Sciatica: The burning truth about leg pain

From djournal.com

The definition of sciatica is an irritation of the sciatic nerve causing discomfort which usually manifests as leg pain.

The sciatic nerve starts in the pelvis and is formed from nerve fibres that come from your spinal cord located in your low back. The sciatic nerve travels down the leg to approximately the level of the knee. The nerve then splits into two separate nerves, the tibial and common fibular nerves. These nerves provide sensation to different parts of your lower leg, as well as control many of the muscles in the leg and foot.

When the sciatic nerve is irritated, it can lead to pain in the pelvis or leg. Sciatica is frequently thought of when there is pain in the low back or hips that radiates down the leg, but actually, sciatic nerve irritation is unusual. It is more common to have a different problem which causes the same or similar symptoms.

Many other causes of low back and leg pain can mimic sciatica including muscle spasms/strain, bursitis, spinal stenosis (narrowing of the spinal canal), arthritis, deep venous thrombosis (DVT), peripheral vascular disease, as well as hip or knee problems, among others.

One of the most common causes of low back pain that travels down the leg is radiculopathy. Radiculopathy is similar to sciatica except, in radiculopathy, the irritation of the nerve happens closer to the spine as the nerve exits the spinal canal in the low back. With sciatic nerve pain (also called sciatica), the irritation happens farther away from the back at the location of the sciatic nerve.

Notify your primary care provider if you experience pain radiating down your leg. Your provider may decide to schedule an office visit where you will be asked for more information about your symptoms. A physical examination will be performed to help determine the source of your pain. Based on the findings, your provider may do additional testing such as blood work or imaging in the form of X-ray, MRI or CT if indicated to better assist in determining the cause of your symptoms.

After determining the cause of the pain, your provider will talk to you about treatments. Often treatments may include medications, exercises or stretches (including possibly physical therapy), or activity modification. In certain instances, you may need to be referred to have more invasive testing or treatments. These may include an EMG (nerve test), ultrasound, injections, or possibly even surgery in severe cases if needed.

Prevention is the best treatment. One of the main causes of back and leg pain is lifting improperly. Using proper techniques such as bending at your knees when lifting heavy objects can help prevent these symptoms from occurring. Avoid lifting objects that are too heavy. If you do need to lift a heavy object, it is best to ask for assistance.

Improvement in symptoms will vary depending on the specific cause of the pain. The majority of people will have their symptoms improve over time. Very rarely is surgery needed.

https://djournal.com/lifestyle/health-lines-sciatica-burning-truth-leg-pain/

How to Identify and Treat Your Sciatica Pain

By Lyle Francois

It is common for people to feel sciatic nerve pain, but that does not mean you have to live with the pain. Here is how you can treat your symptoms.
It's common for people to experience pain caused by irritation of their sciatic nerve. It is known as sciatica. This is the longest and widest nerve in a person's body. It starts in the lower back and ends just below a person's knee. The sciatica nerve controls different muscles in a person's lower legs as well as a person’s sense of touch in that same area of the body, including the foot.

Causes of Sciatica

These are some of the conditions that can cause a person sciatica pain:

- Lumbar spinal stenosis, or the narrowing of a person’s spinal canal in their lower back

- Being overweight

- Wearing high heel shoes for an extended period of time on a regular basis

- Pregnancy

- Degenerative disc disease, or the breakdown of discs in a person’s spine

- Spondylolisthesis, or when one vertebra overlaps with another

- Muscles spasms that occur in a person's buttocks or back

- Spinal injuries

- Spinal infections

- Tumours in the spine that press against the root of a person's sciatic nerve

Symptoms of Sciatica

Some of the more common symptoms of sciatica are a constant pain in the buttocks or leg when sitting, lower back pain, hip pain as well as a burning or tingling sensation that moves down a person's leg. A person may struggle to move a leg or foot because of numbness or weakness or feel a shooting pain that makes it a challenge for one to stand up. If a person experiences mild symptoms of sciatica that don't last longer than eight weeks, medical attention may not be necessary. These situations often resolve themselves. In other cases, people may experience pain infrequently. This does have the potential to become worse over time. It's also possible for people to develop serious sciatica pain that is debilitating.

