What is Sciatica?
Sciatica is irritation of the sciatic nerve which results
in pain, numbness and tingling. Sciatica pain is typically
felt in the lower back radiating down the back of the
thigh to below the knee. The pain may be felt as a cramp,
as shooting pain down the leg or tingling in the leg
or foot. Some patients report that the pain intensifies
with coughing or sneezing, and bending the knees or
squatting may also make it worse.
To better understand the condition, it is helpful to
know a little bit about sciatica anatomy. The sciatic
nerve is the largest nerve in your body, starting as
five pairs of nerve roots in the lower or lumbar spine
and extending through the buttocks and down to the lower
leg. It lies near the sacrum (the bottom vertebrae),
the back of the pelvis, the back of the thighs, behind
the knee and smaller branch nerves travel all the way
to your feet. Its purpose is twofold - to send signals
to the leg muscles from the brain for movement and also
sends information back to the brain about what is happening
in the leg. If there is a problem with the sciatic nerve
the brain will receive the signal as pain.
Many people will experience sciatica at some point
in their lives but not everyone will have it develop
into a chronic condition. Some patients are surprised
by their sciatic pain as they were not aware there was
any problem in the lumbar spine.
The most common cause
of sciatica is a herniated vertebra which pinches the
sciatic nerve, causing pain. A herniated disc is when
the spinal disc, which acts as a cushion between the
bones, or vertebra, of the spine, ruptures and causes
it to push out from its place between the vertebrae.
This causes irritation and compression to the nerves
as the disc pushes into the space where the nerves lie.
It is important to see your doctor when pain of any
kind strikes because the correct diagnosis needs to
be made so that the most appropriate treatment can be
started. Not all back pain can be attributed to sciatica;
your doctor will need to get a complete history of your
pain, do a physical exam and do certain tests to determine
whether you have sciatica. Sometimes an x-ray or MRI
may be ordered but these might not be necessary.
The treatment your doctor advises will be aimed at
reducing the impact on the sciatic nerve. Anti-inflammatory
drugs will help to ease any inflammation around the
nerve, muscle relaxants will allow the muscles to relax
and allow the herniated disc to return to its normal
position and rest will help the body recover. As the
sciatic pain reduces, your doctor may send you for physiotherapy
for specific exercises to strengthen the core muscles
around the spine. Surgery is seldom needed and only
for severe, recurring cases of sciatica.
Between 80% and 90% of patients make a full recovery
after an attack of sciatica with no on-going damage
to the sciatic nerve. Many of these patients will not
have another episode of the condition, particularly
when they include regular, moderate exercise in their
lifestyle.
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