What Causes Sciatica And How To Fix It?

If you are bothered by ongoing lower back pain that runs through your hip and down one leg, and if that pain worsens when you sneeze or bend over, you may have sciatica.

This painful nerve condition gets its name from the sciatic nerve, the largest nerve in the body and the main nerve in your leg. The sciatic nerve originates in the lower back and travels through the buttock, down the leg, and into the foot and toes.

Sciatica, also called lumbar radiculopathy, is most likely to develop between the ages of 30 and 50, according to the American Academy of Orthopaedic Surgeons (AAOS). The Cleveland Clinic reports that nearly 40 percent of all adults will experience sciatica. The condition does not affect people under 20 unless they suffer an injury.

“Sciatica occurs when the sciatic nerve—the largest nerve in the body that begins in the lower back—is irritated,” Dr. Jennifer Caudle, a family medical physician and associate professor at Rowan University School of Osteopathic Medicine in Stratford, NJ, told Yahoo Life. The irritation can occur for several reasons, including a herniated disc, Dr. Caudle said.

A herniated disc, also referred to as a ruptured, slipped, or bulging disc, is the most common cause of sciatica. A herniated disc occurs when the soft cushion between the vertebrae in the spine bulges or breaks and puts pressure on the sciatic nerve. This can be brought on by age-related wear-and-tear of the lower spine, as well as osteoarthritis.

Besides a herniated disc, other common causes of sciatica include:

• Spinal stenosis. This condition occurs when the area inside the backbone narrows and puts pressure on the spinal cord and nerves, including the sciatic nerve.
• Muscle strain or inflammation. Inflammation due to a muscle strain in the lower back or buttock area can put pressure on the sciatic nerve and cause sciatica symptoms.
• Obesity. Excess body weight can increase pressure on the spine and lead to the development of sciatica.
• Pregnancy. The weight of the growing fetus and hormonal changes during pregnancy can sometimes compress the sciatic nerve, leading to sciatica-like symptoms.

Johns Hopkins Medicine reports other causes of sciatica, including poor posture, tumors, blood clots, and an awkward sitting position. In addition, Type 2 diabetes, tobacco use, and lack of physical activity are also contributing risk factors, according to Yahoo Life.

Sciatica can occur off and on throughout life, depending on what is causing the condition at the time.

“As we age, the probability of sciatica shifts from herniated discs in the younger ages to the spinal stenosis in the older ages,” Dr. Brian Cole, an orthopedic surgeon at Englewood Spine Associates, in Englewood, NJ told Yahoo Life.

Common Symptoms of Sciatica

Back and leg pain are the most common symptoms reported by people dealing with sciatica. The pain generally starts from the lower back and radiates down the back of the leg. Many people describe the pain as a sharp, burning sensation or shooting pain. Although the pain can be a mild or dull ache, sciatica pain is uncomfortable nonetheless.

Other sciatica symptoms include:

• A tingling or “pins-and-needles” sensation. This is a feeling similar to when your leg falls asleep when you sit with your legs crossed.
• Difficulty sitting or standing. Pain from sciatica can worsen when sitting or standing for long periods, as these positions can put pressure on the sciatic nerve. Weakness in the leg makes it difficult to move the leg or foot or stand up.
• Certain movements. Symptoms may worsen during certain movements, such as bending over, coughing, sneezing, lifting objects, and twisting the body. These movements increase pressure on the nerve.

An even more severe symptom is urinary incontinence or fecal incontinence. When the sciatic nerve is severely damaged, it may cause a loss of control of bladder and bowel movements.

How Is Sciatica Diagnosed and Treated?

To determine a sciatica diagnosis, a doctor has imaging tests done that may include an X-ray or Magnetic Resonance Imaging (commonly known as MRI), which produces clear and detailed images of the organs and structure inside the body. Tests might also include an Electromyography and nerve conduction study which measures the electrical activity of muscles and nerves.

If the sciatic pain is mild to moderate, the condition will resolve on its own, Dr. Caudle said. An ample amount of time and rest usually “encourages the condition to heal,” according to the AAOS.

Some of the non-medical treatments for sciatic pain include:

• Moving around as much as possible. According to the AAOS, motion helps in reducing inflammation. However, staying in bed during the day can cause pain in other parts of the body.
• Ice and Heat. Cleveland Clinic recommends using a cold pack for about 20 minutes at a time throughout the day during the first 48 to 72 hours, then switching to heat around day three.
• Take over-the-counter medications. Nonsteroidal Anti-Inflammatory (NSAID) drugs, like ibuprofen or naproxen, can help in treating sciatica. Tylenol may be a substitute for people who cannot take NSAIDs.
• Alternative therapies such as acupuncture, massage therapy, and chiropractic care.

If self-care remedies are not effective after six weeks, doctors may prescribe physical therapy, which can help to reduce inflammation and alleviate sciatica-related pain. Physical therapy can also help to strengthen muscles surrounding the spine, pelvis, and hips and reduce pressure on the sciatic nerve.

In some instances, injections are useful treatments.

“Some people may elect for spinal injections, which is another route of administration of anti-inflammatory medication in a higher proportion to a specific area,” Dr. Cole told Yahoo Life.

If non-medical treatments are not effective, doctors may recommend surgery as a last resort. One such surgery is a laminectomy, the removal of part or all of the vertebral bone.

“Surgery may be required when conservative care has failed, or there is a neurologic deficit such as weakness, atrophy of muscles, or bowel or bladder compromise,” Dr. Cole said.

It is important to see a doctor if you are having any of these symptoms, the pain is severe or worsens, or if you have numbness or weakness in the leg. Early diagnosis and treatment can help prevent further complications from sciatica.

Source Links:

https://www.hss.edu/condition-list_sciatica.asp
https://www.health.harvard.edu/pain/5-causes-of-sciatica
https://www.hopkinsmedicine.org/health/conditions-and-diseases/sciatica
https://www.yahoo.com/lifestyle/sciatica-heres-what-you-can-do-to-make-it-less-painful-184747314.html