Diagnosing Sciatica

When a person seeks medical attention for back pain, a physician will want to start with a physical exam. They will check a person's reflexes as well as muscle strength. A patient may be asked to walk on their heels, lift one leg at a time, stand from a squatting position and more. Sciatica pain will often worsen during such activities. The next step may be imaging tests to see exactly where the issue is. This could include an X-ray of the spine to reveal what may be pressing on the sciatic nerve. You could also get a MRI, which could be used to see the detailed images of bone and soft tissue. A CT scan could also be used, and that uses a dye that circulates around the spinal nerve and locates any problems. An Electromyography (EMG) test is another test that could be implemented to calculate the electrical impulses created by a person's nerves that are responding to their muscles. This is a good way to identify nerve compression.

Treating Acute Sciatica

Acute sciatica symptoms normally last less than eight weeks. Over-the-counter medications such as painkillers, nonsteroidal anti-inflammatories as well as acetaminophen can help with acute sciatica symptoms. It's important people check with a pain management specialist like Champey Pain Group to see if over-the-counter medications will help. In many situations, alternating between hot and cold compresses help decrease pain. Regular exercise also helps with acute sciatica. This could involve light stretching, walking or other types of exercise. Always talk with your doctor before starting a workout routine to make sure it is the right one for you.

Treating Chronic Sciatica

This condition involves a person having sciatic pain for longer than eight weeks. Treatment could involve a variety of opiate-based prescription painkillers. Physical therapy is one way to strengthen muscles and increase flexibility. Chiropractic treatment is also a great way to help with the realignment of the spine and the sciatic nerve. Working with pain management specialists has also been successful when treating this condition.

The final option is surgery if the sciatic pain has not stopped with other treatments. A lumbar laminectomy widens the spinal cord to decrease pressure on the sciatic nerve while others would get a discectomy, which will remove a damaged spinal disc partially or totally.

No matter how severe your pain is, it is always a good idea to check with your pain management specialist like Champey Pain Group to make sure your condition does not get uncontrollable. This is a disease that can be treated early, so make sure you get the help you need as soon as you notice signs of sciatic nerve pain.

https://newswire.net/newsroom/blog-post/00094004-how-to-identify-and-treat-sciatica.html

Solutions for sciatic nerve pain

From info-europa.com

Sciatica is a painful condition which may impact your life in a big way. There are different care and solutions available for this problem. The effectiveness of different solutions vary a lot and one solution may or may not work for someone. Let’s find out what are the solutions available for sciatica.
Chiropractic care can help you to get relief when you are suffering from sciatica. According to a study in the Journal of Manipulative and Physiological Therapeutics, people who visited a chiropractor felt better with the treatment which lasted for few weeks. Spinal manipulation can help people suffering from sciatica to get relief from the pain. It may also restore normal mobility around the injured area. Such care may reduce inflammation which will enhance the body’s healing mechanism by creating a suitable environment. Yoga is a very well-known method for quality living. It advocates performing different exercises and postures for healthy living. Yoga can help you in reducing pain and even disability. Scientific studies have been done to see if yoga can actually help people who are suffering from different types of pain and disability. People suffering from back pain showed tremendous improvement when they practised yoga for few weeks. Yoga will help you to strengthen your muscles and improve flexibility at the same time. Different postures and exercises will help you to move better and function in a normal way even when you have sciatica. It will also arrest aggravation of sciatica to other areas than the present ones. You can try yoga when you are trying to get rid of sciatica so that it not only reduces your pain but also improves your mobility and flexibility so that it can function better in your life. However, you should always find the right teacher to learn Yoga from when you are suffering from sciatica. Acupuncture can also help you if you are suffering from sciatica. It will need several sessions to see any improvement but relief may be possible after a few sessions.
Normal acupuncture or warming acupuncture any of these techniques can help people suffering from sciatica. In this method, needles are inserted in certain specific areas of the body to reduce the pain and inflammation. Many people believe that acupuncture can really help in different medical conditions.
Massages really help us by improving our blood circulation and reducing pain in different parts of the body. It can also be applied to people who are suffering from sciatica. However, trigger point therapy may be the best option…

http://info-europa.com/uncategorized/solutions-for-sciatic-nerve-pain/48777

5 overlooked sciatica remedies that could help you

By Karen Gordon

Anyone who has ever experienced sciatica knows what an agonising pain it can be and how it can impact on daily life.

Sciatica is defined as pain or discomfort associated with the sciatic nerve, which runs from the lower back down and buttocks down into the back of the legs to the feet. It's the longest nerve in the body! Pain occurs when there's pressure on, or damage to, the sciatic nerve.

