Sciatica

Causes, Symptoms, and Treatment Remedies




Sciatica Treatment Remedies

 

The contents of this app are provided for educational purposes only and are not intended to diagnose, treat, cure, or prevent any disease or health condition. The information provided should not be considered as a substitute for the advice of a medical doctor or other healthcare professional.

More about Sciatica

Sciatica can be described as a nerve pain triggered by the irritation of the sciatic nerve.

Acute sciatica does not typically require professional treatment; symptoms can be significantly reduced with the use of accessible over-the-counter (OTC) painkillers combined with hot and cold packs and exercise.

Chronic sciatica, on the other hand may require physical therapy (UK: physiotherapy), which may include exercise, applied heat, and other techniques. In rare cases surgery may be required.

Sciatica as a symptom manifests as leg pain which could be excruciating or to some degree appear like a leg cramp. Numbness or tingling sensations down the legs and toes are common.

The pain associated with sciatica begins in the lumbar area and radiates behind the thigh down to your knee.

The pain is worse when one sits, sneezes, or coughs.

Sciatica may either develop gradually or occur suddenly.

A "pinched nerve" in the spinal canal could be the primary cause of sciatica. When the sciatic nerve is pinched by say a bone spur or a herniated intervertebral disc in the spine, it is compressed by some tumour.

The spongy discs in between the vertebrae of your spine are the intervertebral discs. These discs are characterized by a strong outer layer of cartilage and a soft gelatinous centre that plays the role of a shock absorber. When the disc’s outer layer is weakened, by age or injury, the soft centre bulges out resulting to a ruptured or herniated disc.

As the disc’s soft centre bulges through the weakness, it leaks chemicals which irritate the nerve root leading to inflammation.

The various treatment options for sciatica vary from one another depending on the exact cause of the symptoms and the severity of pain registered.

Sciatic pain could be a result of spinal stenosis, a herniated disc, an infection, or a tumour.

Bone spurs, also known as osteophytes, can be described as the bony outgrowths witnessed on the edges of one’s joints. These bony outgrowths are common in arthritis where cartilage is worn thin and bones rub on each other.

In a move to protect your body, new bones form at the edge of joints. The new bones are known as bone spurs.

Within the spine, a bone spur can intrude the nerve’s space causing sciatica. This sciatica pain is caused by the rubbing of bone spurs on nearby nerves and bones.

Sciatica Symptoms

Lower back pain, if experienced at all, is not as severe as leg pain.

Constant pain in only one side of the buttock or leg, but rarely both the right and left sides.

Pain that originates in the low back or buttock and continues along the path of the sciatic nerve - down the back of the thigh and into the lower leg and foot.

Pain that feels better when patients lie down or are walking, but worsens when standing or sitting.

Pain that is typically described as sharp or searing, rather than dull.

Some experience a "pins-and-needles" sensation, numbness or weakness, or a prickling sensation down the leg.

Weakness or numbness when moving the leg or foot.

Severe or shooting pain in one leg that may make it difficult to stand up or walk.

Depending on where the sciatic nerve is affected, the pain and other symptoms may also include foot pain or pain in the toes.

The most prominent symptom of sciatica is pain that radiates from the lumbar region to the buttock area, and down to the back of your leg.

Some persons diagnosed with sciatica complained of a shooting pain that made it difficult for them to stand up.

Such persons may also experience great difficulty moving their leg or feet.

Burning or a tingling sensation in the leg.

A constant pain may also be felt on an individual’s one side of the rear.

Other physical symptoms include numbness, weakness, diminished tendon reflexes, and difficulty coughing and sneezing due to impulse pain.

It is also important to note that unlike general back pain, sciatica does not affect the back but simply radiates to other parts of the nerve beginning from the lower back and down to the buttock area before finding its way to the legs.

The pain associated with sciatica grows with time and may be exacerbated by bending backwards, standing or sitting for an extended period of time, laughing, sneezing, or coughing.

The pain may vary from a mild physical pain to a sharp ache, or excruciating discomfort..

Sometimes persons diagnosed with sciatica may experience a feeling similar to that of a jolt or an electric shock.

