Do you have a constant pain niggling at the small of your back? Does the pain coursing down your leg leave you restless, not allowing you to bat an eyelid throughout the night? Then my friend it is time to get yourself diagnosed, for chances are, that you could be suffering from sciatica.
Intrigued by the word sciatica? In a nutshell, sciatica is a common kind of pain afflicting the sciatic nerve, a large nerve that starts in the lower back at the pelvic area and travels all the way down the leg.
Before we unravel more details about sciatica, let us learn a little more about the sciatic nerve itself.
- The sciatic nerve originates near the spine and is constituted by the branches of the roots of the lumbar spinal nerves.
- It courses through the pelvis and then deep into each buttock.
- This longest and widest single nerve in the body beginning in the lower back, passing down the buttocks, extending down each leg.
Sciatica may result when a nerve root is constricted in your lower or lumbar spine – often owing to a herniated disk in your lower back. The bones or the vertebrae in the spine are interspersed with pads of cartilage called disks. Occupied with a gel like substance, they maintain the flexibility of your spine and serve as shock absorbers to protect the vertebrae when you are active.
If the outer covering of a disk ruptures, gel may leak out and place pressure on a nerve root, inducing pain in your back, leg or both. If the damaged disk is in the lower portion of your back, your buttock, leg or foot may go numb or experience a tingling sensation.
Although a herniated disk leads to sciatic nerve pain, other conditions can also exert pressure on your sciatic nerve. The causes of sciatica include the following:
- Lumbar Spinal Stenosis – Spinal Stenosis is a tapering of one or more areas in your spine – usually in your upper or lower back. When the constriction occurs in the lower spine, it may affect the lumbar and sacral nerves.
- Spondylolisthesis – This condition, usually the outcome of degenerative disk disease, occurs when one vertebra slides slightly forward over another vertebra. The unsettled bone may cramp the sciatic nerve where it leaves your spine.
- Piriformis syndrome – The piriformis muscle originates at your lower spine and links to each thighbone (femur). Piriformis syndrome happens when the muscle turns tight or recedes into spasms, exerting pressure on the sciatic nerve. Extended sitting, falls and car accidents can induce piriformis syndrome.
- Spinal tumors – In the spine tumors can originate inside the spinal cord, within the membranes that wrap the spinal cord or in the distance between the vertebrae and the spinal cord. As it grows, a tumor cramps the cord itself or the nerve roots.
- Trauma – The lumbar or sacral nerve roots can be harmed by a car accident, fall or blow.
- Sciatic nerve tumor or injury – Sometimes a tumor or injury may affect the sciatic nerve itself.
- Other causes – In some cases your physician may not be able to pin down the cause for your sciatica. A number of problems can affect your joints, bones and muscles, all of which can be potential causes for sciatic pain.
Pain that disseminates from your lower (lumbar) spine to your buttock and down the back of your leg can be regarded as the tell-tale signs of sciatica. You may experience the discomfort almost anywhere along the nerve pathway, but it particularly tends to travel down a path from your low back to your buttock and the back of your thigh and calf.
The pain can differ widely, from a delicate ache to an acute, burning experience or harrowing unease. Sometimes it may feel like a jerk or an electric shock. Coughing, sneezing or extended sitting can aggravate symptoms. Most often just one lower extremity is affected.
The symptoms of sciatica include the following:
- You might experience a pain extending along a path from your lower back to your buttock and the back of your thigh and calf.
- The nerve pathway in your leg or foot may go numb or experience muscle weakness.
- Your toes or your foot may experience a tingling sensation or a pins-and-needles feeling.
- You may lose control over your bladder or bowel. This is a symptom of cauda equine syndrome, an unusual but serious condition that calls for immediate care. If you undergo any of these symptoms, look for medical help immediately.
Time and patience usually takes care of mild sciatica. Consult your doctor if self-care measures do not work in healing your symptoms or if your pain thrives longer than a week, is acute or becomes gradually worse. Seek immediate medical help if:
- You undergo sudden, severe pain in your lower back or leg or if you experience muscle weakness or numbness in your leg.
- The pain is preceded by a violent injury, such as traffic accident.
- You have problem regulating your bowels or bladder.
Owing to the many conditions that can constrict nerve roots and induce sciatica, one patient’s treatment options may vary widely from that of the others. A combination of treatment options may often work wonders and many patients check out some combination of the following treatment options:
- The pressure on the sciatic nerve can be eased with the help of physical therapy and chiropractic treatments.
- Trying heat therapy and ice massage therapy in turns can help to ease sharp sciatic pain.
- Anti inflammatory medications like oral steroids or non-steroidal anti-inflammatory drugs may be used to provide relief from inflammation.
- Epidural steroid injections can decrease inflammation around the nerve root and the accompanying low back pain.
- To help regulate the low back pain and leg pain while conforming to other non-surgical treatments, patients may partake of pain medications.
- Surgery can also figure as a treatment option, usually succeeding a course of conservative treatments.
It is essential to keep in mind that what may be beneficial for one patient may not work for another, even if they have the same back problems. For instance, a patient who suffers from sciatica induced by herniated disc may not gain relief from traditional treatments and can be forced to opt for lumbar surgery. Another patient with sciatica from a similar kind of herniated disc may find conservative treatments to be beneficial for providing relief from low back and leg pain.
