About Sciatic Pain

Sciatic pain can be severe and limit your ability to do everyday activities and hobbies. There are several reasons you can develop sciatic pain. There are also a variety of treatment options available to you. To fully manage this condition, you need to understand why it is happening and then play an active role in your treatment plan. Here are some basic information about this condition and your options for treatment.

Identification

• Sciatica is a general term used for symptoms of pain that can begin in the low back and then radiate to the buttocks and down one or both legs. There may or may not be burning or tingling sensations, as well as numbness and weakness in the legs and feet. The sciatic nerve is a large nerve that originates in the low back and travels down the back of the leg to the toes. It connects the spinal cord to the hamstring muscles, the outside of the thigh as well as the muscles in the lower leg and feet. The picture here shows the sciatic nerve in yellow. The red illustrates how the pain can travel down this nerve. Sciatica can be mild and resolve itself within a few weeks. It can also be very debilitating and last for years.

Causes

• Symptoms occur when there is pressure on the sciatic nerve. In most cases this pressure occurs due to changes in the spinal column. This happens because the nerve roots of the sciatic nerve exit through the spinal column. The spinal column is made up of the bones or vertebrae. In between the vertebra are disks, which are round with a jelly-like center. These disks create space between the vertebrae that allows your back to move and they act as shock absorbers. Sciatica can occur when there is pressure on the actual nerve or the nerve roots due to a ruptured or herniated disk. A herniated disk occurs when the disk slips out of place but stays intact. A ruptured disk is when the disk not only shifts position, but also breaks, allowing the jelly like center to escape. Changes to the structure of the vertebrae can also create pressure on the sciatic nerve. This occurs with diseases such as stenosis, spondylolysis or spondylolisthesis. All of these conditions cause a narrowing of the space through which the sciatic nerve roots exit the spine, thus compressing the nerve. Other causes of sciatica include osteoporosis and vertebral fractures. Less common causes are tumors or infections. With all of these conditions, inflammation can occur as well which places additional pressure on the nerve. All of these changes can also cause the nerve to be compressed either slightly or significantly. As the nerve is compressed, nerve impulses can not longer travel from the spinal column to the legs and feet. The result can be muscle weakness and numbness.

Conventional Medical Treatments

• Your treatment options depend on what is actually causing pressure on the sciatic nerve. If you are dealing with a ruptured disk you may need surgery. Spinal fusion surgery may also be required if the pressure is due to disease. This surgery removes some of the vertebral bone which can in turn relieve pressure on the nerve. If you do not need surgery immediately, you can try injections which deliver anti inflammatory medicine directly to the problem area. If the injection is successful, the inflammation decreases along with the pressure on the nerve. Medications such as anti inflammatory drugs, pain killers and muscle relaxants can also be used to manage symptoms.

Alternative Treatments

• Some patients find relief with chiropractic care, which can make manual adjustments to help relieve the pressure. Acupuncture can also be tried. Physical therapy and regular gentle exercise are important components of a back care program. Learning to move correctly, and using good body mechanics is an essential step in preventing and managing your condition. Regular exercise keeps your muscles strong and flexible. The stronger and more flexible your body is, the less stress is placed on the body during everyday activities. If the muscles become weak due to sciatica, then they also become tight and your ability to move will be restricted. This in turn will lead to more pain. In addition, stronger muscles are less susceptible to injury. This means that if you work on strengthening your muscles while you recover from sciatica, you will be less likely to re-injure yourself as you return to normal activity.

Considerations

• Treating sciatica is very difficult and often requires trying several techniques. Since there are many causes for sciatica and because everyone experiences symptoms differently, there is no one magic cure. Surgery is always a last resort, but there are times when it is necessary due to severe pain or nerve compression. Some people get immediate relief from injections and for others they do not work at all. The same is true with chiropractic and acupuncture. For safety, you should have a physician or physical therapist design your exercise program. With conditions such as osteoporosis and stenosis, certain exercises are contraindicated, while others are especially helpful. People with sciatica must be treated as individuals and have a program designed specifically for their unique condition and needs.