In most cases, only one side of an individual’s body is affected. Pain may be felt in one part of the leg while a feeling of numbness may be felt in another part.

Sciatica Causes

Sciatica is caused by a number of conditions, among them a slipped or herniated disc that exerts pressure on your nerve root.

A lumbar herniated disc results when the nucleus pulposus (the disc’s soft inner core) of the disc leaks out via the annulus (fibrous outer core) irritating the nerve root.

A herniated disc can also be referred to as a pinched nerve, protruding disc, slipped disc, bulging disc, or a ruptured disc.

One other cause for sciatica is piriformis syndrome where the piriformis muscle spasms and irritates the sciatic nerve.

The piriformis muscle is a tiny muscle deep within the buttocks.

Lumbar spinal stenosis occurs when the spinal canal narrows due to exertion of pressure on the nerves. This is a common occurrence in adults older than 60 years and results in sciatica.

When one vertebra slips out of place, the opening through which the nerve escapes narrows down leading to sciatica. This is known as spondylolisthesis.

Isthmic Spondylolisthesis is a condition that results when one vertebral body slips forward on another vertebral body. A good example is when the L5 vertebra slips over the S1 vertebra. This combined with the fracture, the collapse of the disc space, and the slipping forward of the vertebral body results to a pinch on the nerve and consequently to sciatica.

The other cause of sciatica is sacroiliac joint dysfunction. In this case, the sacroiliac joint right at the bottom of your spine is irritated which irritates the L5 nerve leading to sciatica.

Sacroiliac joint dysfunction. Irritation of the sacroiliac joint - located at the bottom of the spine - can also irritate the L5 nerve, which lies on top of the sacroiliac joint, causing sciatica-type pain. The leg pain can feel the same as sciatica caused by a nerve irritation.

Pregnancy. The changes that the body goes through during pregnancy, including weight gain, a shift on one's center of gravity, and hormonal changes, can cause sciatica during pregnancy.

Scar tissue. If scar tissue compresses the nerve root, it can cause sciatica.

Muscle strain. In some cases, inflammation related to a muscle strain can put pressure on a nerve root and cause sciatica.

Spinal tumor. In rare cases, a spinal tumor can impinge on a nerve root in the lower back and cause sciatica symptoms.

Infection. While rare, an infection that occurs in the low back can affect the nerve root and cause sciatica.

Some cases of sciatica in women have been linked to changes that occur in the body during pregnancy. Weight gain, a shift in centre of gravity, hormonal changes, and other factors surrounding pregnancy increase the risk of sciatica in women.

Some patients diagnosed with sciatica had spinal tumours which may have impinged on the nerve root causing sciatica in the process.

Muscle strain is also believed to cause inflammation which might irritate the nerve root and cause sciatica.

Infections in the lower back are also responsible for some of the cases of sciatica reported.

A number of risk factors have been associated with sciatica. Some of the risk factors that increase the incidence of sciatica include age, obesity, diabetes, prolonged sitting, and certain occupations.

Some changes in the spine have been linked to age. Such changes include bone spurs and herniated disks, which are common causal factors for sciatica.

Studies have shown that obesity increases strain on an individual’s spine leading to development of spinal changes that may trigger sciatica.

It is believed that since diabetes affects how one uses blood sugar, it can increase the risk of sciatica by damaging nerves.

Sitting in a single position for a prolonged period of time puts you at a much higher risk of sciatica compared to active people.

Job occupations that require one to twist his back or to carry loads on his back will definitely increase the risk of sciatica.

Other causes of sciatica include wearing high heels for women, sleeping on a mattress that is overly soft, and failure to engage in exercises.

Sciatica Diagnosis

Diagnosis for sciatica requires a comprehensive medical history, and an in-depth review of the patient’s symptoms.

Your health care provider may also carry out a physical exam to establish the cause of the symptoms of sciatica.

During the physical exam, your doctor may carry out a straight-leg-raise test where the patient lies on his back with his legs straight. Your doctor will then raise each leg of his patient in a slow fashion to discover the elevation point at which the patient’

The straight-leg-raise test helps identify the affected nerves and makes it possible to find out if there is any problem with any of the patient’s discs.

