Understanding the Causes, Symptoms and Treatments for Sciatica
Understanding the Causes, Symptoms and Treatments for Sciatica Compression of the sciatic nerve, referred to as sciatica, is a prominent source of leg and lower body pain, particularly in middle-age and elderly patients. This relatively common condition can be caused by an injury in the lower back, but more often than not is caused by regular degeneration in the lumbar region of the spine that comes with the normal aging process. In order to treat this painful condition, it is incumbent on a spine specialist to identify the cause of the nerve compression and develop a comprehensive treatment plan that both alleviates the compression and manages the patient’s pain in a meaningful, lasting way.
What Exactly is the Sciatic Nerve? Most people have heard of sciatica, and recognize it as the cause of chronic leg pain, but very few fully understand what exactly causes the condition. The most important thing to know about sciatica is that while symptoms may be experienced in a leg or throughout the lower body, the origin of the pain is usually in the lumbar spine or sacrum in the lower back. The sciatic nerve is the longest, thickest nerve in the body. . This nerve begins in the lower back (with the L4, L5, S1, S2 and S3 nerve roots), travels down through the buttocks, thigh, knee, calves, and culminates near the toes. It is responsible for innervating a wide variety of muscles and muscle groups. Sciatica occurs when the sciatic nerve becomes compressed in the spinal canal, which interrupts the regular function of the nerve and affects the muscles that are innervated by the sciatic nerve. This is why a spinal condition in the lumbar spine can lead to symptoms that are experienced far away from the source of the pain.
The Origin of Sciatic Pain While sciatica can certainly be caused by a traumatic injury in the lower back or other “avoidable” causes, the compression of the sciatic nerve is typically caused by the presence of a degenerative spine condition. As we grow older, the anatomical components of the spinal column gradually begin to break down as a result of years of wear and tear. Some of the most common types of spinal conditions that cause sciatica include: Degenerative disc disease – The intervertebral discs that cushion and separate the vertebrae become worn and can either bulge or rupture into the spinal canal. Facet disease – The vertebral joints that connect and stabilize adjacent vertebrae are coated with cartilage. Over time, this cartilage can slowly wear away as a result of normal use, which eventually leads to osteoarthritis in the spine. Osteophytes – Also known as bone spurs, osteophytes can develop in the spinal canal as a result of bone on bone contact. These growths of bone aren’t symptomatic in and of themselves, but when they irritate other bone, soft tissue or a nerve, symptoms can develop. Stenosis – The narrowing of either the spinal canal or one of the foraminal canals can result in the compression of a nerve root.
The Origin of Sciatic Pain Additionally, soft tissue can become inflamed over time, ligaments can calcify, and the vertebrae can become misaligned in a condition known as spondylolisthesis – all of which can lead to sciatica. However, it is worth mentioning that in most cases the presence of these conditions in and of themselves doesn’t cause sciatica. A herniated disc, for example, can go completely undetected unless the ruptured disc material comes into contact with the sciatic nerve.
Symptoms While pain in one of the legs is the symptom most commonly associated with sciatica, the compression of the sciatic nerve can cause a variety of symptoms, known collectively as radiculopathy, ranging in severity and location. In addition to chronic pain, sciatica can lead to unexpected muscle weakness, fatigue, soreness, diminished reflexes, numbness or tingling in the extremities, a sensation of heat or a feeling of pins-and-needles, and more.
Treating Sciatica The first and most important step for treating sciatica is diagnosing the cause of the symptoms. Quite often, an individual will waste valuable time trying to treat the symptom of sciatica, rather than focusing on the origin of the pain. This is why if you experience pain that persists for several days, it is a good idea to visit a doctor for a complete medical review. During this appointment, a doctor will attempt to discern the cause of your nerve compression by asking you questions about your overall health, lifestyle habits, and recent injuries. Once the review of the medical history is completed, the doctor will complete a physical examination in order to determine the location in the spine of the nerve compression and begin to diagnose the cause of the problem. Typically, the patient will also be referred to a medical diagnostic center to receive an MRI or CT scan. This is an essential step, because it can clearly pinpoint the location of the nerve compression and determine whether a herniated disc, bone spur, or other condition is causing the patient’s pain. In most cases, treatment for sciatica will begin with a series of techniques that are noninvasive and are focused on both managing the patient’s pain and alleviating the nerve compression. In many cases, these treatments can also be completed at home without supervision. However, it is always essential to work closely with a medical professional to ensure that the treatment will be effective and not prolong or worsen your symptoms.
Treating Sciatica Some of the most commonly recommended conservative treatments for sciatica include: The use of pain medication, anti-inflammatories or muscle relaxants The application of heat or ice Limited rest Low-impact exercises Stretching Some patients also have reported pain relief from their sciatica with alternative medicines, such as acupuncture, deep tissue massage, and chiropractics. These treatments are the source of some controversy in the medical field because their long-term efficacy is somewhat disputed, but many patients have used alternative medicine to great effect.
Surgical Options While noninvasive treatment typically offers sufficient relief from sciatic pain, in some cases a surgical decompression procedure may be recommended to permanently remove the source of the discomfort. Depending on the origin of the sciatic pain, either an outpatient endoscopic procedure or an open spine surgery may be recommended. To determine which type of surgery will afford the best chance of recovery, it is vital that the patient speaks with your doctor about all of your options. In some cases, a minimally invasive, outpatient endoscopic procedure might be able to provide the pain relief you require – as with a herniated disc – in a matter of hours. Yet, with other conditions, like severe spondylolisthesis, open spine stabilization surgery is the only real option.
Learn More Living with sciatic pain can be a real burden and have a discernible impact on your quality of life, but you are not without options. Visit your doctor today to determine the cause and severity of your sciatica and begin a regimen of treatments that are designed to provide the patient with the pain relief they require.