The most common cause of sciatica is a disc prolapse – also known as disc herniation or slipped disc, but lumbar degenerative disc disease, bone spurs, lumbar spinal stenosis, spondylolisthesis, piriformis syndrome, or spinal tumours can all result in sciatica.

James Farmer, physiotherapist and personal trainer says:

"Sciatica is really an 'umbrella term' used for non-specific radiating pain anywhere down the back of the leg. Unfortunately it could be a number of different factors creating the pain and therefore there are a lot of factors to consider. Firstly, because there could be a number of causes, it's important to stress that anyone experiencing sciatica should seek the help of a medical professional to get a full assessment."

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We ask our experts what remedies you may have overlooked if your sciatic nerve is acting up…

1. Hot and cold packs

Using a combination of hot and cold packs can go a long way to help relieve the pain. A cold pack can reduce inflammation, which is associated with sciatic nerve pain, whilst heat helps to increase the blood flow to this area. Alternating both cold and heat can give positive results in reducing pain and inflammation. Roger Henderson, our resident GP, says:

''Initially, you might get relief from a cold pack placed on the painful area for up to 20 minutes several times a day. Use an ice pack or a package of frozen peas wrapped in a clean towel and do not apply for more than a few minutes. After two to three days, apply heat to the areas that hurt. Use hot packs, a heat lamp or a heating pad on the lowest setting. If you continue to have pain, try alternating warm and cold packs.''

2. Try stretching

Stretching exercises for your lower back can help relieve nerve root compression, advises Roger. He says to avoid jerking, bouncing or twisting during the stretch, and try to hold the stretch for at least 30 seconds.

''You can do knee to chest stretch to help reduce the irritation of the sciatic nerve and improve flexibility of your lower back.''

Lie on your back on a mat with your feet straight and hip-width apart.

Keep your upper body relaxed and bend your right knee upwards with an inhale.

Clasp your hands behind the thigh and gently pull it towards your chest as far as is comfortable.

Keep the other leg flat on the surface.

Hold this position for 20 seconds with controlled deep breaths and then lower your leg gently.

Switch legs and repeat. Repeat 3 to 5 times.

Finally do this exercise with both the legs 3 to 5 times. You can also do exercises like spinal rolling, knees rocking, floor twists, and back extensions.

Physiotherapist and personal trainer James Farmer agrees that a simple piriformis stretch will often help ease any tension on the sciatic nerve and ease the sciatic pain. He says that if he knows the sciatica is not a result of a serious back injury, such as a disk prolapse, he will use a technique called neural flossing.

''Nerves don't stretch, and they're not a big fan of tension either. Nerves need to be able to slide and move freely without becoming 'snagged'. This snagging of the sciatic nerve creates tension in the nerve, and this can often lead to sciatic pain. Neural flossing is a method by which you can mobilise the nerve and ease any tension placed on it. With neural flossing it's important the nerve isn't put under further tension. Instead, it is 'flossed'.''

3. Get a Massage
A massage will not only relax the muscles in your back, it can help loosen muscles, tissues that are effected by the sciatic nerve, whilst also improving blood flow. Michele Pernetta, one of the UK's leading yoga teachers and founder of Fierce Grace says oiling the body is incredible for nerve pain. She says:

''Use sesame oil or buy the Pukka "Mahanarayam oil" from a health food store, heat it and massage it in all over the body especially affected area and the soles of the feet. Or get an Ayurvedic massage from a trained practitioner.''

 4. The heat in hot yoga

A study in the journal Pain reported that people with chronic back pain who practiced Iyengar yoga for 16 weeks saw pain reduced by 64% and disability by 77%. The effect on sciatic pain is less clear, but Michele says that the heat in hot yoga can be good for it.

''Oil the body before and/or after, but do the modifications to not overstretch the hamstrings. Stop stretching your legs as this can aggravate sciatica. Stretch your lower back with your knees bent.'' 

5. Take it easy

Don't forget to take it easy, says Roger. But don't simply lie in bed because this has been shown to actually worsen the condition.