As part of the physical examination, your health provider may examine your muscle strength and to some extent the reflexes. He may ask you to tip-toe, to move your legs one after the other, or to rise slowly from a squatting position.

During such activities, genuine pain caused by sciatica will obviously be registered.

Alternative diagnostic tests may also be performed by your health provider to establish other possible causes of the patient’s sciatic pain.

Such diagnostic tests may include use of X-ray to look up for possible fractures in the patient’s spine or use of computed tomography (CT) scan to image the structures of the back.

Your health provider may also carry out a nerve conduction velocity study, electromyography, or evoked potential testing to analyse the movement of electrical impulses in the sciatic nerve.

To determine if a vertebra or disc is the cause of the sciatic pain, doctors may inject dye between the vertebrae.

Sciatica Treatment

Acupuncture. The practice is centered on the philosophy of achieving or maintaining well being through the open flow of energy via specific pathways in the body. Hair-thin needles (that are usually not felt) are inserted into the skin near the area of pain.

Acupuncture has been approved by the U.S. FDA as a treatment for back pain, and the National Institutes of Health has recognized acupuncture as effective in relieving back pain, including sciatica.

Spinal adjustments and manual manipulation performed by appropriately trained health professionals (such as chiropractors, osteopathic physicians, physical therapists) are focused on providing better spinal column alignment, which in turn should help to address a number of underlying conditions that can cause sciatic nerve pain.

Your doctor may prescribe a number of drugs to relieve sciatica pain including anti-inflammatories, muscle relaxants, narcotics, tricyclic antidepressants, and anti-seizure medications.

If a patient reports dampening in pain, a physical therapist may come up with a rehabilitation program to stop reoccurrence of the pain or injury.

In most cases, physical therapy would involve posture correction exercises, muscle strengthening, and flexibility boosting.

Doctors may also suggest use of steroid injections (corticosteroid medication) to stamp down inflammation around the nerve root.

The frequency with which the steroid injections may be served is restricted by clinicians to avoid serious side effects.

Clinicians may suggest surgery in cases where the compressed nerve results in substantial weakness, and significant bowel or bladder incontinence.

Surgery is also the preferred mode of treatment when the patient’s pain fails to subside with other therapies.

During surgery, surgeons may opt to get rid of the bone spur. They may also remove that portion of the herniated disk that presses on the pinched nerve.

Numerous self-care treatment approaches have also been suggested by clinicians to treat sciatica. These treatments include lifestyle as well as home remedies such as cold packs, hot packs, stretching and over-the-counter medications.

A cold pack may be placed right above the painful area several times in a day (say for 20 minutes) to relieve the patient of pain.

Hot packs such as a heating pad can be used where the cold pack does not produce the required results. Clinicians recommend alternating cold and warm packs to help deaden sciatica pain.

Over-the-counter medications such as ibuprofen and naproxen could be used as pain relievers.

Acupuncture and spinal adjustment are some of the alternative therapies recommended by doctors to relieve low back pain.

In acupuncture, hair-thin needles are inserted by practitioners into the skin at certain points of the patient’s body. You should choose a licensed practitioner with extensive training to perform this procedure.

Spinal adjustment, also known as spinal manipulation, is a form of therapy exclusively used as the treatment option for restricted spinal mobility.

Spinal adjustment helps in the restoration of spinal movement which consequently reduces pain and boost functionality.

Exercises for Specific Sciatica Conditions. The specific sciatica exercises will depend on the underlying medical condition causing the sciatica pain, as well as a number of other factors, such as the patient's level of pain and overall conditioning.

Sciatica Exercises for a Herniated Disc

The low back is gently placed into extension by lying on the stomach (prone position) and propping the upper body up on the elbows, keeping hips on the floor. This should be started slowly and carefully, since some patients cannot tolerate this position at first.

Hold the press-up position initially for five seconds, and gradually work up to 30 seconds per repetition. Aim to complete 10 repetitions.

From the prone position (lying flat on the stomach), press up on the hands while the pelvis remains in contact with the floor. Keep the lower back and buttocks relaxed for a gentle stretch. This position is typically held for 1 second, repeated 10 times.

