Sciatica is one of the most common painful affections out there, and it comes with a plethora of unpleasant symptoms that could affect the quality of life. Generally speaking, it can be caused by inflammation or irritation of a nerve. However, pinching is just as common, not to mention the compression of the nerve. The affected nerve is located in the lower back. All these signs have one thing in common – a slipped or herniated disc. As a result, the nerve root is under pressure.
If there is one good news about sciatica, that is the fact that most people can have it ameliorated with time – sometimes, even without treatment. Then, there are also self-care or homemade treatments that will ameliorate the condition. But before getting there, it is important to know a few things about sciatica, understand how it works and who is more exposed to it. So, what can you do to prevent or treat this unpleasant affection?
What is Sciatica?
Sciatica is easy to describe as nerve pain – simple as that. It is caused by injuries to the sciatica nerve. The condition can occur even without an apparent injury – irritation is just as common. Such issues usually arise around the glutes or buttocks. This nerve is easy to get affected because it is the largest in the body. It is also thick and long – about the same thickness as a finger. It consists of a few different nerve roots. Two of them come from the lower back area, while the other three come from the final part of your spine. These roots all come together to create the sciatic nerve.
The nerve runs in two different directions, through each side of the body. Initially, it goes through the hips and the buttocks. It follows down through the leg and ends under the knee. Then, it is split into a few other nerves. These nerves go further down and run through the toes as well.
While injuries are among the causes of sciatica, the truth is such things are extremely rare because injuring this nerve is difficult. In other words, the actual sciatica is basically the pain. It initially begins in the lower back. If left untreated or if the causes are not removed, it will go down through the leg. The so-called injury to your nerve is basically an inflammation or an irritation. The problem also occurs when the nerve is compressed or pinched.
People with sciatica will experience all kinds of problems. Initially, pains are mild and less likely to affect everyday activities. With time, they become more severe, and they spread. Such issues can occur anywhere along the nerve. Simply put, you may experience problems in the lower back, but you may also feel it in your hips. It can affect the legs, as well as the buttocks. As it spreads down through the leg, you will feel weakness and numbness as well. Every now and then, tingling sensations will occur and can go to your toes too.
Symptoms
If you ask five different people how they feel with sciatica, they may give you five different answers. The truth is the pain varies widely, and it depends on the actual cause. For example, you might experience occasional jolts of pain. Some others will feel shooting sensations or sharp painful sensations. Then, you may also feel burning sensations – sciatica may feel like stabbing, or perhaps it brings in an electrifying feeling.
Sometimes, the pain is consistent. While you could get used to it, it may also cause distress. Other times, the pain comes and goes out of nowhere. If it affects the leg as well, it tends to be more severe than in your lower back. As you sit down or stand for long times, the pain will intensify. It can also become more severe when you twist the upper part of the body. Sudden movements will also intensify the pain – such as a sneeze or perhaps a deep cough.
Sciatica is less likely to affect both legs at the same time, but it is not impossible either. Most people will only experience it in one leg only. But then, it all depends on where the nerve is pinched. There are more areas over the spinal column that could affect it, so this is the main factor.
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Causes
There are more causes behind sciatica, and some of them are actually related to medical conditions. Even if the cause is not an actual disease, it is often medically related. For instance, a slipped, or herniated disc is the main cause of sciatica. Such an issue will add pressure on the nerve root. The problem is quite common – only in the USA, 20% of all people will experience a slipped disc at some point.
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A disc is like a pad. It is like a cushion. There is always a disc between two vertebrae in the spine. The disc has a soft central part, which is like gel. When there is too much pressure on the disc, one of its outer walls will crack. At this point, the gel will simply bulge. Such things can target every disc in your spine. When it happens around the vertebrae in the lower back, it will affect the sciatic nerve, hence the associated pains.
1. Degenerative disc disease
The degenerative disc disease is not to be overlooked either. Basically, the discs between your vertebrae will wear down. After a certain age, it becomes a natural process that everyone goes through. But if it occurs while you are still young, it is associated with a medical condition. As the discs lower down, the height will also go down. The passageways are narrower, meaning the sciatic nerve roots can be easily pinched as they go out of the spine.