''Do activities you are able to tolerate, and do not expect to feel better overnight.''

http://www.netdoctor.co.uk/healthy-living/wellbeing/a27114/overlooked-sciatica-remedies-that-could-help-you/

Suffer from Sciatica? Look to This for Relief

By Genevieve Cunningham

If you have never suffered from sciatica, you should definitely count yourself among the lucky. Sciatica is a very painful condition, and for many people, it’s a condition with very little relief in sight. It seemingly comes out of nowhere and can range on the pain scale from mild to absolutely debilitating. Luckily, many people are finally finding a way to help manage the pain of sciatica with regular chiropractic care. If you or someone you know suffers from this painful condition, take a look at how getting chiropractic care at The Joint Chiropractic in Pasadena may help.

First, What Exactly is Sciatica?

This condition stems from the sciatic nerve, which runs from the lower back through the rear and into the leg. Sciatica is simply the term we use to explain pain that occurs because of this nerve. The pain usually happens when the nerve gets pinched or compressed, causing a great amount of pressure to be placed directly on the nerve.

Does Everyone Get Sciatica?

In short, no. Not everyone suffers from this ailment, but the important thing to remember is that anyone can suffer from it. It most often happens to adults between the ages of 30 and 50, but it’s also fairly prominent in pregnant women.

Will I know if I have Sciatica?

You will absolutely know if you have sciatica because the symptoms are quite painful and distinct. Those who suffer from it may experience sharp or aching pains in the lower back, rear, or down into the leg. It can also cause a tingling or numb feeling in any of these body parts as well.

What Will the Chiropractor Do for Me?

Chiropractic care is actually one of the best options for treating sciatica. This is a gentle form of care that can release the compression of the sciatic nerve. The chiropractor will use a form of spinal manipulation to gently but deliberately place the spine back into its proper alignment, which can alleviate pressure, compression, tension, and pain.

Where Can I Get Chiropractic Care?

If you would like to try chiropractic care for your sciatica or for any other reason, visit with chiropractors at The Joint Chiropractic. At The Joint, you’ll meet with friendly and professional chiropractors who truly care about your health and well-being. You can also use their walk-in visits and affordable pricing plan to your advantage for an effective and low-stress experience. You don’t have to live with sciatica permanently. Get some relief and a boost in your overall health by getting to The Joint as soon as today.

http://www.thejoint.com/california/pasadena/pasadena-east-31028/196380-suffer-from-sciatica-look-to-this-for-relief

Will I Ever Run Pain Free Again? How to Overcome Sciatica

By John Davis

Sciatica can be a pain in the butt…and the back…thigh…calf…even foot.
That may be a pun, but it has a lot of truth in it. Running with sciatica can make running almost unbearable, and a sciatica flare up can make us wonder will I ever run again?
Today, we are going to look into how the sciatic nerve causes pain while running, how you can treat the numbness of sciatica and running, while finding a solution to make sure it is safe to run in the future. Finally, we will answer the question that every runner will be wondering; can I run with sciatica?
Is it sciatica you are struggling with?
Let’s find out:
How is it possible for one injury to cause pain in so many places?
Unlike the most common running injuries, sciatica is a nerve problem.  

Where does the sciatic nerve run?

The sciatic nerve, from which the term “sciatica” originates, is an enormous structure that runs from your lower back through your glutes, down your hamstrings and calves, and into your foot.
It controls muscular activation for practically the entire posterior chain, i.e. the muscles on the back-side of your lower body.  
These muscles are the prime movers for runners, so any disturbance to the sciatic nerve is bad news, and why running with sciatica pain is so dehabilitating.
Because of the nerve’s tremendous length, the symptoms of sciatica are myriad.
Running with sciatica nerve pain can become almost impossible, as it presents itself as a shooting, aching, or radiating pain anywhere along the sciatic nerve.
Most often, however, pain is felt in the lower back, tailbone area, and glutes, and pain may sometimes radiate down the hamstring.  
In more rare cases, the pain can radiate into the calf and even the underside of the foot. Sciatic calf pain can get worse after prolonged sitting or with internal rotation of the leg, but this is not always the case.

Does Running Aggravate Sciatica (and How Do I Know If It Is Sciatica)?

One standard diagnostic test is the single-leg raise.  
While lying flat on the ground, have an assistant raise your leg up (or use a rope) on the affected side, keeping your knee straight.  

The test is considered positive if the maneuver provokes lower back or sciatic nerve pain.  
This straight leg raise will often reproduce sciatic nerve pain if the cause is a herniated disc
Another manual test that can often reproduce sciatic nerve pain involves lying on your back while bending the knee on the affected side.  
Plant affected side’s foot on the opposite side of the body (i.e. on the outside of the opposite knee), and attempt to internally and externally rotate the affected leg against resistance.  In most cases, this will reproduce pain as well.