Upper back extension. In the prone position with hands clasped behind the lower back, raise the head and chest slightly against gravity while looking at the floor (stay low). Begin by holding position for 5 seconds, and gradually work up to 20 seconds. Aim to complete 8-10 repetitions.

In the prone position with the head and chest lowered to the floor, lightly raise an arm and opposite leg slowly, with the knee locked, 2 to 3 inches from the floor. Begin by holding position for 5 seconds, and complete 8 to 10 repetitions. As strength builds, aim to hold position for 20 seconds.

Curl-ups. For the upper abdominals, the patient should lie on the back with knees bent, arms folded across the chest, and the pelvis tilted to flatten the back. Then curl-up lifting the head and shoulders from the floor. Hold for two to four seconds, then slowly lower to starting position. As strength builds, aim to complete two sets of ten curls.

For the lower abdominals, tighten the lower stomach muscles and slowly raise the straight leg 8 to 12 inches from the floor, keeping the low back held flat against the floor. Hold leg raise for eight to 10 seconds, then slowly lower to starting position. As strength builds, aim to complete two sets of ten lifts.

Water exercises are also excellent to strengthen the lower abdominal muscles, and even just walking in waist-deep water can be helpful.

Sciatica Exercises for Spinal Stenosis

Back flexion. Lie on the back and gently pull the knees to the chest until a comfortable stretch is felt. After 30 seconds, slowly return to starting position. Aim to complete four to six repetitions of this flex.

Get down on the hands and knees, then sit back on the heels with the chest down and arms outstretched. After 30 seconds, slowly return to starting position. Aim to complete four to six repetitions of this stretch. Do not bounce on heels.

Lie on the back and press the low back into the floor by tightening the lower stomach muscles, pulling the navel (or belly button) in and up, hold for 10 seconds. Aim to complete eight to ten repetitions of this press.

Hook-lying march. For a more advanced sciatica exercise, this position may be held while marching in place in the hook-lying position, slowly raising alternate legs 3 to 4 inches from the floor. Aim to 'march' for 30 seconds, two to three repetitions, with 30-second breaks in between repetitions.

Curl-ups. Another strengthening exercise that may be recommended by spine specialists to strengthen the lower abs is called a curl-up. These are done by folding arms across chest, flattening the back by tightening lower abs, then raising the head and shoulders from the floor. Hold for two to four seconds, then slowly lower to starting position. As strength builds, aim to complete two sets of ten curls.

Sciatica Exercises for Degenerative Disc Disease

Hook-lying march. While lying on the back on the floor, with knees bent and arms at sides, tighten the stomach muscles and slowly raise alternate legs 3 to 4 inches from the floor. Aim to 'march' for 30 seconds, for two to three repetitions, with 30-second breaks in between repetitions.

Hook-lying march combination. Same exercise as described above, but includes raising and lowering the opposite arm over the head.

Bridging. Start by lying on the back with the knees bent, then slowly raise the buttocks from the floor. Hold bridge for eight to 10 seconds, then slowly lower to starting position. As strength builds, aim to complete two sets of ten bridges.

Raise one leg behind with the knee slightly bent and no arch in the back or neck. Hold for four to six seconds, then slowly lower to starting position. As strength builds, aim to complete two sets of ten leg raises.

Lying face down, with elbows straight and arms stretched above the head, raise one arm and the opposite leg 2 to 3 inches off the floor. Hold for four to six seconds, then slowly lower to starting position. As strength builds, aim to complete two sets of opposite side raises.

Raise one leg behind with the knee slightly bent and no arch in the back or neck. Hold for four to six seconds, then slowly lower to starting position. As strength builds, aim to complete two sets of ten leg raises.

For a slightly more advanced exercise, raise one leg with the knee slightly bent and no arch in the back or neck and also raise the opposite arm. Hold for four to six seconds, then slowly lower to starting position. As strength builds, aim to complete two sets of ten leg raises.

Exercise for Sciatica from Isthmic Spondylolisthesis

Pelvic tilt. Specialists treating patients with sciatica from isthmic spondylolisthesis frequently recommend the pelvic tilt, as it will hold the lower spine in the flexed position. This includes lying on the back with knees bent and flattening the back by tightening the lower stomach muscles, pulling the navel in and up. Hold this position for 10 to 20 seconds, then relax the muscles. Aim to complete a set of 10 pelvic tilts to strengthen the lower stomach muscles.