As these passageways become narrow, the issue is referred to as spinal stenosis. It is not always caused by the degenerative disc disease – at times, it could kick in by itself. When it is an actual problem itself, it abnormally narrows the spinal canal. There is less space for the cord and nerves, hence the problem.
2. Spondylolisthesis
Spondylolisthesis is another common problem that may lead to sciatica. It occurs when one of your vertebrae slips a little. It is out of line with the other vertebrae, but especially with the ones next to it. At this time, the space required for the nerve to exit is dramatically reduced. As a direct consequence, the spinal bone will pinch the nerve, causing sciatica.
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3. Osteoarthritis
Osteoarthritis is even more common and can easily cause sciatica. It tends to occur in older individuals. Bones wear out, as well as the spine. As a result, the lower back nerves will be compressed, and the sciatic nerve makes no exception either.
4. Tumors
Tumors might as well be among the causes of sciatica, yet these things are rare. However, a tumor growing in the lumbar spinal canal will put pressure on the sciatic nerve. It will compress it and cause unpleasant pains.
5. Piriformis syndrome
The piriformis syndrome is also quite rare, yet the condition can occur and cause sciatica. Just like the name clearly mentions it, it affects the piriformis muscle. The muscle is quite small and located in the buttocks. As it tightens, it experiences spasms. All these spasms will pressure the sciatic nerve and cause all kinds of problems.
On the same note, the cauda equina syndrome is even rarer, but it is more serious. It targets a few different nerves by the end of the spinal cord. All these nerves are known as cauda equina. The condition will trigger harsh pains through the leg, as well as numbness and loss of bladder control. The bowel is also affected.
Apart from all these medical issues, a traumatic injury will also cause sciatica, especially if it affects the lumbar part of your spine or the actual sciatic nerve.
Risk factors
Sciatica is more or less likely to occur based on different lifestyle factors. For example, if you have an injury, the risk is much higher. Even if the injury does not cause sciatica straight away, you have some weakness and it may lead to it overtime. Lower back injuries are quite varied. Past injuries are also harmful because even if they occurred long ago and you are healed, there is still some weakness in the area.
1. Aging
Life is also a cause of sciatica. Sciatica is often associated with the natural aging process. Basically, your bones will deteriorate overtime. Spinal discs will also wear down – it is perfectly normal though. Normal aging will affect the nerves as well, so they are more likely to be pinched or injured. Any change could be an issue in the long run.
2. Being overweight
On the other hand, overweight individuals could experience the same issues. Try to see the spine as a crane – a vertical one. Holding a bit of weight will be alright. After all, your muscles work like counterweights. But then, everything you have in front of the body will be the weight your back needs to pull. The heavier you are, the more your muscles will need support. Being overweight can cause a plethora of back issues, pains, and strains.
From the same point of view, it might be handy having a strong core too. The core is the upper part of your body, and muscles you need to focus on include the abdomen and back. If you have a strong core, you will be properly able to support the lower back and everything around the spine. Now, imagine your chest – the rib cage is supportive enough for that area. However, the lower back does not have such a cage, so you will need to rely on muscles.
Your job may also contribute to the development of sciatica. An active job will put pressure on your whole body, and the back makes no exception. The more physical it is, the more likely you are to experience sciatica. For instance, working in a small shop is different from working in a warehouse, where you might need to do a lot of lifting. While it may seem relaxing, an office job with long sitting hours will also increase the risk of lower back issues.
3. Other affections
Certain affections will lead to sciatica as well. Diabetes is known for causing lots of damage throughout the body, and it may also increase the chance to end up with nerve damage – inevitably, sciatica will kick in. Osteoarthritis is similar. It can damage the spine and expose the nerves to all kinds of risks – injuries are only one step away.
