What Is Sciatica?
Sciatica refers to pain that travels along the path of the sciatic nerve. The sciatic nerve travels from the lower back through the hips and buttocks and down each leg.
Sciatica most often occurs when a herniated disk or an overgrowth of bone puts pressure on part of the nerve. This causes inflammation, pain and often some numbness in the affected leg.
Although the pain associated with sciatica can be severe, most cases clear up with treatment in a few weeks. People who have severe sciatica and serious leg weakness or bowel or bladder changes might need surgery.
The symptoms of sciatica include:
- Moderate to severe pain in lower back, buttock and down your leg.
- Numbness or weakness in your lower back, buttock, leg or feet.
- Pain that worsens with movement; loss of movement.
- “Pins and needles” feeling in your legs, toes or feet.
- Loss of bowel and bladder control (due to cauda equina).
During the physical exam, Doctor might check muscle strength and reflexes. For example, walk on your toes or heels, rise from a squatting position, and lift your legs one at a time while lying on your back. Pain from sciatica will usually get worse while doing these moves.
- Tests: People with severe pain or pain that doesn’t improve within a few weeks may need:
X-ray. An X-ray of the spine may reveal an overgrowth of bone that can be pressing on a nerve.
- MRI: This procedure uses a powerful magnet and radio waves to produce cross-sectional images of the back. An MRI produces detailed images of bone and soft tissues, so herniated disks and pinched nerves show on the scan.
- CT scan: Having a CT scan might involve having a dye injected into the spinal canal before the X-rays are taken (CT myelogram). The dye then moves around the spinal cord and spinal nerves, making them easier to see on the images.
- Electromyography (EMG): This test measures the electrical impulses produced by the nerves and the responses of the muscles. This test can confirm how severe a nerve root injury is.
For pain that doesn’t improve with self-care measures, some of the following treatments might help.
Medications: The types of drugs that might be used to treat sciatica pain include Anti-inflammatories, Corticosteroids, Antidepressants, Anti-seizure medications, Opioids
Physical therapy: Once the pain improves, a health care provider can design a program to help prevent future injuries. This typically includes exercises to correct posture, strengthen the core and improve range of motion.
Steroid injections: In some cases, a shot of a corticosteroid medication into the area around the nerve root that’s causing pain can help. Often, one injection helps reduce pain. Up to three can be given in one year.
Surgery: Surgeons can remove the bone spur or the portion of the herniated disk that’s pressing on the nerve. But surgery is usually done only when sciatica causes severe weakness, loss of bowel or bladder control, or pain that doesn’t improve with other treatments.
It’s not always possible to prevent sciatica, and the condition can come back. To protect your back:
- Exercise regularly.To keep the back strong, work the core muscles the muscles in the abdomen and lower back needed for good posture and alignment. A Doctor can recommend activities.
- Keep good posture when sitting.Choose a seat with good lower back support, armrests and a swivel base. For better low back support, place a pillow or rolled towel in the small of the back to keep its normal curve. Keep knees and hips level.
- Use your body correctly.When standing for long periods, rest one foot on a stool or small box from time to time. When lifting something heavy, let your legs do the work. Hold the load close to your body. Don’t lift and twist at the same time. Find someone to help lift heavy or awkward things.