery period. Building strength is a vital step in ensuring you do not suffer a future attack. Increased core and muscle strength means there will be less pressure on your spine as you sit or perform everyday activities.
Using a combination of hot and cold compresses is a common treatment for sciatica. These are a simple way to relax and relieve pain.
You should be careful of the heat level you use. If your skin is numb as a result of your symptoms, you might not notice if a heat source begins to scald you.
The pain of sciatica might be managed through medication. This will often be non-steroidal anti-inflammatory medications, such as ibuprofen. If the pain persists for an extended period, some patients might be given steroids in pill form.
In some cases, steroid injections might be administered. However, these do not affect every patient’s pain levels. It is important to speak with your doctor before taking any medication for a prolonged period.
If all treatments fail, your physician and chiropractor may suggest surgery. This will only be recommended if the underlying cause of sciatica cannot be treated naturally. The type of surgery will depend on the cause of the sciatica.
At Michigan Chiropractic Specialists, we can help you alleviate discomfort and identify the source of your sciatica pain. Contact our practice today for a consultation so that we can get you back to your best health and your daily routine.