Sciatica is pain in the lower back or legs caused by irritation of the sciatic nerve. The largest nerve in the body, the sciatic nerve stretches from the lumbar spinal cord in your lower back all the way down to your feet and is responsible for transmitting sensory information from these areas of the body. Sciatic pain is usually felt extending from the lumbar area to behind the thigh, and can even reach below the knee. In most cases is it felt on only one side of the body at a time.
Pain from sciatica can range from mild to severe, and it may feel like it’s radiating over a large area or be sharp and localized. Transitioning from sitting to standing and vice versa can trigger sharp sciatic pain, as can any sudden lower-back movement. Those suffering from sciatica can experience leg numbness, “pins and needles,” burning sensations, foot numbness, limping, and muscle weakness.
Common causes of sciatica are a herniated disk pressing on the nerve, trauma to the lower back, pregnancy, joint dysfunction, degenerative disc disease, and spondylolisthesis.
Herniated disc: This is one of the most common causes of sciatica. A herniated or bulging disc can cause disc material to push against a nearby nerve root, compressing the nerve tissue and causing sciatica. In addition to this pressure, a herniated disc also contains hyaluronic acid, which can cause nerve inflammation, compounding the pain from the compression.
Degenerative disc disease: Though the name is frightening, this is the most common cause of lower back and neck pain and is simply a byproduct of aging. One of the symptoms of degenerative disc disease is inflammation that can irritate the sciatic nerve. Another symptom is muscle spasms attributed to the body attempting to stabilize the spine to prevent additional damage, which can impinge on the sciatic nerve in the process.
Pregnancy: Weight gain and elevated fluid retention associated with pregnancy can compress the sciatic nerve where it passes through the pelvis. An expanding uterus can also compress the sciatic nerve at the base of your spine. In the third trimester, when the baby begins shifting into the birth position, its head can end up pressing against the nerve.
Spondylolisthesis: This condition is most prevalent in older individuals, characterized by the bones, joints and ligaments in the spine gradually weakening and losing their ability to keep the spinal column properly aligned. As these spinal components shift, they can encroach on the sciatic nerve, putting pressure on the nerve and causing pain when standing or walking.
Sacroiliac Joint Dysfunction
The sacroiliac joint connects the spine with the pelvis. Sciatic pain arising from sacroiliac joint dysfunction is not true sciatica, as it does not involve compression of the nerve root, but stems from joint inflammation that can irritate the nearby sciatic nerve. The symptoms, however, can be similar.
There are three million cases of sciatica in the United States each year. Sciatica is usually self-diagnosable and may not require lab tests or medical imaging. Some cases of sciatica can benefit from self-care treatments such as applying an ice pack to the affected area, regular physical exercise, and stretching. More serious cases may require physical therapy, massage, acupuncture or chiropractic treatment. In addition to these physical treatments, some severe forms of sciatica may require an epidural steroid injection to alleviate the pain, pain medication, anti-inflammatory drugs, muscle relaxants or analgesics like Tylenol.
Sciatica pain can last weeks or months, depending on the root cause and treatment used. There is no quick fix, but the right treatment and management can relieve the pain and allow the resumption of normal activities. For diagnosis and treatment recommendations, contact the Pain Care Clinic of Idaho to schedule an appointment. Call (208) 629-2492.