Curl-ups. Strengthening the abdominals with the curl-ups will also help maintain a proper lower spine position. Lie on the back with knees bent, fold arms across the chest, tilt the pelvis to flatten the back by pulling the navel (or belly button) in and up. Then curl-up, lifting the head and shoulders from the floor. Do not attempt to lift too high, and bring the head and chest towards the ceiling. For patients with cervical spine problems, place the hands behind the head forsupport. Hold for two to four seconds, then slowly lower to starting position. As strength builds, aim to complete two sets of ten curls.

Hook-lying march. As another form of stabilization exercise, the hook-lying march and hook-lying combination are again useful here as well. Aim to 'march' for 30 seconds, two to three repetitions, with 30-second breaks in between repetitions.

Stretches and Exercise for Sciatic Pain from Piriformis Syndrome

Lie on the back with the legs flat. Pull the affected leg up toward the chest, holding the knee with the hand on the same side of the body and grasping the ankle with the other hand. Trying to lead with the ankle, pull the knee towards the opposite ankle until stretch is felt. Do not force ankle or knee beyond stretch. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.

Lie on the floor with the legs flat. Raise the affected leg and place that foot on the floor outside the opposite knee. Pull the knee of the bent leg directly across the midline of the body using the opposite hand or a towel, if needed, until stretch is felt. Do not force knee beyond stretch or to the floor. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.

Lie on the floor with the affected leg crossed over the other leg at the knees and both legs bent. Gently pull the lower knee up towards the shoulder on the same side of the body until stretch is felt. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.

Sacroiliac (SI) Joint Exercises for Sciatic Pain

Single knee to chest stretch. Pull one knee up to the chest at a time, gently pumping the knee three to four times at the top of the range of motion. Do 10 repetitions for each leg.

Press-up. From the prone position, press up on the hands while the pelvis remains in contact with the floor. Keep the lower back and buttocks relaxed for a gentle stretch. Hold the press-up position initially for five seconds, and gradually work up to 30 seconds per repetition. Aim to complete 10 repetitions.

Lumbar rotation - non-weight bearing. Starting by lying on the back with both knees bent, keep the feet flat on the floor while rocking the knees from side to side. The thighs should rub together and the knees will not move very far. The lower spine should remain fairly still. Rock the knees for 30 seconds.

Sciatica Prevention

Preventing sciatica is not an easy task given its tendency to recur in persons with a history of sciatica. However, a number of suggestions have been floated to help in prevention of sciatica and to reduce its risk.

Regular exercises of the back and core muscles (lower back and abdomen muscles) will help in the prevention of sciatica. Your doctor should suggest alternative forms of exercises.

Regular exercises help strengthen the muscles of your abdomen and lower back which ar essential for supporting your spine.

Maintaining a proper sitting posture and choosing a seat that adequately supports your lower back is highly recommended by clinicians to prevent occurrence of sciatica. You can use a pillow to support your lower back.

Maintaining a healthy diet and the right weight keeps sciatica at bay.

Prolonged bed rest and inactivity should also be avoided.

Practicing proper lifting techniques helps prevent sciatica. Studies have shown that smoking favour disc degeneration.

keeping off from smoking lowers your risk of experiencing sciatica.

Sciatica Statistics & Facts

Sciatica typically affects one single side of the patient’s body.

The most prominent method recommended to prevent sciatica is to stay active and to eat healthy.

Persons developing sciatica will first complain of lower back pain.

The sciatic nerve is the largest and longest nerve in the body.

Sciatica is most common in people aged between 25 and 45 years.

Sciatica may also be triggered by gunshot wounds, pelvic fractures, and other forms of trauma to a person’s buttock area or thighs.

Sciatica is more prevalent than back pain.

About 90 percent of the cases of sciatica respond to conservative treatment. Treatment may take 12 weeks (3 months)

Sciatica occurs in 1-10 percent of the population.



Sciatica Treatment Remedies plus




The contents of this app are provided for educational purposes only and are not intended to diagnose, treat, cure, or prevent any disease or health condition. The information provided should not be considered as a substitute for the advice of a medical doctor or other healthcare professional.

