The sciatic nerve is the longest nerve in your body. It runs from pelvis through your buttock and hip area and down the back of each leg. It controls many of the muscles in your lower legs and provides feeling to your thighs, legs and feet.
Sciatica refers to pain that radiates along the path of the sciatic nerve, from your back into your buttock and leg. You may feel the discomfort almost anywhere along the nerve pathway, but it is most likely to follow a path from your lower back to buttock and the back of thigh and calf. The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating discomfort. Sometimes it may feel like an electric shock. Sciatic pain often starts gradually and intensifies over time. It may be worse when you cough or sneeze, and prolonged sitting or walking can also aggravate symptoms. Usually only one lower extremity is affected
Sciatica frequently occurs when a nerve root is compressed in your lower spine, mostly as a result of a herniated disc in the lower back. Disks are pads of cartilage that separate the vertebrae in your spine. They keep the spine flexible and act as shock absorbers to cushion the vertebrae when you move. As you grow older, the discs may start to deteriorate, becoming drier, flatter and more brittle. Eventually, the tough fibrous outer covering of the disc may develop tiny tears, causing the jelly-like substance in the disc’s centre to seep out. The herniated disc may then press on a nerve root, causing pain in your back, leg or both. Other conditions can also put pressure on the sciatic nerve, including, spondylolisthesis, trauma, sciatic nerve tumor and spinal tumors.
Mild sciatica usually goes away given a little time and patience. Call your doctor or physiotherapist if self-care measure fail to ease your symptoms or if your pain lasts longer than six weeks, and the pain is severe or becomes progressively worse.
Risk factors for sciatica are health problems, lifestyle choices and inherent qualities, such as age or race. They include:
Age – Age related changed in the spine are the most common cause of sciatica. You are likely to have some degeneration in the discs in your back by the age of 30. Most people, who develop herniated discs, are in their 30s and 40s.
Occupation – A job that requires you to twist your back, carry heavy loads or drive a motor vehicle for long periods makes you more prone to develop sciatica.
Physical activity – Although walking and jogging have been associated with an increased risk of sciatica, exercise in general has not. In fact, people who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are.
Genetic factors – Researchers have identified two genes that may predispose some people to disc problem.
Diabetes – This condition affects the way your body uses blood sugar and increases the risk of nerve damage.
For most people, sciatica responds well to self management. You will heal more quickly if you continue with your usual activities, but avoid what may have triggered the pain in the first place. Although resting for a day or two may provide some relief, prolonged bed rest is not a good idea. In the long run, inactivity will make your symptoms worse.
Other measures good for sciatica include using cold packs to reduce inflammation and relieve discomfort, applying hot pack and massaging to help relieve muscle spasm and stretching the lower back to feel better and may help relieve nerve root compression. Some over-the-counter medications can help to reduce pain and inflammation, but make sure you consult with the pharmacist or your doctor.
Physiotherapy and acupuncture play a vital role to help with relieving sciatica discomfort. Rehabilitation typically includes exercises to help correct your posture, strengthen the muscles supporting your back and improve your flexibility. The exercise physiologist can design a rehabilitation program to help prevent recurrent injuries. These treatment programs then should become part of your daily routine at home or at gym permanently.
When conservative managements do not alleviate your pain and the pain gets progressively worse, then surgery might be the last choice of management. Surgery is most often performed to remove a portion of a herniated disc that is pressing on a nerve. You may experience immediate results from disc surgery, but it does not stop degenerative changes and your pain may recur in time.
Preventing sciatica is not always possible. However, it is still very important to do so through exercising regularly, maintaining proper posture when you sit and stand, and using good body mechanics. Poor posture stresses the back, leading to fatigue and stress on joints and nerves. Before you lift something heavy, decide where you will place it and how you will get there. Bend at your knees, not your back, so that you legs do the lifting. Carry objects close to your body at about waist level. Don’t twist at your waist, but turn by stepping around.
If you have any further concerns, please contact us at Mycare Health Professionals.