While a demanding job could be an issue, having an inactive lifestyle is just as problematic. Sit down for hours on a daily basis and ignore exercises – your muscles will weaken. They need to be stimulated and challenged to be efficient. As they fail to stay toned and flexible, you have a higher risk of developing sciatica.
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Last, but not least, certain life factors could be an issue as well. If you smoke, you have a higher risk of developing sciatica. Nicotine will damage the spinal tissues and affect bones. It speeds the aging process, and vertebral discs will go in the same direction.
4. Pregnancy
Now, sciatica is extremely common in pregnant women. Most people naturally assume that the extra weight of the baby adds to the risks. However, this is not really the main cause behind the incidence of sciatica in pregnant women. In fact, some hormones will be imbalanced and cause the loosening of various ligaments. Ligaments hold the spine together and keep the discs protected. Since they are loosened, they will turn slightly unstable. Discs may slip, and nerves could get easily pinched. The position of the baby will also add to the pressure.
The best part about it is that pregnant women can ease the pain throughout pregnancy, and it will also fade away after birth. Physical therapy will also help, as well as massages, showers, heat, and so on. Practicing good posture will also ease the discomfort.
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Signs
Symptoms of sciatica are quite straightforward and bring in a series of painful sensations. Pain can be moderate, but it can also turn severe if the affection is left untreated and the causes are not eliminated. The pain will most commonly affect the lower back, but it can also go through the buttocks and down the legs.
Apart from pain, weakness will inevitably target the affected areas. It may go even further and affect the feet too. The same goes for numbness. If the pain tends to aggravate with movement, chances are you suffer from sciatica. At some point, it can be severe and prevent movements at all.
When it goes down the leg, it might be perceived in different ways too. For instance, you could feel needles in your legs, feet, and toes.
In rare cases – when sciatica is caused by the cauda equina syndrome, loss of bladder and bowel control may also occur.
Diagnosis
The medical history plays an important role in the diagnosis of sciatica because it can provide lots of details regarding the potential causes. Then, you will need to mention all the symptoms and their frequency. As you go through a medical exam, you will need to walk around for the doctor to see how you carry the weight – they will pay attention to your spine as well. You may need to lie on the back and keep the legs straight – the doctor will lift one leg at a time to see when the pain begins.
This kind of procedure shows the doctor which nerves are more likely to be affected. Moreover, the doctor can determine whether or not you have disc problems. A few stretches will also help. This is the basic test, but further research might be needed. For instance, the doctor may ask for spinal X-rays. This way, they need to see potential tumors, infections, or disc-related issues or fractures.
MRI and CT scans may also be required if your problem is more complex. They will also provide highly detailed images of the bones, as well as the soft tissues around them. A simple MRI scan will show pressure on certain nerves, but it will also identify a potential arthritis or a herniated disc. MRI scans are almost always performed – even if the affection has already been diagnosed, they basically confirm it.
Other potential tests done include electromyography or a myelogram.
Treatment
The primary purpose of a treatment for sciatica is to help the patient overcome the pain. Since the pain also reduces the overall mobility, it will also work on this aspect. Now, each cause asks for a different treatment. Unless you have been through an accident or a severe injury, chances are you can overcome sciatica with homemade treatments. You will, indeed, need a doctor to diagnose the affection, but then, self-care treatments will get you back on your feet.
1. Ice and hot packs
There are more self-care treatments out there, and finding a mix of different therapies is the way to go. For example, apply ice and hot packs on a daily basis. Initially, you need to begin this therapy with ice packs. Ice will annihilate the swelling, but also the pain. You do not necessarily need to get ice – a bag of frozen vegetables will do. Apply such packs for not more than 20 minutes, but do it a few times a day. Once you are done with the ice, apply a hot pack or a heating pad. Again, you will need it for 20 minutes. If you still experience pain, alternate between them and see which one helps.
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2. NSAIDs
Your doctor may also recommend some over the counter drugs. They are meant to reduce inflammation and swelling. NSAIDs are the most common options out there and include aspirin, ibuprofen, and other painkillers. Since these are actual medications, they will come with potential side effects, especially the aspirin. You do have alternatives if you cannot take NSAIDs.
