What You Need to Know about Sciatica
If you're experiencing shooting pains or aches in your leg or buttock, you likely have sciatica. You may not realize, however, that sciatica isn't a full diagnosis, but rather a symptom of a larger problem.
What is Sciatica?
Your sciatic nerve is the largest and thickest nerve in your body. It extends from your spine’s lumbar region spanning down the buttocks and the back of the thigh. The nerve divides above the back of your knee and becomes the tibial and the common peroneal nerve, which run down to your lower leg and foot. Sciatica is a nerve pain condition that occurs when a herniated disk, bone spur on the spine or spinal stenosis presses against the nerve, which sends radiating pain from your lower back all the way down to your feet, in extreme cases. Sciatica usually affects one side of your body. While sciatica is painful, it can be treated non-operatively. In some cases, patients elect to have surgery, but it’s not always necessary.
Causes of Sciatica
The sciatic nerve is the largest nerve in your body, and it's composed of multiple single nerve roots that branch along the lower spine and come together to form the main sciatic nerve. When this nerve is irritated or compressed, it causes sciatica. Many people feel the most pain in their buttocks or legs (on one or both sides) because the nerve runs from the lower region of your spine (the lumbar section), through your buttocks and into each leg. Therefore, sciatica may be caused by any of these issues in that area:
- Degenerative Disc Disease
- Herniated or Bulging Discs
- Spinal Stenosis
- Piriformis Syndrome
- Isthmic Spondylolisthesis
- Sacroiliac Joint Dysfunction
If you suspect you have sciatica, you'll want to know the symptoms it causes. Here's what you should look for:
- Constant aching pain in your buttock or leg, usually only on one side of the body. However, pain on both sides is also possible, especially if one side is more severe.
- Pain that starts in your lumbar area and follows a path through your buttock or into your leg.
- Pain that lessens when you walk or lie down, but worsens when you stand still or sit.
- Sharp pain. Some patients describe it as feeling like an electric shock. Difficulty moving your lower leg or foot due to weakness or loss of feeling in your leg.
- Tingling pain in your leg or buttock.
- Difficulty standing or walking due to sharp pain.
- Pain in your foot or toes, though foot or toe pain alone is uncommon. It's usually accompanied with leg pain.
Sciatica Treatment Options
The key is to find what is causing the sciatic nerve irritation and take steps to relieve that pressure. It may occur from a re-aggravation of an old injury, or from a recent activity. Dr. Allen Conrad BS, DC, CSCS, a chiropractor at Montgomery County Chiropractor Center recommends these treatments for sciatica:
- Chiropractic spinal decompression therapy. The lumbar spine discs may be compressing the sciatic nerve, and this low force decompression treatment has been effective in treating sciatica.
- Ice, not heat. Ice with a towel can help reduce the inflammation and swelling associated with sciatic irritation. Heat can help with spasm, but will increase the chances of increased swelling 7 to 8 times more and should be avoided.
- Massage therapy. Massage therapy for the back and affected leg is effective in reducing the spasm associated with an irritated sciatic nerve.
- Electrical Muscle Stimulation. This treatment modality can help relieve spasm and pain associated with sciatica and is commonly used in association with spinal decompression therapy.
- Avoiding prolonged sitting and standing. Each person may react differently to sciatica, depending on which part of the nerve is irritated. Commonly, prolonged sitting will irritate the condition, so it is best to avoid prolonged sitting and standing until the condition resolves and avoid sitting in one spot for longer that an hour at a time.
- Therapeutic exercise. It is best to avoid stretching or exercise until the inflammation of the nerve is resolved, otherwise you may be causing additional damage.
In some advanced cases, arthritic degeneration has developed in your low back, and this is causing compression of the sciatic nerve. This condition is commonly treated with muscle relaxers and in some cases a surgical consult.
How Sciatica Affects Your Quality of Life
Ben Weissenstein, 27, is an Internet entrepreneur who experienced sciatica over the course of three months during the launch of one of his businesses. The pain was enough to make him defer his business plans so that he could treat his pain. “I would have never thought that sitting in a chair, being on the phone, sending emails, or going to meetings would result in a really intense physical injury,” he says. “Leaning over your desk and doing that consistently adds up.”
Weissenstein shared about the difficulty of getting into a car and having to wear a back brace to contain the pain. For people like Weissenstein who live with sciatica, day-to-day activities that we usually don’t consider become among the most difficult to perform. Activities like driving, walking, standing, sitting at a desk and sleeping can cause intense pain.
Mariann Farrell, 67, was a music educator until two car accidents ended her career. “Horrible” sciatica pain left her bedridden for 18 months, while her husband was left to manage the family and run the household on his own. “I got very depressed, helpless and hopeless,” she recalls. “I thought, if I can lie in bed and be very quiet and still, the pain would go away.” Instead, her pain intensified. She finally decided to get out of bed, and she began living life again despite the pain.
Robin Hamill-Ruth, an anesthesiologist, pain management specialist, and president of the American Board of Pain Medicine, says, "Once a person identifies how they can be a person who lives with chronic pain, and still have a quality of life and still be a person, they tend to do much better." As was the case on Weissenstein and Farrell. Once they took action—Weissenstin chose physical therapy and Farrell chose refocusing her energy—they felt more in control of their pain as opposed to their pain being in control of them.