Sciatica
Definition
Sciatica pain treatment is necessary to ease the discomfort related to it, but first, here's what Sciatica is about:
Sciatica is not actually a disease, but a symptom that something abnormal is occurring. It is used by different people to describe different conditions. Some individuals use the term to describe any kind of pain that starts in the lumbar, or lower back region and radiates down the leg. Other people use the word "sciatica" specifically to describe the condition that happens when a spinal disc herniates in the lumbar area, causing pressure on the nerve roots. While there is no cure for Sciatica due to it being more of a "disorder" rather than a disease, Sciatica pain treatment can help to manage the condition so that suffering individuals are able to go about their day.
Sciatica usually occurs in the area that is near the nerve root that is injured or compressed and runs down the leg to the foot. Other symptoms associated with dysfunction or (abnormality of function) of the nerve may also occur, such as muscle weakness. The pain can also worsen when the individual suffering from this disorder sits down. The pain is known to travel quickly along the path of the sciatic nerve, and is typically described as "shooting pain." This shooting pain can sometimes be relieved by specific sciatica stretches and sciatica exercises.
Sciatica pain treatment includes exercises like yoga stretches to help alleviate some of the discomfort associated with the nerve dysfunction including:
- Sitting pigeon pose
- Forward pigeon pose
- Single knee to opposite shoulder
- Sitting spinal stretch
- Standing hamstring stretch
Resorting to sciatica pain treatment that includes exercise and stretches, may entail some professional assistance. These maneuvers and exercises may not be easy to complete alone. A physical therapist will be able to safely assist you, especially when it comes to correct body alignment among other.
Chiropractors can also assist when it comes to Sciatica pain treatment which includes the likes of "spinal manipulation" which can assist regular function and mobility to the affected areas of the body.
Another form of Sciatica pain treatment includes acupuncture, an ancient form of medicinal practice originating from China and is used for various pain relief. The treatment is based on restoring the body's natural vital energy or "Qi" so that it can begin to heal itself from within. Many patients have found acupuncture to be an effective sciatica pain treatment. Acupuncture is excellent for people who are not very flexible as opposed to those who stretch on a regular basis.
Massage and surgery are also some effective options for Sciatica pain treatment, to help suffers enjoy a more "normal" day-to-day lifestyle.
Prevalence
Depending on how it is defined, approximately 20% to 40% of people suffer from sciatica.
Risk factors
Sciatica pain treatment is a great way to help you manage the pain related to this abnormality. Some factors that increase your risk of developing sciatica are beyond your control, but there are also some lifestyle changes you can make to decrease your chances of developing the condition. Risk factors for sciatica include the following:
- Age: This risk factor is beyond your control. The older you are, the greater your risk of sciatica. Changes in your spine that occur as you age, like bone spurs and herniated discs, are the most frequent cause of sciatica. Sciatica exercises and sciatica stretches to increase strength and flexibility may decrease the risk of early onset degenerative changes.
- Obesity: People who are overweight have an increased risk for sciatica. Maintaining a healthy weight can help prevent extra body weight from increasing stress on your spine. Stress on the spine contributes to the changes that trigger sciatica.
- Occupation: There is no conclusive evidence to prove this, but if your job requires heavy lifting and carrying or twisting of your back you may be at increased risk for sciatica. Sciatica exercises to strengthen your muscles may be helpful.
- Prolonged sitting: Sitting for extended periods or being sedentary most of the time increases your risk of developing sciatica. Sciatica stretches and sciatica exercises can be done to break up periods of prolonged sitting may be helpful.
- Diabetes: This disease increases your risk of nerve damage that leads to sciatica. People with diabetes may find sciatica stretches and sciatica exercises beneficial.
Reasons
Sciatica pain treatment can be managed as well as incorporated into your lifestyle if you suffer from it. The following are some of the causes leading to sciatica:
- Spinal disc herniation: A herniated disc occurs when the nucleus pulposus, which is the gel-like inner substance of an intervertebral disc, breaks through the annulus fibrosus, which is the tough, outer rim of the tire-like structure. Pain is the most common symptom. However, nerve compression and inflammation can cause other symptoms including numbness, tingling and/or weakness in the extremities. When a disc ruptures in the lumbar part of the spine it can lead to sciatica.
- Spinal stenosis: The word "stenosis" means narrowing. Spinal stenosis refers to a narrowing of the spine, and it occurs when the bones of your back, the vertebrae, compress the spinal cord or the nerves that branch out from it to the muscles. Spinal stenosis can affect any region of the back, but it happens most frequently in the lower (lumbar) spine. Lumbar spinal stenosis can cause sciatica to occur. Sciatica stretches may help to relieve this as well as sciatica exercises.
