Sciatica is a symptom of structural problem in the lower back, where the sciatic nerve becomes trapped or pinched. The pain tends to affect the buttocks and the back of the thighs, can travel down the back of the leg and even as far as the feet. It may also cause numbness, feel pins and needles, or weakness in those areas. The most common cause is a trapped nerve, but it can also be caused by a slipped or bulging disc in the lower back, causing pressure on the sciatic nerve.
Other causes include an abscess, inflammation of the sciatic nerve, or the after effect of minor injury to the back, such as lifting too heavy a weight in the gym, or sitting in an awkward position. The sciatic nerve is the largest nerve in the body that begins from the nerve roots in the spinal cord in the low back and extends through the buttock area to send nerve endings down the lower limb.
“I am very interested in this topic, because I do have 5 nodes slipped discs now and some were already 50% pinching my nerve, and that news was given by my doctor about 6 years ago as of this writing. Imagine how I managed my pain and my posture all these years. I typically feel the pain from the lumbar area to behind the thigh, sometimes pulsating when it radiates down below the knee. Terrible, but manageable, only if you read and learn more about this spinal infrastructure change that causes a painful nerve condition.”
Typically, the sciatica affects only one side of the body. This is most common and occurs when a herniated disc, bone spur on the spine, or narrowing of the spine called as spinal stenosis compresses part of the nerve, which causes inflammation, pain and often some numbness in the affected leg.
Osteoarthritis is another common cause of nerve root damage that may cause sciatica. It is characterized by the formation of bone spurs, or bits of protruding bones, that may press on the nerve roots. Sometimes, older people may also develop a spinal stenosis, where the space around the spinal cord narrows and squeezes the nerves.
Rarely can meningitis or spinal cord tumors cause the pain. It is also possible for the sciatic nerve to be compressed further outside the spinal column in the pelvis or buttocks. People suffering from the slipped discs may get confined to bed for a few days, but most common disturbance is the difficulty found in bowel and bladder control due to pressure on the nerves in the lower portion of the spine.
The pain that radiates from the lower lumbar down to the back of your leg can vary widely, from a mild ache to a sharp, burning sensation or excruciating pain. Sometimes, it can feel like a jolt or electric shock. It can be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms.
Mild sciatica usually goes away over time, but if your pain lasts longer than a week, is severe or becomes progressively worse, you have to get immediate medical help, especially when you have trouble controlling your bowels or ladder. We cannot help it, but age related changes in the spine, such as herniated discs and bone spurs.
Tests may include X-Rays, MRI Scans, CT Scans, and nerve conduction studies to determine the health or disease of a nerve. Although sciatica can be very painful, it is rare for the disorder to cause permanent nerve damage. Most of the pain results from inflammation and usually gets better within a few weeks.
If you are diabetic, this condition affects the way your body uses blood sugar, and increases your risk of nerve damage. Also, if you have a sedentary lifestyle and sit for prolonged periods, you are likely to develop sciatica more than active people. Although most people fully recover from sciatica, often without treatment, sciatica can potentially cause permanent nerve damage.
The condition may recur and it is not always possible to prevent sciatica. You have to keep your back strong, and pay special attention to your muscles in the abdomen and lower back, which are important in maintaining proper posture and alignment.
The key is to maintain proper posture and use good body mechanics with whatever you do, especially when you sit and stand for long periods. When you take a sit, choose a seat with good lower back support, armrests and a swivel base. You may want to consider placing a pillow or a rolled towel in the small of your back to maintain its normal curve, while try to always keep your knees and hips level.
When you stand for long periods, rest one foot on a stool or small box from time to time. Avoid lifting and twisting simultaneously. When you lift something heavy, hold the load close to your body and let your lower extremities do the work.
The sciatic nerve, also known as the ischiatic nerve originates from the lower back, from L4 to S3 segments of the sacral plexus, which is a collection of nerve fibers that emerge from the sacral part of the spinal cord. The nerve travels through the pelvis and becomes one nerve, where it sits in front of the piriformis muscle. It then passes to the rear of the piriformis (in the buttocks), through the pelvis, down the lower limb and ends at the back of the foot, making it the longest nerve in the body.
Here are top tips for managing your back pain
- Exercise and activity are the most important ways of helping yourself if you have back pain, the idea is to remain as active as possible
- Keep moving and continue with activities such as walking or swimming
- Take pain killers to keep you moving comfortably, only when advised by your doctor
- Avoid sitting for too long when driving or at work
- Gently stretch to prevent stiffness
- Take care when lifting, bending your hips and knees to use the power in your legs
- Check your posture when using computers, games or watching television
- Check the mattress of your bed to make sure it supports your back properly
- Don’t smoke, it impairs your circulation, which affects how quickly your body can recover
- Strengthen your trunk muscles as this may help to protect and support your back
- Eat a healthy diet and exercise, as being overweight can be a cause of back pain
- Use hot or cold compresses when in pain
- Put some anti-inflammatory gel, such as Voltaren Emulgel
Simple ways to relieve sciatica
Lie down on your back with your knees bent and feet flat on the floor. Place your hands underneath your buttocks (palms down) alongside the base of your spine. Close your eyes, and taking long, deep breaths, rock your knees from side to side for two minutes.
