One of the more common ailments that’s presented to me by patients is Sciatica or sciatic like symptoms. Most of the time sciatica is self-diagnosed so here are the facts.
What is Sciatica?
Sciatica is nerve pain from an injury or inflammation of your sciatic nerve. Pressure on the spinal cord or nerves is often the cause. As well as pain, tingling or numbness may occur in your back or bottom that may also radiate down your leg and into your feet and toes.
Your sciatic nerve is the longest and thickest nerve in your body and can be up to 2cm wide. Despite its name, it’s not just one nerve, It is in fact a bundle of nerves that come from five nerve roots branching off from your spinal cord.
You have two sciatic nerves, one on each side of your body. Each sciatic nerve runs through your hip and glute muscles on one side. They each go down the leg on their side of your body until they reach just below your knee. After this, they split into smaller nerves that are then connected to soft tissue further down, including your lower leg, foot and toes.
How common is sciatica?
Sciatica is a very common condition. Nearly half of the population experience some form of sciatica during their lifetime. It is more common in ages 30 and above.
Symptoms of sciatica
Pain - Usually brought on by coughing, sneezing or other abrupt movements. The pain can be a radiating burning feeling or a shooting pain like an electric shock.
Tingling or “pins and needles” - This is a very similar sensation to when a leg falls asleep because you sat cross-legged.
Numbness - This is when you can’t feel any sensation on the affected areas.
Muscle weakness - This is a more serious symptom and is when the muscle command signals in the nerves are having trouble reaching their destinations in your back or legs.
Conditions that can cause sciatica include
Herniated discs.
Degenerative disc disease.
Spinal stenosis.
Spondylitis
Osteoarthritis.
Injuries.
Pregnancy.
Age related wear and tear.
Being overweight or obesity.
Having weak core (spinal muscles) strength.
Physical inactivity.
What are the complications of sciatica?
Most people recover fully from sciatica in a relatively short space of time. However, there is a small chance of chronic (long-term) pain. If there’s serious damage to one or more of the nerves, chronic muscle weakness, such as foot drop might happen. That’s when nerve damage causes numbness in your foot, which affects walking.
Sciatica can also potentially cause permanent nerve damage, resulting in a loss of feeling in the affected legs.
How is sciatica diagnosed?
A healthcare provider can diagnose sciatica using a combination of methods. They’ll review your medical history and ask about your symptoms. They’ll also do a physical examination.
How is sciatica treated?
Treating sciatica usually involves trying to decrease pain and increase mobility. Many treatments are things you can do yourself.
Self Treatment
Ice - Cold or ice packs (or a bag of frozen veg) can help reduce the initial pain and inflammation during the first 24-48hrs. Apply cold for 15-20 minutes at a time, several times a day (wrap ice pack in a kitchen towel)
Heat – If the pain is still there after 48hrs switch to a heat pad or wheat bag. Apply heat for 20 minutes at a time. You can also alternate between hot and cold packs if one gives more relief than the other.
Anti-Inflammatories - such as Ibuprofen or cold/heat gels
Stretching and activity – ask a healthcare or fitness provider for suitable stretches and core strengthening exercises
If self-treatment doesn’t work, then it’s advisable to consult a healthcare professional.
Healthcare professional treatment
Prescription medications - Painkillers, muscle relaxers and anti-inflammatories may help with symptoms.
Physiotherapy - The aim of this is to find exercises that will decrease sciatica by reducing pressure on the nerve. These include stretching, walking, swimming and core strength exercises.
Holistic therapies - These treatments are a great alternative to taking medications or Physiotherapy. Holistic therapies include Sports Massage, Massage Therapy, Dry Cupping, Osteopaths or Clinical Pilates.
Spinal injections - Injections like cortisone are also an option.
Surgery – This may be the only option if sciatica is severe. A specialist consultant will determine the course of action at this point.
How to prevent sciatica in the first place
Maintain good posture - Use correct posture techniques while sitting, standing or lifting.
Maintain a healthy weight - Your GP/practice nurse can guide you on diet and physical activity.
Stay active - This can include stretching, strength training. Core and flexibility exercises can also improve back pain.
Take time to recover if needed - Don’t try to work through back/leg pain.
And finally…
When should I see my healthcare provider?
You should talk to your healthcare provider if you have moderate pain or worse.
Can sciatica occur down both legs?
Sciatica usually affects only one leg at a time. However, sciatica can occur in both legs in rare cases.
Does sciatica occur suddenly, or does it take time to develop?
Sciatica can come on suddenly or gradually. It depends on the cause.
How can I tell if the pain is hip or sciatica related?
Hip problems, such as arthritis in your hip, usually cause pain in your groin, or pain when you put weight on your leg whereas sciatica is predominantly felt in the lower back and/or back of the leg.
If you have any questions relating to sciatica or anything else, then please feel free to contact me.
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