- Piriformis syndrome: This is a disorder of the nerves and muscles that occurs when the piriformis muscle, which is located near the joint of the hip in the buttocks, presses on the sciatic nerve. The sciatic nerve is thick and long, running along the side of or passing through the piriformis, down the back of the thigh and calf and branching off into a network of smaller nerves, eventually ending in the feet. Spasms of the piriformis muscle can cause pressure on the sciatic nerve and sciatica stretches and sciatica exercises done gently can help to relieve this syndrome.
- Other conditions: Sciatica can also be caused by arthritis or bone spurs. Tumors can also cause compression of the nerve roots or the spinal cord. Traumatic injuries to the spine can lead to the condition. Sometimes pregnancy causes sciatica. Specific gentle sciatica exercises and sciatica stretches are sometimes recommended during pregnancy.
Symptoms
The classic symptoms of sciatica are usually pain that starts in the lumbar or lower spine and radiates into the buttock. From there on, the pain travels down the back of the legs, in some cases affecting just one leg and can travel on toward the feet or foot depending on the severity.
The pain and symptoms of sciatica may be felt in many different areas where the sciatic nerve runs, but it most commonly follows a path that leads from the lower back area to the buttocks and down the backs of the legs. Gentle sciatica exercises done to relieve this compression can sometimes be helpful.
As mentioned in sciatica treatment, exercises and yoga stretches, as well as acupuncture, massage, and chiropractic sessions can all assist in treating sciatica. Many patients have found treatment to resolve the symptoms of sciatica, however in more severe cases, resorting to surgery can work even more effectively.
Symptoms of Sciatica is often self-diagnosed
In many cases, the individual suffering will be able to self-diagnose the nerve dysfunction. However, here are some tips on just how to tell if the pain is nerve related or simply sore muscles.
Weak knees
You may feel pain in your knees as the sciatic nerve is the body's largest nerve that runs from the back down to the toes. If this nerve is pinched it can result in all forms of pain and discomfort including weakness in your legs.
The severity of pain in the selected region
The amount of pain sciatica causes varies from mild to excruciating. It can feel like an ache, a sharp burning pain or an electric shock. Sometimes it is worse with coughing or sneezing. Prolonged periods of sitting can cause an increase in symptoms. Sciatica stretches to relieve this compression can sometimes be beneficial. In most cases, only one side of the body is involved.
Some people with sciatica also have muscle weakness, tingling or numbness in the lower extremity on the affected side. It's also possible to have numbness and tingling in one part of your leg, and pain in another. Sciatica exercises and stretches can sometimes help to relieve the numbness and tingling.
Symptoms of Sciatica can be miss diagnosed due to the piriformis muscle situated in the buttocks that can have a similar effect of pain within the region. Many athletic individuals suffer from Piriformis Syndrome, as the muscle causes pressure on the sciatic nerve running from the lumbar down to the toes.
Diagnostic procedures
Doctors typically diagnose sciatica through a thorough physical examination and by taking a history of the patient's symptoms. Usually, if the patient is experiencing radiating pain in one leg, which is typical of sciatica, and at least one sign of nerve involvement, the diagnosis of sciatica can be made.
The diagnostic test most often used is a straight leg lift to assess for Lasègue's sign. The sign is positive if the pain in the sciatic nerve is produced when the straight leg is lifted 30 to 70 degrees. Lasègue's test is positive in approximately 90% of sciatica patients, however, about 3/4 of the patient's who test positive, do not have the condition.
Another way to be sure of the symptoms of sciatica is directly related to bowel and bladder control. In extremely severe conditions, the sciatica nerve pressure on the lower back region of the cuada equina will cause loss of bladder and bowel control leading to frequent trips to the toilet and worse. This would need extreme measures of surgery to help alleviate the problem. Spinal surgery is exercised to help reduce the pressure on the nerves and to help restore normal function to the bowels and bladder.
In some cases, the symptoms of sciatica can resolve itself after a time, but this may not be so for all individuals.
While imaging testing is not typically used to diagnose sciatica, sometimes tests like magnetic resonance imaging (MRI) or computerized tomography (CT) scans can help find what is causing the condition, such as a herniation of a lumbar disc.
If you're experiencing symptoms of sciatica then attempt some helpful stretches and exercises, being careful not to injure or cause further pressure on the sciatic nerve.
The dangers of ignoring symptoms of sciatica
Athletes may suffer from this disorder, but so can regular people. As mentioned in a previous article, sciatica can occur due to various aspects some include sitting too long, the type of job you do, diabetes and age for that matter.
If you choose to ignore the symptoms then you may end up suffering a lifetime of pain, which could possibly have started out mild but suddenly with time could worsen.
Seeking treatment for the symptoms of sciatica can also save you money in the long run, you may not need as many visits to the chiropractor or sports therapist, nor extreme spinal surgery. Tackling the problem sooner than later is very important.