Reposition your hands every few minutes to enable different parts of the buttocks muscles to be pressed. Gently move your legs from side to side with your knees pulled up your abdomen and your feet off the floor, and support your legs by holding them with your palms just behind your upper legs.
Taking physical therapy session can teach you how to improve your posture as well as reduce any future strain on your back. The Physical Therapist can teach you a range of exercises to strengthen the muscles that support your back and improve the flexibility of your spine.
Transcutaneous nerve stimulators (TENS units) are sometimes useful for more chronic forms of sciatica. Hydrotherapy, which is simply sitting in a whirlpool bath or warm shower gently relieves pain and relaxes muscles.
Tractions can reduce the effects of gravity on the spine by gently pulling apart the bones, the intent of which is to reduce the disc herniation. Deep tissue massage relieves deep muscle tension and spasms, which helps prevent the muscle motion at the affected area.
Heat therapy increases the blood flow to the target area, while the cold therapy or cryotherapy slows the circulation and reduces the inflammation, muscle spasms, and pain. You can use the hot and cold packs for this at home.
You should not use the heat therapy if you have these conditions
- Vascular disease
- Deep vein thrombosis
- Multiple sclerosis
- Heart or hypertension disease
The cold therapy works by reducing the blood flow to a particular area, which can significantly reduce inflammation and swelling that causes pain, especially around a joint or a tendon. It can temporarily reduce nerve activity, which can also relieve pain.
Do not use cold therapy if you have
- Sensory disorder
- Poor circulation
- Stiff muscles or joints
Knowing when to use the cold or heat therapy can significantly increase the effectiveness of the treatment. Some situation may require both applications. Arthritic patients, for example, may use the heat for joint stiffness and cold for swelling and acute pain.
Tight lower back muscles can place stress on your nerve roots. A massage therapy can help loosen these muscles and prevent the pinching or irritation. Massage encourages the release of pain fighting endorphins and provide temporary relief from the pain and burning sensation in your leg.
If you have a slipped disc, make sure the particular area where the disc slipped should not be touched or even massage, just do it with the surrounding area to relieve the pain. Relief will always depend on what is causing, or contributing to the cause of the condition.
For example, if disc herniation causes the sciatic pain, it may take 6 weeks for the disc herniation to subside before relief is longer lasting. Treatment during pain times may only provide short lived, symptomatic relief.
- Avoid excessive consumption of foods that drain the body of thiamine and magnesium, such as coffee, tea, colas, and fizzy drinks, chocolate and refined sugars, which reduce the ability of the body to cope with pain. The lack of magnesium and thiamine can also contribute to your muscular pain and spasms.
- An effective dietary approach may involve increasing your consumption of magnesium rich foods to help release muscle contractions, such as dairy products, fish, brown rice, lima beans, clams etc.
Sciatica rarely occurs before age 20, and becomes more common in middle age. It is most likely to develop around age 40 or 50. It tends to develop over time.
With sciatic pain, it is important that you understand your condition and what causes the pain, as well as the importance of maintaining your posture, avoid prolonged sitting, keeping a healthy weight, and always do walking or swimming exercises.
If you have to sit for long due to work, make sure you stand and walk around every 30 minutes for at least 5 minutes. Walking can improve your blood circulation and decrease the pain levels. Walking can also increase your endurance and ability to walk without pain.
Circulation can be one of those things you probably never think about. One of the easiest ways to get your blood pumping optimally again is by exercising. Standing up and walking around for 5 minutes every 30 minutes can prevent the undesirable physical and emotional consequences of long bouts of uninterrupted sitting.
Studies have shown that sitting motionless reduces blood flow to the legs, thus increasing the risk for atherosclerosis and the buildup of plaques in the arteries. People who sit for more than 8 or 9 hours daily also are at a heightened risk for diabetes, depression and obesity compared with people who move more often.
Let me share this with you…
“I have my slipped discs since I was in my grade 6 and now I am 50. It is really true that managing your weight, your diet and your lifestyle can help you relieve the pain. I walk about 3k every morning, have hot packs every night for 3 sessions, and do my upper body workout with resistance bands and dumbbells. I also shifted to brown rice, mongo beans, vegetables, fruits, and salmon belly fish.”
Courteney, H. & Zeal, G. (2001). 500 health tips. South Africa: Struik Publishers.
Mayo Clinic. Sciatica.
NHS UK. Sciatica treatment.
PhysioHey NHS UK. Sciatica.