Sciatica

The sciatic nerve is the longest nerve present in our body extending from the lower back to the back of each leg. When this nerve compresses or irritates, it causes pain, and the condition is called as sciatica. The pain is usually felt in the buttocks and legs. Although the pain associated with the condition is severe, in most of the cases the pain may go naturally, but in few, it can last for a year or more and may require surgery.

Signs and symptoms

Pain is the main and common symptom of sciatica. It ranges from mild to severe and may become worse by sneezing, coughing, or sitting for a long time. Other symptoms of sciatica include numbness, tingling sensation that radiates from lower back to one or both the legs, and finally to your toes.

Call your doctor immediately when you experience these symptoms and if the pain last longer than a week.

Causes

A “slipped disc” is the common cause of sciatica which occurs when one of the discs present between the spinal bones or vertebrae gets damaged and presses the nerves. However, the reason for the damage is still not known. As you become old, your discs become less flexible and more likely to rupture.

Other causes include:

  • Growth or tumor formation within the spine
  • Spondylolisthesis – Slipping of vertebra out of the position
  • Spinal stenosis – Narrowing of the nerve passage in the spine
  • Cauda equina syndrome – it is a rare and serious condition caused by compressed and damaged nerves in the spinal cord
  • A spinal injury or infection

Risk factors

The conditions that increase the risk of sciatica include:

  • Age: age-related changes in the spine or vertebrae, such as herniated disks and bone spurs

  • Obesity: overweight increases the stress on your spine that triggers sciatica

  • Prolonged sitting: if you have sedentary lifestyle and sit for prolonged periods then you are more likely to develop sciatica than other people

  • Diabetes: this condition increases the risk of nerve damage

  • Carrying heavy load or drive motor vehicles for a long period might increase the risk of having sciatica.

Complications

The condition can be managed on its own without any treatment in few patients. But if the symptoms are persistent, and the condition is left untreated, then you may end up with permanent nerve damage. Therefore, do not ignore if you have loss of sensation or weakness in the affected leg, loss of bowel or bladder function.

 

Diagnosis

Your doctor diagnoses the condition based on your symptoms and then provides appropriate treatment. Your doctor performs a passive straight leg raise test during which you will be asked to walk on your toes or heels and lay flat on your back, and lift one leg at a time. If you have pain or your symptoms worsen while lifting one of your legs, then your doctor may suspect sciatica. The following tests may be recommended to confirm the diagnosis:

  • X-ray - to check if there is any overgrowth of the bone that may be pressing the nerve
  • MRI scan and CT scan - gives detailed images of the bones and soft tissues
  • Electromyography - this test confirms nerve compression caused by herniated disc or narrowing of spinal canal

Treatment

If your pain doesn’t improve on its own, your doctor would suggest few treatment options:

Medications - These are mainly prescribed to relieve the pain. The commonly used medications are anti-inflammatory drugs, muscle relaxants, narcotics, tricyclic antidepressants, and anti-seizure medications. Sometimes, corticosteroid injections are prescribed as they reduce pain by suppressing inflammation around the irradiated nerve.

Physical therapy - This therapy is recommended as it includes various exercises to correct your posture, and strengthen the muscles of your back and improve your flexibility. Usually, stretching exercises are advised, as they help in alleviating the sciatic