Sciatica
Sciatica describes persistent pain felt along the sciatic nerve, which runs from the lower back, down through the buttock, and into the lower leg. The sciatic nerve is the longest and widest nerve in the body, running from the lower back through the buttocks and down the back of each leg. It controls the muscles of the lower leg and provides sensation to the thighs, legs and soles of the feet.
Although sciatica is a relatively common form of low back and leg pain, the true meaning of the term is often misunderstood. Sciatica is actually a set of symptoms — not a diagnosis for what is irritating the nerve root and causing the pain.
Sciatica occurs most frequently in people between 30-50 years old. Most often, it tends to develop as a result of general wear and tear on the structures of the lower spine, not as a result of a specific injury.
What are the symptoms of sciatica?
The most common symptom associated with sciatica is pain that radiates along the path of the sciatic nerve, from the lower back and down one leg; however, symptoms can vary widely depending on where the sciatic nerve is affected. Some may experience a mild tingling, a dull ache or even a burning sensation, typically on one side of the body. Some patients can also report a pins/needles or numb sensation or muscle weakness in the leg or foot.
Pain from sciatica often begins slowly, gradually intensifying over time. In addition, the pain can worsen after prolonged sitting, sneezing, coughing, bending, or other sudden movements.
What causes sciatica?
The most common cause of sciatica is irritation of the sciatic nerve in the lower back due to a herniated or ruptured disc. Other conditions can also put pressure on the nerve including: spinal stenosis (due to arthritis), pregnancy, trauma (fall, car accident, etc), piriformis syndrome, sacroiliac dysfunction, spondylolisthesis or spinal tumors/infections.
How is sciatica diagnosed?
Dr. Erin will begin by asking you to describe the pain and any factors that help it feel better or worse. She’ll then ask you what your goals and expectations are for treatment so that she can prepare a treatment plan for you. The examination will focus mostly on your low back and legs, checking your reflexes, strength and taking you through a variety of tests to pinpoint the cause of your sciatica. In some cases, Dr. Erin will order x-rays, a MRI or CT image to rule out a serious condition or to confirm a disc injury.
What are my treatment options?
For most people, sciatica responds very well to chiropractic care along with rehabilitative exercises to stengthen the muscles that support the spine. Sometimes massage, acupuncture or electrical stimulation are also used to help decrease your pain and inflammation levels.
The most important thing is to stay as active as possible and avoid bed rest. In the long run, inactivity can make your symptoms worse, whereas regular exercise has been shown to reduce the intensity of pain associated with sciatica.
80-90% of patients with sciatica can recover without surgery. If you do not respond to conservative care within 6 weeks, Dr. Erin will refer you to a orthopedic specialist for a consultation to make sure you do not require surgical or injection treatments.