Sciatica in and of itself does not describe a medical diagnosis. It is actually what is known as an underlying symptom of another medical condition; most prevalently it is associated with ailments such as spinal stenosis, a herniated disc or degenerative disc disease.
It is most often described as leg pain that originates in the lower back and travels down through the buttocks and along the sciatic nerve in the back of the leg. It is often accompanied by numbness, weakness and a tingling sensation at times.
If you are suffering from what you believe to be pain related to the Sciatic nerve, it’s best to consult an experienced St. Louis chiropractor immediately.
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It often is characterized by the following symptoms:
- Pain that is definitely worse when sitting down
- It’s a pain that generally only occurs on one side of your buttocks or leg
- The pain is often described as burning, searing or tingling as opposed to a dull ache
- It’s sometimes associated with numbness, weakness or difficulty moving your leg
- The pain may be so sharp at times it makes it difficult to stand or walk
Other Facts
The symptoms of sciatica usually occur because the large sciatic nerve gets compressed or irritated in what is known as the lumbar spine. The sciatic nerve is the largest nerve that is found in the human body.
The pain can vary greatly from person to person. For one person the affliction might just be infrequent and annoying while for another person the constant sharp pain can be incapacitating. Permanent nerve damage is rarely associated with sciatica pain.
The sciatica pain symptoms that each individual person experiences are often determined by where the sciatic nerve is pinched. Over the year’s medical professionals such as doctors, chiropractors and physical therapists have learned where to target their treatments based on the pain symptoms a patient is feeling.
The Course of Sciatica Pain
The chance of developing sciatica pain increases with age. It rarely occurs before age 20, peaks when someone is in their 50’s and then for some unknown reason starts to decline again. It is an ailment that tends to develop over time instead of being the result of an injury.
More often than not, people get better within a few weeks or months and rarely is sciatica treated with surgery or other advanced forms of pain treatment. For those few that do not see improvement along this time frame their sciatica condition may be extremely excruciating and even disable them.
Common causes of Sciatica
- Lumbar herniated disc
This happens when the inner core of a disc, the softer part, starts to leak out through the much harder outer core of the disc. When this happens it irritates the nerve root in the area. This condition is also known by several other names including a ruptured disc, slipped disc or bulging disc.
- Degenerative disc disease
Disc degeneration tends to be a fairly normal part of aging but when one or more discs become problematic it can irritate the nerve root and that often causes sciatica pain. The sciatic irritation occurs from the fact that inflammatory proteins from the inside of the disc become exposed to the nerve roots in the area.
- Isthmic spondylolisthesis
This ailment shows up as the result of a small stress fracture that takes place and in turn allows a vertebra to slip forward. The forward movement of the vertebra can pinch the nerve and result in painful sciatica.
- Lumbar spinal stenosis
Thus takes place when there is a narrowing of the spinal canal. It is an age related problem in most instances and is fairly common in those adults over 60 years of age. It usually results from one or more of the following conditions taking place; the overgrowth of soft tissue in your back, the enlargement of your facet joints or a herniated disc is putting pressure on some of your nerve roots.
- Piriformis syndrome
There is a muscle in your buttocks called the piriformis muscle that the sciatica nerve runs under. Even though this is not a true clinical sciatica condition, if the muscle somehow irritates or pinches the sciatica nerve roots it often time’s results in sciatica type pain.
- Sacroiliac joint dysfunction
This condition results due to an irritation of the sacroiliac joint which is located at the bottom of your spine. When this happens sciatica type pain will sometimes occur.
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Less Common Causes of Sciatica
- Pregnancy
- Scar tissue
- Muscle strains
- Spinal tumors
- Infections
Common Symptoms of Sciatica
- Usually the pain that you experience as a result of sciatica will only be felt on one side of your body and it usually radiates down into your leg through your buttocks and lower thigh.
- If lower back pain is present it is usually less severe than your leg pain.
- The pain is fairly constant on one side and rarely if ever felt on both sides of your body.
- It is pain that feels better when laying down or walking but gets aggravated when sitting or standing.
- It can be associated with numbness or weakness down your leg.
- The pain is usually describes as sharp or a burning sensation.
- It can be hard to stand up and walk when you first start moving.
- There is a possibility the pain can even travel to your feet and toes.
Sciatica Treatments
Rarely if ever does sciatica progress to the point where surgery is necessary. Symptoms that require medical treatment immediately usually include extreme, prolonged leg weakness or bowel and bladder dysfunction such as incontinence.
As with all sciatica treatments the ultimate goal is to lessen or eliminate the corresponding pain and to alleviate any neurological symptoms which are causing the nerve root to be compressed.
