Sciatica is a frequent cause of individuals seeing a medical doctor. The distress caused might vary tremendously from one individual to another. It usually gets better in 4 to 6 weeks but can last longer.
What is sciatica?
Sciatica is where the sciatic nerve, which runs from your lower back to your feet, is irritated or compressed. Typically, sciatica affects only one side of your body. Sciatica most commonly occurs when a herniated disc, bone spur on the spine, or narrowing of the spine (spinal stenosis) compresses part of the nerve. This causes inflammation, pain, and often some numbness in the affected leg.
Although the pain associated with sciatica can be severe, most cases resolve with non-operative treatments in a few weeks. People who have severe sciatica that is associated with significant leg weakness or bowel, or bladder changes, might be candidates for surgery.
Risk factors for sciatica
Sciatica results from irritation of the root(s) of your lower lumbar and lumbosacral spine. Additional common causes of sciatica include degenerative disc disease (breakdown of discs which act as cushions between the vertebrae), spondylolisthesis (a condition in which one vertebra slips forward over another one), pregnancy and muscle spasm in the back or buttocks.
Other things that may make you more likely to have sciatica include:
• Aging (which can cause changes in the spine, like bone spurs or herniated discs)
• Diabetes
• Being overweight
• Not exercising regularly
• Wearing high heels
• Sleeping on a mattress that is too hard or too soft
• Smoking
• Your job, especially if it involves driving for long periods of time, twisting your back, or carrying heavy things
What are some symptoms associated with sciatica?
For some people, the pain from sciatica can be severe and disabling. For others, the sciatica pain might be infrequent and irritating, but has the potential to get worse. Common symptoms – of sciatica include the following:
• Lower back pain
• Pain in the rear or leg that is worse when sitting
• Hip pain
• Burning or tingling down the leg
• Weakness, numbness, or a hard time moving the leg or foot
• A constant pain on one side of the rear
• A shooting pain that makes it hard to stand up
When to see a doctor
Mild sciatica usually goes away over time. Make an appointment to see your doctor if self-care measures fail to ease your symptoms – or if your pain lasts longer than a week, is severe or becomes progressively worse. Get immediate medical care if:
• You have sudden, severe pain in your lower back or leg and numbness or muscle weakness in your leg
• The pain follows a violent injury, such as a traffic accident
• You have trouble controlling your bowels or bladder
Diagnosis
Once you have visited your doctor, he/she will carry out a detailed clinical history and physical examination. If your pain is severe, the doctor might order imaging tests to confirm the diagnosis.
Treatment
Most people with sciatica feel better after self-care activities or at-home remedies like:
• Using cold or hot packs
• Stretching
• Taking over-the-counter pain medication
You should not do the following:
• do not sit or lie down for long periods – even if moving hurts, it is not harmful and can help you get better faster
• do not use hot water bottles to ease the pain – you could scald yourself if your skin is numb
If your pain is not getting better, you should make an appointment with your doctor. Your doctor might suggest other options. He or she might also refer you for physiotherapy – including exercise advice and techniques like massage (manual therapy) and or psychological support – to help you cope with the pain.
If your pain is severe and treatments from your doctor have not helped, he or she may refer you to a specialist for:
• painkilling injections
• a procedure to seal off some of the nerves in your back so they stop sending pain signals
• surgery – an operation called decompression surgery can sometimes help relieve sciatica
How to prevent recurrence of sciatica?
It some cases it might be possible to prevent sciatica. The following are recommended:
• stay active – take regular exercise
• use a safe technique when lifting heavy objects
• make sure you have a good posture when sitting and standing
• sit correctly when using a computer
• lose weight if you are overweight
If you are a smoker, stop smoking as smoking can increase your risk of getting sciatica.
Conclusion
Sciatica pain is caused by an irritation, inflammation, pinching or compression of a nerve in the lower back. The most common cause is a herniated or slipped disc that causes pressure on the nerve root. Most people with sciatica get better on their own with time and self-care treatments. If pain persists, then a visit to your doctor is warranted where several management options will be discussed and a treatment plan going forward instituted.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
