What causes sciatica?
Sciatica is the nerve pain that occurs following irritation, inflammation, or injury to the sciatic nerve itself. Though the sciatic nerve is rarely the actual source of injury, the term “sciatica” is widely used throughout the medical community to describe any pain originating in the lower lumbar region of the back that also radiates down one leg.
There is often no rhyme or reason for sciatic pain. The pain may gradually worsen or a person may wake up feeling excruciating sudden pain depending on the cause of injury. Common causes of sciatica include:
Arthritis or osteoarthritis in the spine may result in cartilage degenerating over time, irritating the sciatic nerve.
A herniated disk, the most common cause of sciatica, results in increased pressure on the nerve root attached to the sciatic nerve, causing injury and irritation.
Discomfort due to natural wear on the body, including the disks located between each vertebra in the spine. Degenerative disk disease often leads to a decrease in height of a person, as well as spinal stenosis which pinches the sciatic nerve.
Spinal stenosis is classified as the abnormal narrowing of an opening or exit passage of the spinal column where nerve roots travel. When these passageways narrow, it affects the space available for the spinal cord and nerves, like the sciatic nerve, causing pain, pressure, and injury to the nerve root.
How is sciatica diagnosed?
Diagnosing sciatica often requires a medical professional. Your doctor will begin by having you detail your past medical history, assess the current symptoms you are experiencing, and perform a physical exam including various tests.
Testing often includes:
Walking in a straight line for your physician so he/she can evaluate how efficiently your spine can carry the weight of your body.
Walking on your toes and then heels to assess the strength of your left and right calf muscles.
Straight leg raises where you lie flat on your back with your legs extended straight. Your medical provider will raise each leg slowly, one at a time, to determine and make note of the angle at which pain begins.
Imaging, including x-rays, MRI, or CT scans.
These various tests allow your health care provider to determine the approximate area of the affected nerve as well if a disc is compromised.
Symptoms of sciatica
Sciatica symptoms vary from one person to the next. The most common symptom of those suffering an injury to the sciatic nerve is sharp, shooting pain along the sciatic nerve.
Other symptoms include:
Tingling or the feeling of “pins and needles” in the feet or toes
Muscle weakness in the affected area
Symptoms of irritation to the sciatic nerve are often only present in one leg rather than both. A person may experience pain in one area of the leg and numbness or tingling in another.
The pain ranges from a mild ache to a burning sensation or sharp, excruciating pain that radiates from the lumbar spine down the back of the leg. The pain is often worsened by long periods of inactivity or sitting, as well as coughing or sneezing.
What is the treatment of sciatica?
Treatment for sciatica is dependent on the severity of symptoms, cause of injury, and whether it is an acute (new) or chronic (previously existing) problem.
Acute sciatica treatment
Acute sciatica treatment, when symptoms are mild, can often be treated at home with an over-the-counter pain reliever, light exercise including walking and stretching, and alternating with a cold and hot compress to alleviate pain.
Chronic sciatica pain
Chronic sciatica pain is treated with a combination of at-home care and medical care from a licensed professional. It includes over-the-counter management as well as prescription pain management, anti-inflammatories, muscle relaxers, and tricyclic antidepressants when warranted. It also includes various therapies, like physical therapy and cognitive behavioral therapy, to alleviate symptoms, strengthen muscles, and provide long-term comfort and relief during a flare-up of pain.
Chiropractic care is a specialized type of care designed to alleviate pain, pressure, and improper alignment of the musculoskeletal system through controlled pressure, manual manipulation, and intentional traction devices. Chiropractic care for sciatica allows for natural, non-invasive treatment options to help patients cope with both acute sciatica pain and chronic, long-term, or recurrent irritation of the sciatic nerve.