The nerve of sciatica

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A common condition experienced by millions of people knows all too well how painful it can be.  Sciatica – just the sound of it sounds unnerving and that’s exactly what it is affecting.  The annoying pins and needles feeling or excruciating shooting pain originating in the buttocks and radiating down the leg(s) results from pressure on the nerve roots coming from the spinal cord.  A nerve called the sciatic nerve runs from the lower back, through the buttocks and down the back of each leg and is the largest nerve in the body.  It begins from nerve roots in the lumbar spinal cord in the lower back and the resulting sciatica is also sometimes referred to as sciatic nerve pain.

Causes of sciatica

If you have sciatica you are not alone as it is considered to be very common with more than 3 million cases in the United States each year.  The causes of it are numerous and typically start with a problem in the lower spine such as:

·      Herniated Disk

Also known as a ruptured or slipped disk, this is the most common cause of sciatica.  A pad of tissue called a disk is between each of the vertebral bones in the spinal column.  A herniated disk occurs when there is bulge putting pressure on the nerve roots.  If this is the cause, sciatica will usually go away within a few months as over time, the inflammation and compression of the disk shrinks and pulls away from the sciatic nerve bringing relief from pain.

·      Spinal Stenosis

This condition is typically happening after age 50 when there is a narrowing in one or more areas of the spine.  This is due to wear and tear of the disks and spinal (facet) joints leading to the spaces between the vertebrae to narrow with bony growths or disk bulges forming compressing the roots of the sciatic nerve.

·      Spondylolisthesis

Another condition that may develop due to wear and tear is spondylolisthesis.  If a vertebrae slips slightly forward it narrows the space needed for the spinal nerve roots and can possibly lead to sciatica.

Other less common causes of sciatica might include cysts or tumors compressing the sciatic nerve, pain related to the sacroiliac joint that connects the spine to the pelvis, or nerve damage in the legs due to peripheral neuropathy which is a complication of diabetes.

Treatment for sciatica

Time is needed for the body to heal and in about 75 percent of people with sciatica, the symptoms of it will generally go away within about one to three months.  Because of the shooting, burning pain, the main form of treatment is to control the discomfort during this time of healing.  This can include:

·      Medications

Usually a nonprescription pain reliever is the first choice for pain relief.  If the pain is severe and unbearable, there are certain prescription medications that can be tried to help with discomfort.

·      Modified activity

If the pain is particularly bad, resting for a day or two is advisable but what is not good is to have long periods of inactivity.  This can lead to loss of muscle strength and bone mass.  It is best if a person can continue with their daily routine as tolerated.  Modifications can be made of easy walking, swimming or using a stationary bike can still allow some activity without diminishes in physical fitness.  There are certain exercises that can help relieve sciatica and improve lower back flexibility.  

·      Physical therapy

Physical therapy is a good way to regain movement and flexibility in the lower back along with stretching exercises.  Another treatment method is to apply a heating pad or an ice pack wrapped in a towel to the area of pain for 15-minute intervals three or four times a day to improve symptoms. 

·      Other treatments

Alternative ways to treat sciatica can be losing weight as this help reduce stress on the lower spine which could be compressing the sciatic nerve roots; also some people find relief from acupuncture or massage therapy.

·      Surgery or injections

If a person is failing to find relief from sciatic symptoms and the pain is ongoing, then other options might include injections or surgery.  Inflammation-reducing corticosteroid injections into the area of the nerve root is effective with pain relief usually lasting for a few months, but there is a limit on the number of injections a person can have.

Another option is surgery to relieve the compression.  This is usually reserved for those who are beginning to have muscle weakness or loss of bladder or bowel control. 

With any pain a person is experiencing, always have a physician examine you to get an accurate diagnosis and to recommend the optimal way to treat it.