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3. Exercise
Other than that, a bit of exercise will also help with your mobility. You do not need anything intense, but just simple stretches. Whether you ask the doctor or a specialized fitness instructor, stretching exercises are the most common options out there. If they feel comfortable, core strengthening exercises are also recommended.
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Every patient experiences sciatica in a different way. The above-mentioned self-care treatments can be done at home without even seeing a doctor. But then, pain is different, as well as its intensity. Moreover, sciatica has numerous cases. Sometimes, it can be quite aggressive and seriously limit the patient’s mobility. Generally speaking, you can try the self-care treatments for about six weeks, on a daily basis. If you cannot see any improvements, you should reach your doctor.
4. Prescription medications
Prescription medications might be the next step forward. You will most likely be given muscle relaxants. They prevent the discomfort and muscular spasms. Prescription pain killers are also common. It normally depends on how intense the pain is.
5. Physical therapy
Physical therapy is also a step forward. You need to find exercises that reduce the affection by working on the nerve pressure. Stretching exercises are the most popular ones. They improve the flexibility. Aerobic exercises are also recommended. Your doctor may also send you to a physical therapist to customize the treatment and find what truly works for you.
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6. Spinal injections
Spinal injections represent one of the last options – you will usually get anti-inflammatory drugs. They go in the lower back, and their main role is to reduce the swelling. Injections are given with anesthesia, and they usually provide relief for about three months. Ideally, you should try to find a better solution that targets the actual cause.
7. Alternative therapies
Finally, alternative therapies have gained lots of notoriety lately. They manage different types of pain, and sciatica makes no exception either. Yoga is a good starting point, but you can also see a chiropractor or try acupuncture. Massages will provide pain relief too.
When surgery becomes an option
No one really wants to get there, but surgery is a last resort. It is the last option, and it is recommended in severe cases. Spinal surgery becomes your last option when nothing else works. You have tried everything for months, and nothing works. Instead of experiencing pain relief, the pain actually aggravates, so your problem is quite severe. Moreover, you experience weakness. Your muscles will feel weak. In some cases, patients even lose bladder or bowel control.
Surgery can also be recommended earlier than that. It depends on the actual cause of the affection. If you have a year of symptoms and the pain does not go away, chances are you need surgery. Pain is severe, and you can barely stand anymore. You will be admitted to a hospital, and a few tests will be performed. If you have already lost bladder or bowel control, surgery becomes a bit of an emergency – these signs are usually associated with the cauda equine syndrome.
The surgery will usually clear out the pressure on the nerves. Certain nerves are pinched or pressured due to instability in the spine. The surgery will remove this pressure.
There is a different type of surgery that might relieve sciatica too. The so-called microdiscectomy is not too invasive. It is tiny and removes pieces of herniated discs that put pressure on nerves. On the other hand, during a laminectomy, a part of the vertebral bone that could pressure the nerve will be removed. The doctor will decide what type of surgery is more suitable for your situation.
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Disc herniation and sciatica
Sciatica can hit out of nowhere, but it can also develop gradually. It depends on more factors, and the cause is one of them. For example, a disc herniation will bring it in suddenly. You will experience the pain straight away. On the other hand, if you suffer from arthritis, chances are the pain will get in gradually, and you may not notice it until it is too intense.
Sciatica is quite common. Up to 40% of all people in the western world will have sciatica episodes at some point or another. Again, it can be treated and may never come back. But then, many jobs can cause it, as well as an unhealthy lifestyle. In fact, back pain is one of the most common causes, and for this people reach their doctors.
Conclusion
Bottom line, sciatica is less likely to require surgery. Most cases can be handled with self-care treatments or even medical treatments. Time is also a top requirement to overcome this condition. Obviously, if such therapies and time will not help you cure sciatica, you will need to see a specialist doctor. The doctor will analyze the pain and recommend other options as well. Surgery is rarely needed and only in extremely severe cases, so there is not much to worry about.
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