What is Sciatica?

Sciatica (pronounced sai-AT-ti-ka) is the name given to any pain stemming from the irritation of the sciatic nerve. Anything that irritates this nerve can cause pain that ranges from mild to severe; usually, from a compressed nerve root in the lumbar (lower) spine.

The sciatic nerve is the longest nerve in the human body. The sciatic nerve runs from one’s spinal cord, goes through the hips, and down to the thighs. It extends to the buttock area and runs down to the lower limb.

The sciatic nerve is also the largest nerve with the thickness of that of your finger.

Its primary responsibility is to control leg muscles and sensation in feet and the legs.

Sciatica is not, in fact, a condition, but rather a symptom of another problem involving the sciatic nerve.

Sciatica Symptoms

Pain in the rear or leg that is worse when sitting.

Burning or tingling down the leg.

Weakness, numbness, or difficulty moving the leg or foot.

A constant pain on one side of the rear.

A shooting pain that makes it difficult to stand up.

Sciatica Causes

Lumbar herniated disc. A herniated disc occurs when the soft inner core of the disc (nucleus pulposus) leaks out, or herniates, through the fibrous outer core (annulus) and irritates the contiguous nerve root. A herniated disc is sometimes referred to as a slipped disc, ruptured disc, bulging disc, protruding disc, or a pinched nerve. Sciatica is the most common symptom of a lumbar herniated disc.

Degenerative disc disease. While disc degeneration is a natural process that occurs with aging, for some people one or more degenerated discs in the lower back can also irritate a nerve root and cause sciatica. Degenerative disc disease is diagnosed when a weakened disc results in excessive micro-motion at that spinal level, and inflammatory proteins from inside the disc become exposed and irritate the area (including the nerve roots).

Isthmic spondylolisthesis. This condition occurs when a small stress fracture allows one vertebral body to slip forward on another (e.g. the L5 vertebra slips over the S1 vertebra). With a combination of disc space collapse, the fracture, and the vertebral body slipping forward, the nerve can get pinched and cause sciatica.

Lumbar spinal stenosis. This condition commonly causes sciatica due to a narrowing of the spinal canal. Lumbar spinal stenosis is related to natural aging in the spine and is relatively common in adults over age 60. The condition typically results from a combination of one or more of the following: enlarged facet joints, overgrowth of soft tissue, and a bulging disc placing pressure on the nerve roots, causing sciatica pain.

Piriformis syndrome. The sciatic nerve can get irritated as it runs under the piriformis muscle in the buttock. If the piriformis muscle irritates or pinches a nerve root that comprises the sciatic nerve, it can cause sciatica-type pain. This is not a true radiculopathy (the clinical definition of sciatica), but the leg pain can feel the same as sciatica caused by a nerve irritation.

Sciatica Treatment

For acute sciatic pain, heat and/or ice packs are readily available and can help alleviate the leg pain, especially in the initial phase. Usually ice or heat is applied for approximately 20 minutes, and repeated every two hours. Most people use ice first, but some people find more relief with heat. The two may be alternated.

Over-the-counter or prescription medications may also be helpful in relieving sciatica. Non-steroidal anti-inflammatory drugs (such as ibuprofen, naproxen, or COX-2 inhibitors), or oral steroids can reduce the inflammation that is usually a contributing factor in causing sciatica pain.

Certain forms of massage therapy have been shown to have a number of benefits for back pain, including increased blood circulation, muscle relaxation, and release of endorphins (the body’s natural pain relievers).

If the pain is severe, an epidural steroid injection can be performed to reduce the inflammation. An epidural injection is different from oral medications because it injects steroids directly to the painful area around the sciatic nerve to help decrease the inflammation that may be causing the pain.

Many sciatica exercises serve to strengthen the abdominal and back muscles in order to provide more support for the back. Stretching exercises for sciatica target muscles that cause pain when they are tight and inflexible. When patients engage in a regular program of gentle strengthening and stretching exercises, they can recover more quickly from a flare up of sciatica and are less likely to experience future episodes of pain.

For a complete list of sciatica exercises and stretches, please go back and unlock all sciatica health tips.



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