If a person experiences repeated flare-ups of sciatica they will need to be treated so the pain does not get worse as time passes. Here are some non-surgical methods for treatment of the pain and that can help to prevent the condition from getting worse:
- Sciatica Exercises
Exercise can help realign the area that often affects the sciatic nerve. It can also loosen the area so pinching of the nerve is lessened or eliminated altogether. This should be undertaken in a structured approach and should start out slowly at first. If you suffer from severe sciatica pain you may even have to wait a day or two in between sciatica exercises.
- Heat or Ice
Many patients have found pain relief from sciatica by applying heat to the area or ice packs. Some people prefer one over the other and for some patients a combination of both works best. It is preferred in most cases to try ice packs first. These treatments are usually applied in 20 minute increments.
- Pain Medications
Both prescription and over the counter medicines have shown to be effective for treating sciatic nerve pain. NSAID’s such as ibuprofen and naproxen or oral steroids work by reducing the inflammation that often contributes greatly to sciatica pain.
- Epidural Steroid Injections
These injections have also been found to reduce inflammation that causes sciatica pain. They are most often used in cases where the sciatica pain is extremely severe. It is a much more localized treatment than is taking oral steroids because it’s injected right into the painful area that is causing the problem. The effects of the injection last for varying amounts of time; for some it may only last a week while for others it may bring a year or more of relief. Perhaps the most vital point of injections is that they usually will allow a patient to progress to the point where they can start doing sciatica relief exercises.
Alternative Forms of Treatment
In addition to standard forms of medical treatment, alternative medical treatments have also been proven very effective in eliminating sciatica conditions and eliminating sciatic nerve pain. Here are three of the most popular alternative forms of sciatica treatment:
- Chiropractic Manipulation
These are highly trained health professionals that specialize in spinal adjustments. Their main area of concern is to properly align your spine so that compressed nerves and other underlying spinal conditions are lessened or eliminated. These are very effective methods to treat sciatica pain. These manipulations also help to create a much better healing environment for your body.
- Acupuncture
This is the practice of achieving open energy flow throughout the body by using nerve pathways. It is an approved method by the FDA for relieving back pain and is also recognized as an effective back and sciatica pain treatment by the National Institute of Health. It involves placing hair thin needles in specific places in the body that are known to relieve pain.
- Massage Therapy
Massage therapy has many benefits for the body including the relief of back pain and sciatica pain. It helps to improve blood circulation, relaxes muscles, releases the body’s natural pain relievers called endorphins and helps to reduce stress.
- Physical Therapy
These medical professionals are experts in establishing supervised exercise and stretching programs that will do such things as help relieve and eliminate sciatica pain. They also use techniques that involve the electrical stimulation of muscles to speed healing.
The ultimate goal of any alternative sciatica treatment is to lessen sciatica pain and prevent its recurrence.
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Exercises
The Good news for most people is that sciatica problems almost always get better on their own and often times the healing process will take only a few days or weeks. The vast majority of sciatica cases are healed in less than 12 weeks. Following the initial goal of sciatica pain relief the treatment will turn its attention toward sciatica nerve pain elimination and the prevention of its recurrence. This is often done through exercise.
These exercise routines tend to combine exercises that focus on building strength, increasing flexibility and also stretching problem areas to avoid things such as nerve compression. They will usually have an aerobic conditioning element to them also. These programs usually start with very gentle exercises and progress to more strenuous exercise as the patient’s condition improves.
- Strengthening Exercises
These types of exercises are great for sciatica relief because they help strengthen the support structure of your spinal column by focusing on muscles, tendons and ligaments. As far as sciatica treatment goes, these exercises usually concentrate on the buttocks, lower back, stomach and hip muscles. A strong spine naturally stays in alignment and is more flexible so it can resist injury better when your spine is extended or twisted.
- Stretching
This is highly recommended in the case of sciatica pain because it will target muscles that may be causing it because they have become very tight and inflexible. Hamstring stretching exercises are particularly effective in alleviating sciatic nerve pain.
- Low Impact Aerobic Exercise
The key words here are ‘low impact’. Cardiovascular exercises help to create a much better healing environment for your body. These can include such normal everyday activities as walking, swimming or riding a bike. Aerobic conditioning also spurs on the release of endorphins which as stated before are your body’s natural pain remedy.
Surgery to Treat Sciatica Pain
There are a few situations where people suffering from sciatica pain may want to consider surgery:
- The duration of the pain in the leg has lasted more than 6 weeks and the pain is severe and debilitating.
- A variety of non-surgical techniques have not had the desired effect of lessening the pain or correcting the condition.
- The sciatica pain is impacting your daily life by limiting your participation at work, home and at other activities.
- Urgent surgery may be necessary if the pain is making your legs severely weak or it’s affecting your bowel and bladder control.
The decision to have surgery is almost always left entirely up to the patient. The good news is that surgery helps lessen the severity or eliminate sciatica pain over 90% of the time.
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