There are many myths associated with sciatica. Enlisted below are some of them and the actual facts corresponding to each of them.
Myths about sciatica
Myth: Sciatica can be done away within a few weeks employing conservative treatment methods.
Truth: This is not the case for all patients. Sciatica can last much longer, even for months, depending on the cause.
Myth: Surgery is usually considered to be the last resort for patients suffering from sciatic pain.
Truth: Although many patients shy away from surgery, for some, surgery might work wonders for pain relief. If the conservative treatments have not proved beneficial, the patient’s pain is acute, or if the patient cannot carry out his daily activities, surgery may turn out to be the most effective treatment.
Myth: It is advisable to stay in bed and refrain from physical activity when sciatica happens.
Truth: Bed rest is usually advisable for a day or two when the sciatica initially flares up. However, refraining from any activity for longer periods of time can typically induce a downward spiral where bouts of pain cause inactivity, leading to more pain and so on.
Now that you have figured out the facts about sciatica, it is time to get introduced to some exercises for sciatica.
Exercises for Sciatica
As mentioned before, exercise is usually preferred to bed rest for providing relief from sciatic pain. Patients may take it easy for a day or two after the initial flare-up of their sciatic pain but post that period a sedentary lifestyle will usually aggravate the pain. Lack of exercise and movement might decondition the back muscles and sap it of its capacity to support the back. The deconditioning and weakening may cause back injury and strain which may induce excess pain. Moreover, active exercise is important for maintaining healthy spinal disks. Motion helps in interchange of nutrients and fluids within the discs to preserve their health and stop pressure from being exerted on the sciatic nerve.
Any sciatica exercise program will include the following typical features:
- Core Muscle Strength Many sciatic exercises concentrate on imparting strength to the abdominal and back muscles in order to lend more support to the back. Stretching exercises for sciatica are aimed at muscles that induce pain when they are tight and rigid. When patients participate in a regular program of gentle strengthening and stretching exercises, they can revive quickly from a bout of sciatica and are less likely to undergo future episodes of pain.
- Specific Diagnosis Most exercise programs will be individualized to focus on the underlying cause of the patient’s sciatic pain, such as lumbar herniated disc or spinal stenosis. Performing the wrong type of exercise can aggravate the sciatic pain, so it is essential to avail of an accurate diagnosis before embarking on a program of sciatic exercises.
- Hamstring Stretching Irrespective of the diagnosis, a regular routine of hamstring stretching will be beneficial for most kinds of sciatica. The hamstrings refer to muscles at the rear of the thigh. Excessively tight hamstrings increase the stress on the low back and are responsible for some of the conditions leading to sciatica.
- Exercise correctly As mentioned in the above point, performing the right exercises but performing them sans proper form can make the exercise relatively ineffective and possibly trigger aggravated or increased pain. It is generally recommended to conform to the exercises under the vigilant eye of a properly trained medical practitioner, such as a chiropractor, physical therapist or physiatrist.
- Aerobic exercises Besides particular sciatica exercises, aerobic conditioning may also prove to be beneficial for overall body fitness. Walking is an effective form of exercise for the low back because it is considerably low impact but can render all the advantages of an aerobic workout. If possible, it is best to gradually prepare oneself for three miles of exercise walking at a swift pace each day.
Before initiating any exercise program, patients should consult a health professional to get their pain correctly diagnosed and to eliminate any serious issues. The proper exercises vary on the basis of the condition that is responsible for the sciatic pain, so patients should try not to treat their sciatica by themselves before seeking professional help.
It is said that prevention is better than cure. While it is not always possible to ward off sciatica and you may find yourself reverting back to the condition, the following are some suggestions that can play an important role in safeguarding your back.
Ways to prevent Sciatica
- Regular exercise Daily exercise is the most essential thing that you can do for your overall health as well as for your back. Focus on your core muscles- the muscles in your abdomen and lower back that are imperative for proper posture and alignment. Seek your doctor’s help to know about particular activities.
- Proper Posture You should concentrate on keeping a good posture as you take your seat. Go for a seat that renders good support to your lower back and features arm rests and a swivel base. You can also think of putting a pillow or rolled towel in the small of your back to keep up its normal curve. Maintain your knees and hips level.
- Proper body mechanics Being alert of how you stand, how you hoist heavy objects and your sleeping posture can contribute a lot towards the health of your back. That is because poor posture creates pressure on your back, causing fatigue and stress on joints and nerves.
If you stand for extended periods, place one foot on a stool or small box at small intervals. While you stand, keep the reading material at eye level instead of stretching forward.
When you pull something heavy, allow your lower extremities to take the pressure. Your movement should be straight up and down. Keep a straight back and bend only at the knees. Keep the load close to your body. Refrain from lifting and twisting at the same time. Seek help if the object is heavy or awkward or if you’re exhausted.
Sciatica is undoubtedly a condition that can spell a lot of pain for you but don’t let it get the better of you. Just follow the aforementioned ways and fight it back!
Read more about typical sciatica symptoms and treatment >>>