Sciatica is a common condition that refers to pain that radiates along the sciatic nerve. The sciatic nerve is a long, thick nerve that extends from the lower back, through the hips and buttocks, and down each leg to the feet. If the sciatic nerve is compressed or irritated, it can cause sciatica. Although the pain associated with sciatica can be extremely painful, most cases can be treated successfully with nonsurgical methods.
What Causes Sciatica?
Sciatica is the result of something pinching or rubbing the sciatic nerve. It can be caused by a number of different conditions but the most common cause is a herniated disc. This is when the soft cushion of tissue between the spinal bones (vertebrae) leaks out and presses on nearby nerves, including the sciatic nerve. Other causes of sciatica include back injuries, an overgrowth of bone on the vertebrae (bone spur), and spinal stenosis, which involves the narrowing of the spinal canal and compression of spinal nerves. In rare cases, the sciatic nerve can be compressed by a tumor or damaged by a disease (such as diabetes).
There are a number of factors that can increase the risk of developing sciatica, including:
- Age-related changes in the spine
- Obesity (increases stress on the spine)
- A sedentary lifestyle or prolonged sitting
- Diabetes (increased risk of nerve damage)
- Occupation (jobs that involve sitting for long periods, carrying heavy loads, or twisting of the spine)
- Smoking
Symptoms
Sciatica typically only affects one side of the body, and the primary symptom is pain that radiates from the lower back to the buttock and down the back of the leg. The pain can vary from a mild ache to a sharp stabbing, burning, or shooting sensation. Some even experience excruciating pain as well as tingling, numbness, and muscle weakness in the buttocks, legs and/or feet. Prolonged sitting, certain movements, or sneezing and coughing can also aggravate symptoms.
Mild sciatica often goes away over time and can usually be alleviated with self-care treatments such as rest and over-the-counter pain relief and anti-inflammatory medications. If self-care fails to work successfully, or if pain lasts longer than a week or gets progressively worse, you should see your doctor. Seek prompt medical care if you have:
- Sudden, severe pain in the lower back or leg with numbness or muscle weakness in the leg
- Trouble controlling the bowel or bladder
- Pain following a violent injury such as an auto accident
Diagnosis
In order to treat the symptoms of sciatica appropriately, your doctor will perform a physical examination and ask about your symptoms and medical history in order to determine the cause of the sciatica. Your doctor may also order lab results or imaging tests in order to diagnose the cause correctly. These can include:
- X-ray
- MRI (Magnetic Resonance Imaging)
- CT (Computed Tomography) scan
- EMG (Electromyography)
- Nerve conduction studies
- A bone scan
Treatment
Although sciatica typically gets better within a few weeks, in some cases, it can last longer and disrupt or prevent normal day-to-day activities. If symptoms do not improve significantly with rest and over-the-counter medications, your doctor may recommend prescription medication or steroid injections to reduce swelling and relieve pain. Steroid injections can take a few days to start working but usually last for up to 3 months.
Physical therapy may be recommended to reduce pain, muscle spasms, and loss of motion as well as to stretch and strengthen muscles. Physical therapists can create individualized treatment plans to help stretch and strengthen back muscles, improve flexibility and mobility, and prevent issues in the future. Aquatic therapy may also be beneficial to ease discomfort and allow exercises to be done with less stress on your body.
Rehabilitation specialists can offer effective treatment for sciatica. They work to design an individualized program which may include therapeutic exercise and manual techniques (such as myofascial release, muscle energy, active release, and neural mobilization) to relieve painful symptoms and prevent future problems.
Surgery is usually only recommended when nonsurgical methods have provided little to no relief of symptoms. Surgery is performed to correct the problem causing compression on the nerve, and the type of surgery will depend on the diagnosis.
Pain and Rehabilitation Specialists in Wilmington, Newark, Middletown, Smyrna & Dover, DE
If sciatica is affecting your health, talk to the experts at Delaware Back Pain & Sports Rehabilitation Centers. Our multidisciplinary team of medical professionals are committed to quality patient care and offer a comprehensive approach to help get you better faster and back to your active lifestyle. We offer pain management, chiropractic care, rehabilitation therapy, leading-edge technologies, and more. To find out more, call us at one of our 7 locations or use our online request form to schedule an appointment today.
