The term “Sciatica” is often misunderstood. Some people use this term to describe any kind of radiating back pain. However, as the name suggests, it is actually more of a description of symptoms instead of an actual diagnosis term. Sciatica can be defined as pain radiating along the sciatic nerve, which runs down the back of one or both legs from the lower back.
Now that we have a better understanding of what the sciatica term really means, let’s dive a bit more into this very aggravating condition, or should we say painful condition.
The most common symptoms and signs of Sciatica besides low back pain that may be achy, dull or sharp, includes:
- Sharp shooting pain in leg or thigh
- Cramping sensation in leg(s)
- Prolonged sitting or standing make increase pain in low back and leg(s)
- Increased pain with sneezing, coughing
- Tingling and/or numbness in leg(s) (i.e. pins and needles) sensation that may or may not extend into the foot/toes
What are some common causes of sciatica? Well believe it or not, sometimes you can have sciatica without injury. In this case, sciatica commonly appears due to wear and tear also known as degenerative disc disease that can cause narrowing of the spine (spinal stenosis) and results in compression of the sciatic nerve. These spinal changes subsequently lead to pain, tingling, numbness, inflammation and radiating pain down the back of the leg(s).
Sciatica can also be due to traumatic injury and/or repetitive overuse injuries, which include motor vehicle accident, sports injuries or even injuries “on-the-job”. Whether your sciatica is due to injury or wear and tear, the results are the same, Radiating low back pain along the sciatic nerve. In severe cases, bowel and/or bladder function could be impacted causing some individuals incontinence.
- Herniated disc (pressure from disc on the nerve root)
- Bone spur
- Degenerative Disc Disease
- Spinal Stenosis (spinal canal narrowing)
After a thorough and comprehensive physical examination that includes musculoskeletal and neurological exam, the medical doctor can often confirm the diagnosis without radiographic images. However, radiographic images, such as MRIs or X-rays can often assist in confirming the cause and the diagnosis. Moreover, studies such as a Nerve Conduction Velocity and Electromyography study can help determine which nerves are involved and the severity. Although the symptoms are similar regardless of the cause of the sciatica, the treatment may vary depending on the cause.
It is important to note that more than 80% of patients will get better over time without surgical intervention.
There are many options available to patients experiencing sciatica. Many of the treatment options can be most effective when combined or used in adjunct with other therapeutic modalities. No matter what treatment option becomes effective, it is key that therapeutic exercises that include flexibility and strength become part of your lifestyle for long-term benefit.
Physiotherapy (stretching, strengthen core muscles, low back, and lower body)
OTC pain medication (i.e. NSAIDs)
Hot compress (relax muscle spasms)
Cold compress (decrease inflammation)
Biofeedback – help reduce stress and manage pain
Regenerative Injection Therapy (platelet rich plasm, prolotherapy) – regenerate and strengthen degenerative and disrupted connective tissue
Epidural Injections (Steroid) – decrease inflammation in low back and lower extremities
Lumbar laminectomy – removal of the lamina (portion of the vertebrae bone) to relieve the pressure off the sciatic nerve
Microdiscectomy- removal of disc fragments from the herniated disc to relieve pressure off the sciatic nerve.