Sciatica is one of those conditions that cannot be concealed for long as its symptoms are as clear as crystal. Although back pain can be caused by many things, you can tell straight away whether or not it's sciatica. Find out in this guide what telltale signs to watch out for to instantly spot the presence of this musculoskeletal condition.
What is Sciatica?
Sciatica occurs when the sciatic nerve gets injured and causes excruciating pain in the back that spreads throughout the legs. The sciatic nerve is located in the lower spine and goes through the hip, buttock and down to the leg and foot. You know it's sciatic pain when it only affects one leg. Rarely does sciatica affect both legs, though it may happen.
Sciatica pain usually develops from the growth of a bone spur on the spine or by disc herniation, a condition in which the intervertebral disc in your spine erodes due to injury or ageing. The spinal column consists of 33 tiny bones called vertebrae, which are separated by round, flat intervertebral discs that serve as cushions to avoid friction between the bones and as shock absorbers for the spine, protecting it from the impact of stress when you walk, run or jump.
Placing too much stress on the discs makes them susceptible to all kinds of injuries such as herniated discs. When that happens, the gel-like substance in the middle of the disc leaks and irritates the spinal nerves, including the sciatic nerve, which is the largest nerve formed by the merging of five spinal nerve roots in the lower spine. This sets off a sharp sciatic nerve pain.
What are the Symptoms of Sciatica?
Sciatica symptoms are easily recognisable as they're distinctly unique to other types of back pain. If the pain radiates down to your foot, there's no doubt that you have sciatica. The most common sciatica symptoms include:
- Moderate to severe pain that travels from the lower back, buttock to the side or back of leg
- Muscle spasm and numbness
- Muscle weakness in the affected leg or foot
- Pain with movement
- Loss of bowel control
- Loss of bladder control
What are the Causes of Sciatica?
Disc degeneration, resulting from wear and tear, unhealthy lifestyle choices or a chronic condition, is the primary cause of sciatica as it shortens the spinal discs, which in turn narrows the spaces between the vertebrae of the spine and puts too much pressure on the sciatic nerve roots. Other risk factors for sciatica include:
- Excess body weight
- Sitting for long periods
- Poor posture
- Carrying heavy loads
- Sacroiliac joint dysfunction due to a fall or sudden twisting
- A medical condition such as diabetes or osteoarthritis
- Degenerative disc disease such as lumbar disc herniation
How is Sciatica Diagnosed and Treated?
Sciatic pain is not a hopeless case. In fact, early diagnosis of sciatica is the key to preventing permanent nerve damage. The diagnostic process starts with a physical exam. The doctor may ask you to perform a series of movements, such as walking on your toes and heels and getting up from a sitting or squatting position as well, for the assessment of your calf muscles. As leg pain is a common symptom of this painful condition, the doctor has to check your legs' muscle strength.
The straight leg raise test is one of the most common ways to diagnose patients with sciatica. During which, you will be asked to lie on your back with your legs straight. Then, the doctor will raise each leg to determine at which point you experience pain. Some patients with sciatica would complain about leg pain during this procedure, while others would feel a shooting pain as a result of the piriformis muscle, which is located in the buttock, pinching the sciatic nerve.
A series of imaging tests may also be ordered for severe symptoms. These may include any of the following:
- Magnetic resonance imaging (MRI) provides detailed images of the bone and soft tissues.
- X-ray reveals the growth of bone spurs, fractures and other disc problems.
- Computerized tomography (CT) scan takes cross-sectional images of the bone that can be studied on a computer monitor. It is usually recommended if a patient has a herniated disc, complains about back pain that comes with fever, and has problems with bladder function.
- Electromyography (EMG) measures the electrical impulses that travel through the sciatic nerve and the response of the muscles.
- Myelogram detects tumours, cysts and other problems in the spinal column.
Depending on the severity of sciatica, its symptoms can be reduced with the application of hot and cold packs. An ice pack alleviates pain and swelling, while a heating pad helps to loosen up the tight muscle and increase range of motion.
Muscle relaxants, anti-inflammatory drugs and over-the-counter pain relievers are other common treatments for sciatica, though prolonged use of these medications can cause adverse reactions like dizziness, headache, irritability, blood clots, stomach ulcers and kidney problems among others.
Physical therapy is found to be an effective treatment for sciatica as it eases the pressure on the nerve through different stretching movements and an aerobic exercise program. However, it's important to consult a qualified physical therapist before starting on any exercise as some fitness routines can do more harm than good to your condition. Research shows that excessive hamstring stretching, squats and leg exercises will only lead to further compression of the sciatic nerve.
Massage therapy, acupuncture and chiropractic care are other complementary therapies that have been proven to be effective in treating sciatica pain.
Can Sciatica be Prevented?
Avoiding putting so much stress on your back is the only way you can prevent sciatica. Although nothing can prevent disc degeneration, there are ways to defer it and maintain a strong, healthy spine into old age. Here are some helpful tips:
- Maintain a healthy diet to achieve a healthy weight. Although you don't necessarily have to stick to a plant-based diet if you don't want to, eating foods that are devoid of saturated fats and refined carbs and high in protein, calcium, magnesium, omega-3 fatty acids and vitamins B, C, D and K is a sure-fire way to combat sciatica.
- Perform a gentle exercise every day. Regular exercise improves flexibility, increases endurance and tones the core muscles, which consist of the abdominal and lower back muscles.
- Maintain proper posture at all times to reduce pressure on your spine. To do this, pull your shoulders back, tuck your stomach in and keep your head aligned with your spine.
- Don't drink and smoke. Alcohol weakens the spine as it dehydrates the intervertebral discs. Smoking, on the other hand, reduces the blood supply to bones and aggravates lumbar pain.
If you have visible signs of sciatica, it's not too late to treat it. You may get in touch with a qualified physical therapist, chiropractor, acupuncturist or massage therapist in your local area through the Natural Therapy Pages. Moreover, working with a nutritionist or dietitian is a great way to upgrade your diet with healthier, bone-friendly foods.