If you’ve got pain that radiates from your lower back, through your buttocks, and down one leg, you may be experiencing the symptoms of Sciatica. The condition gets its name from the Sciatic nerve, which follows the pathway just described. Although the nerve branches out and runs down both sides of the lower back, buttocks, and both legs, you’ll typically experience Sciatic pain on only one side of your body. The pain caused by Sciatica can range from mild to severe, and can also be accompanied by tingling or numbness.
What Causes Sciatica?
Several lumbar spine (lower back) issues can cause Sciatica. There are five sets (or pairs) of nerve roots in your lower back, and the trouble begins when one or more become compressed. What can cause this compression? Typically, it’s a herniated lumbar disc or a bone spur that’s the culprit. It can also be caused by a tumor or by damage caused by diabetes, although this is more rarely the case. An injury can also damage the Sciatic nerve as can Spinal Stenosis, which is a narrowing of the bone channel housing the spinal nerves or the spinal cord. Basically, anything that compresses, irritates, or inflames the Sciatic nerve, which is the largest nerve in the body, can cause symptoms of Sciatica or Sciatic nerve pain.
Who’s at Risk?
Anyone can be affected by Sciatica, but the most common risk factors are
- advancing age
- obesity
- diabetes
- prolonged sitting
- trauma from injury to the lower back caused by twisting, heavy lifting, etc.
- pregnancy
- arthritis
How Sciatica is Diagnosed
Your doctor may initially come to a tentative diagnosis after asking you to perform certain activities such as raising your legs one at a time as you lie on the examination table, walking on your toes, or rising from a squatting position. These are all activities that tend to worsen the pain of Sciatica. The next step will likely be x-rays and/or other imaging tests such as a CT scan or MRI, to determine what is causing pressure on or irritation of the Sciatic nerve.
Treatment Options
Treatment will likely start with non-invasive measures such as anti-inflammatory medications, muscle relaxants, or pain medication, all of which are designed to lessen pain. Your doctor will also likely prescribe self-care measures such as alternating cold and heat therapies and stretching exercises. (Bear in mind that although these measures will help, they’re only treating the symptoms and aren’t getting to the root of the problem.)
Once the acute pain has been reduced, the next step will likely be a program of physical therapy designed to improve lower back strength, correct problems with your posture that might be contributing to discomfort, and improve flexibility. In many cases, the combination of self-care, medication, and physical therapy will be enough to address the problem. If pain persists and is severe, your doctor may recommend an injection of corticosteroids to ease inflammation around the nerve root; however, the relief you’ll experience from an injection is temporary, often lasting a few months, and due to the risk of serious side effects from these powerful drugs, the number of shots your doctor can give you is limited.
Certain alternative therapies such as acupuncture may also help to relieve pain. Some lower back pain can be relieved with chiropractic care, although radiating pain (as is the case with Sciatica) is not usually one of them.
Will You Need Surgery?
Surgery for Sciatica is not common and is usually used as a last resort when symptoms aren’t relieved through less invasive measures, or if they cause loss of bladder or bowel control. Surgery might involve removing the offending bone spur, or removal of the portion of the disc that’s pressing against the Sciatic nerve.
If you’re a resident of Luzerne County, PA, or a surrounding area, the doctors of physical therapy at Cawley Physical Therapy are ready to help reduce your pain and get your life back to normal! Give us a call at 570-208-2787 or send us an email at cawleyptfrank@gmail.com.
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