Sciatica

 

Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body.

Sciatica most commonly occurs when a herniated disk, bone spur on the spine, or narrowing of the spine (spinal stenosis) compresses part of the nerve. This causes inflammation, pain, and often some numbness in the affected leg.

Although the pain associated with sciatica can be severe, most cases resolve with non-operative treatments in a few weeks. People who have severe sciatica that’s associated with significant leg weakness or bowel or bladder changes might be candidates for surgery.

Symptoms

Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg is the hallmark of sciatica. You might feel the discomfort almost anywhere along the nerve pathway, but it’s especially likely to follow a path from your low back to your buttock and the back of your thigh and calf.

The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating pain. Sometimes it can feel like a jolt or electric shock. It can be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms. Usually only one side of your body is affected.

Some people also have numbness, tingling, or muscle weakness in the affected leg or foot. You might have pain in one part of your leg and numbness in another part.

When to see a doctor

Mild sciatica usually goes away over time. Call your doctor if self-care measures fail to ease your symptoms or if your pain lasts longer than a week, is severe or becomes progressively worse. Get immediate medical care if:

• You have sudden, severe pain in your low back or leg and numbness or muscle weakness in your leg
• The pain follows a violent injury, such as a traffic accident
• You have trouble controlling your bowels or bladder

Causes

Risk factorsSciatica occurs when the sciatic nerve becomes pinched, usually by a herniated disk in your spine or by an overgrowth of bone (bone spur) on your vertebrae. More rarely, the nerve can be compressed by a tumor or damaged by a disease such as diabetes.

Risk factors for sciatica include:

• Age. Age-related changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica.
• Obesity. By increasing the stress on your spine, excess body weight can contribute to the spinal changes that trigger sciatica.
• Occupation. A job that requires you to twist your back, carry heavy loads, or drive a motor vehicle for long periods might play a role in sciatica, but there’s no conclusive evidence of this link.
• Prolonged sitting. People who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are.
• Diabetes. This condition, which affects the way your body uses blood sugar, increases your risk of nerve damage.

Complications

Although most people recover fully from sciatica, often without treatment, sciatica can potentially cause permanent nerve damage. Seek immediate medical attention if you have:

• Loss of feeling in the affected leg
• Weakness in the affected leg
• Loss of bowel or bladder function

Prevention

It’s not always possible to prevent sciatica, and the condition may recur. The following can play a key role in protecting your back:

• Exercise regularly. To keep your back strong, pay special attention to your core muscles — the muscles in your abdomen and lower back that are essential for proper posture and alignment. Ask your doctor to recommend specific activities.
• Maintain proper posture when you sit. Choose a seat with good lower back support, armrests, and a swivel base. Consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Keep your knees and hips level.
• Use good body mechanics. If you stand for long periods, rest one foot on a stool or small box from time to time. When you lift something heavy, let your lower extremities do the work. Move straight up and down. Keep your back straight and bend only at the knees. Hold the load close to your body. Avoid lifting and twisting simultaneously. Find a lifting partner if the object is heavy or awkward.

Pinched Nerve

The symptoms of a pinched nerve in the back sometimes also affect surrounding areas.

Nerves in the spine can be compressed by surrounding bone or tissue. If this happens, a person has a pinched nerve in their back.

Nerves are responsible for sending signals to the brain. When a nerve is compressed, the pressure disrupts the signals, resulting in symptoms.

A pinched nerve often causes pain, numbness, and tingling. The location of these symptoms depends on that of the compressed nerve.

If a pinched nerve is at the top of the spine, symptoms may affect the neck or arms. Doctors call this issue cervical radiculopathy.

Symptoms of a pinched nerve in the upper back can include:

• pain that starts in the neck and may travel down the arm
• tingling sensations in the hand, or specifically the fingers
• weakness in the arm, shoulder, or hand
• numbness

Nerves in the lower back can also become compressed. Doctors refer to this as lumbar radiculopathy. This condition often manifests as sciatica.

Symptoms of a pinched nerve in the lower back can include:

• pain that radiates from the lower back to the legs or feet
• numbness and tingling in the legs or feet
• muscle spasms or weakness

If a person does not experience tingling or numbness, they may have a different type of back pain, such as muscle pain. This can occur due to wear and tear, sprains, or weakness.

An injury can damage tissues in the spine or cause them to become inflamed. In either case, it can put pressure on the nerves.

Other causes of a pinched nerve in the back can include:

• A herniated disk: The disks between the vertebrae in the spine can become compressed and bulge, putting pressure on nearby nerves.
• Spinal stenosis: This refers to a narrowing of the spinal column, which puts excess pressure on the nerves around the spinal cord.
• Arthritis: This causes inflammation around joints and bones, which can increase pressure on nerves in the spine.
• Bone spurs: A bone spur is an extra growth of bone, which can form on the spine and compress surrounding nerves, causing reoccurring episodes of pain.
• Spondylolisthesis: This involves a vertebra in the lower spine dislodging and pinching nerves.
• Infection: The vertebrae or discs of the spine can become infected, leading to inflammation and nerve pain.

Risk factors

Certain factors make developing back pain more likely. They include:

• Aging: The disks between the vertebrae lose their ability to cushion with age, increasing a person’s risk of a pinched nerve. Spinal stenosis also becomes more likely with age.
• Physical fitness: People who do little exercise or who have weaker abdominal muscles are more likely to develop back pain, possibly from an injury. The same is true for people who are generally inactive but then try intense physical exercise.
• Overweight or obesity: Both place extra strain on the back, making back pain more likely.
• Uneven posture: If the neck, shoulders, spinal column, or hips are out of alignment for prolonged periods, it can place pressure on nerves in the back.

A doctor may be able to diagnose a pinched nerve with only a physical examination. They may also perform tests to check the person’s reflexes and muscle movement.

The doctor may ask the person to demonstrate their range of motion, such as by lifting a leg while keeping it straight. This can also indicate which movements trigger pain. All of this information can help with a diagnosis.

In some cases, the doctor may need further tests to determine the exact location and cause of a pinched nerve. Tests may include:

• an X-ray, which can show structural problems, such as bone spurs
• an MRI, which can show the condition of the spinal cord, disks, and nerves
• a CT scan to examine the spinal structures
• electromyography, which shows the electrical impulses of muscles

The right treatment depends on the severity and cause of a pinched nerve.

Some people can treat a pinched nerve in the back at home, while others require professional treatment. Recovery may take days or weeks.

Plenty of rest and gentle movements can help the body repair. Avoiding strenuous exercise and heavy lifting is key to supporting recovery and preventing further damage.

Over-the-counter pain relief medication, such as nonsteroidal anti-inflammatory drugs, may help relieve pain and reduce inflammation.

If a person has pain in the top of the spine, a cervical collar may help. This is a soft, padded support structure that wraps around the neck, helping the neck muscles rest and relieving nerve pressure caused by neck movement.

When pressure on a nerve is severe or chronic, a doctor may suggest oral or injected steroids to reduce swelling and pain, particularly any that radiates to the lower body.

Some people require surgery to correct the cause of pressure and stabilize the spine.

 

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
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