Sciatica: Symptoms, Cause, and Treatment
Sciatica is a symptom of pain in the lower back area, caused by compression or irritation of the sciatic nerve.
The sciatic nerve is the longest nerve in a human body, running from the back of the pelvis all the way down both legs.
Sciatica can be a symptom of several other medical conditions rather than a condition on its own, which will be described below.
Symptoms of Sciatica
Sciatica can cause several common symptoms including:
-lower back pain, ranging from very mild to very painful.
-Pain in the buttocks and legs that generally worsens during sitting period
-Weakness, numbness, and tingling sensation on the mentioned areas, especially in the affected leg and can cause difficulty of movements
-Constant pain on one side of the buttocks
Symptoms of sciatica usually affect both legs and buttocks more often than general back pain, the pain can be made worse by sitting for a long period of time, sneezing, and coughing.
Causes of Sciatica:
Sciatica is mainly caused by lower lumbar and lumbosacral spine irritation, which in turn compress and/or irritate the sciatic nerve.
This condition, however, can be caused by other medical conditions such as:
-Lumbar Herniated disc
Spinal discs act as cushions and shock absorbers between each vertebra. When a disc is damaged, it can break open and rupture creating a herniation. Herniated disc is more common for the lower back (lumbar) area rather than upper back or neck.
While a herniated disc won't cause any pain when there's no contact with the nerve, sciatica can happen when the herniated disc pressed on the sciatic nerve.
-Lumbar Spinal Stenosis
Spinal stenosis refers to the narrowing of spaces in the vertebrae (spine), which in turn will cause pressure on the nerves and the spinal cord itself. 75% of spinal stenosis occurs in the lumbar (lower back) area.
When the narrowing creates pressure to the sciatic nerve, sciatica can occur as a symptom.
-Degenerative Disc Disease
Not actually a disease as the name suggest, this condition refers to the degenerative changes on the spinal discs as we age, which can include loss of fluid in discs and tiny breakdown in the outer layer.
More commonly happen in the lower back (lumbar area), it can cause sciatica when the degenerated disc is located near the sciatic nerve.
The slipping of a vertebra caused by a fracture of one or both wing-shaped parts of the bone. When such occurrence happens, the vertebrae can slip backward of forward over the bone below.
Other common cause that may cause sciatica can include:
Pregnancy can put more strain in the lower back area, and in turn, can irritate the sciatic nerve.
Being overweight means more pressure are put on the lower back area, often compressing and irritating the sciatic nerve.
Cramping in lower back or buttocks can cause sciatica.
Being in a bad posture for a prolonged time can strain the lower back muscles and irritate the sciatic nerve.
Treatment of Sciatica
On most cases, no specific treatment is necessary for sciatica. The condition can naturally improve over the period of approximately six weeks.
However, in more severe cases, or when the pain becomes persistent, some methods of treatments are available below:
Some self-treatment to help reduce the sciatica symptoms are as follows:
1. Being Physically Active
Physical exercise will reduce the pain associated with sciatica, as well as strengthen the muscles that support the lower back area.
Bed rest, when prolonged, can be counterproductive for sciatica symptoms, and one should aim to return to being active as soon as possible.
2. Compression Packs
Using hot or cold compression packs depending on preference can reduce the severity of the pain.
When the pain becomes unmanageable, or persistent, painkilling medications such as paracetamol, ibuprofen, amitriptyline, or in more severe cases, morphine, can help reduce the associated pain.
Your general practitioner may refer you to a physiotherapist.
Physiotherapy can strengthen the lower back muscle, improve the flexibility of the spine, as well as improve your posture to reduce further strain on your lumbar.
Usually utilized for severe cases, spinal corticosteroid or local anesthetic as a strong painkiller can be an option.
Surgery is very rarely a necessity for sciatica, however, then the sciatica is a symptom of other, more severe diseases as mentioned before, surgery can be considered.
For example, herniated or slipped disc will sometimes need surgery as a necessary treatment.
Correct diagnostic of the cause is necessary before deciding a surgical option, as surgical procedures will also vary with different causes, such as:
-Laminectomy is often utilized for spinal stenosis, removing the lamina of the vertebrae
-Discectomy is more common for herniated disc, removing the part of herniated disc that pressed the sciatic nerve
-Fusion surgical method is utilized to fuse a slipped vertebra, using a cage (metal or plastic) between the vertebra to support it back to position