You may even have the fortune of not being diagnosed with sciatica but possibly something easier to treat like sore muscles for example.
As you age, you may not be able to tolerate the discomfort of sciatica and this could lead to other complications. Surgery may also become more of a higher risk.
Pathological changes
Sciatica is most often caused by compression of the last three lumbar nerves, the first three sacral nerves or of the sciatic nerve. Treatment for sciatica pain may include gentle sciatica exercises to help relieve the compression which may sometimes be beneficial, depending on the severity of the pain and discomfort. When radiating pain is due to pressure on a dorsal nerve root, rather than on a nerve, the condition that results is considered to be a lumbar radiculopathy. If inflammation also occurs, the condition is radiculitis.
Chiropractors and other spine specialists can help diagnose what the problem may be and the necessary treatment and care to take in order to resolve or alleviate the discomfort. There are various measures of treatment for sciatica pain and when diagnosed early, the better the chances of being able to lead a normal life without the additional pain.
If swelling occurs in the spinal canal, it can spread to the joints of the spine, causing pain in the lower back and radiating or referred pain into the backs of the thighs. Radiating pain in a lower extremity, with numbness and tingling, can also result due to nerve compression related to muscle spasms or tension in the muscles surrounding the sciatic nerve, usually the piriformis muscle in the buttocks. Gentle sciatic stretches can sometimes help relieve this piriformis muscle pain.
Treatment
Most cases of sciatica can be reduced spontaneously over a course of a few weeks to months if the cause is lumbar disc herniation. Conservative treatment is usually recommended for the first six to eight weeks. Some of the typical conservative measures for the treatment of sciatica pain include:
Medications
- Nonsteroidal Anti-inflammatory Drugs (NSAIDs): These medications are available over-the-counter and will help control the pain of sciatica as well as help reduce the inflammation. Some common NSAIDs are ibuprofen, aspirin, and naproxen.
- Muscle relaxants: These medications are available only with a prescription and your doctor may suggest them to help relieve muscle spasms. Examples of muscle relaxants for sciatica include cyclobenzaprine (Flexeril) and methocarbamol (Robaxin).
- Narcotics: These medications also require a prescription from your doctor and are generally only used for extreme sciatica pain due to their potential for addiction. Examples are hydrocodone (Vicodin) and oxycodone (Percocet).
- Antidepressants: Some types of pain are relieved by medication that is also used to treat depression. A doctor's prescription is required for these medications. Examples are venlafaxine (Effexor) and duloxetine (Cymbalta).
- Anti-seizure medications: Your doctor may prescribe medications used for epilepsy to help control your sciatica pain. An example is a gabapentin (Neurontin).
Physical therapy
After the most severe sciatica pain starts to improve, your doctor may recommend physical therapy or another form of rehabilitation to help prevent further injuries. Resorting to rehab as part of your treatment for sciatica pain typically includes:
- Exercises - to strengthen your back and abdominal muscles certain exercise is needed such as those focused on your core. Sciatica exercises are critical to your recovery. Pilates, Tai Chi, and low impact aerobics can be done.
- Stretches to improve or maintain your flexibility. Sciatica stretches can help improve or your flexibility. These stretches can include several yoga techniques such as mentioned in another article "forward pigeon pose", "knee to opposite shoulder", "standing hamstring stretch" and "sitting spinal stretch" to name a few.
- Learning ways to correct your posture - yoga may help to accomplish correct posture as well as gait training.
Steroid Injections
In some cases of sciatica, physicians recommend injections of a corticosteroid into the area directly surrounding the affected nerve root. This form of treatment for sciatica pain includes Epidural Steroid medications to help relieve pain by reducing inflammation in the area. The benefits typically last for a few months, sometimes up to a year. You can only receive a limited number of these injections because of the risk of serious side effects is greater if they are given too frequently for sciatica.
Always remember to speak to a specialist to thoroughly weigh the pros and cons, especially if you need long-term treatment. This will also help you to make an informed decision.
Surgery
Surgery is usually only used if nerve compression is causing extreme weakness, loss of bowel or bladder control or pain that is increasing and not improving despite other treatments. Resorting to surgery as a form of treatment for sciatica pain is usually more of the last option.
There are two main types of surgery when it comes to sciatica namely:
Microdiscectomy or Disectomy
This procedure results in the removal of all or specific herniated discs that are pinching the sciatic nerve. Microdiscectomy is minimum invasive and recovery time is swifter.
Laminectomy
Laminectomy is also known as Laminotomy is the removal of part of the lamina which is responsible for protecting the spinal cord and canal. Laminectomy (removal of the entire lamina).
Again, querying the pros and cons as well as the risks involved is very important and your specialist will be able to answer all questions that you may have related to it.
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