Abduction or adduction of the bent and internally rotated leg against external resistance can often reproduce sciatic pain originating from the piriformis.

Is sciatica always the cause of lower back pain?

Historically, the cause of sciatica was assumed to be a herniated disc in the lower back.  
When a disc bulges out of the spine, it can press on the sciatic nerve and cause shooting pain along the nerve.  
Indeed, according to a medical paper by Aaron G. Filler and other doctors at UCLA, the single leg raise is almost always positive when sciatica is caused by a herniated lumbar spine disc.2
However, a large number of people with sciatica don’t have a herniated disc, or if they do, it isn’t the cause of their pain—doctors note that somewhere around 40% of healthy, pain-free people have herniated discs as well.
In many ways, sciatica is really more of a symptom than an injury itself.

What are the running with sciatica symptoms?

Herniation of a lumbar spine disc can cause sciatic nerve pain, but so can a number of other conditions which have been detailed in the medical literature.
First among these is piriformis syndrome, a somewhat-nebulous term that’s often used to refer to cases of sciatic nerve pain that do not appear to involve the lumbar spine.  
Filler et al. write that MRI scans are very accurate at diagnosing or ruling out involvement of the piriformis muscle as the cause of sciatic nerve pain.
If you’ve determined your sciatica is related to your piriformis, you should see our companion article on piriformis syndrome.
Rarer causes of sciatica include stress fractures of the sacrum, avulsion fractures to the ischial tuberosity (the attachment point on the pelvis for the hamstring muscles), and fibrous tissue in the upper part of the hamstring muscle.
If your pain may be a hamstring issue, we have a great discussion about what others have tried on our hamstring tendonitis article.
How Common is Running with Sciatica?
Among distance runners, sciatica is not particularly common.  
According to one study of over 2,000 injured runners, injuries to the spine, gluteus medius area, and hamstrings constituted only about eight percent of all running injuries—and of course sciatica of any type accounts for only some fraction of this.
Another study of injured runners pegs lower back problems (including sciatica, but also run-of-the-mill back pain) at 4.4% of all running injuries among marathoners.
As a result of the relative rarity and difficulty of identifying a specific cause, risk factors for sciatica are hard to pinpoint.  
Data from studies on the general population show that frequent heavy lifting is a risk factor for sciatica—lifting heavy weights at the gym with improper technique might be one culprit for distance runners.  
For unknown reasons, simply being tall appears to put you at risk of sciatica related to a herniated disc, though strangely, it does not seem to increase your risk of other lower back problems.  
Among women, having given birth is a possible risk factor as well.  

Effective Sciatica Treatment and Relief

Because it is somewhat rare among runners, there are not many high-quality studies on treatment protocols for sciatic nerve irritation.  
A proper diagnosis of the cause of the nerve irritation should always be the first course of action.  
Medical examination by a doctor, sometimes combined with an MRI of the lower back and pelvis area, should be able to identify the root cause of the nerve pain.

Sciatica treatment exercises

In many cases, physical therapy can be helpful.  
Because there are no set protocols on managing sciatica, however it arises, seeing an experienced therapist who is accustomed to working with distance runners is your best bet.  
For piriformis-related sciatica, rehab exercises will likely focus on glute strength, including the abductors and external rotators of the hip.  
This usually involves the familiar family of hip strength work for runners: side leg lifts, clamshells, glute bridges, and theraband work.  
For sciatica arising from a lower back problem, rehab more often entails stretching and strengthening exercises for the abs and back muscles.  
Given that inflammation is often a factor in sciatic nerve irritation, this is one case in which a nonsteroidal anti-inflammatory drug like ibuprofen or naproxen can be useful.
A 2011 review article by Ryan Petering and Charles Webb at Oregon Health and Sciences University reviewed the medical literature on treatments for lower back pain in athletes, concluding that NSAIDs were one of the few treatments with fairly solid evidence supporting their use.
However, if the cause of sciatica is proven to be a bone stress injury, taking an anti-inflammatories is not a good idea.

Do injections for sciatica pain work?

Injections of anti-inflammatory medications into the painful area are another fairly common treatment; these are sometimes also co-opted as a method of diagnosis.  
For example, if an MRI shows that an aggravated piriformis muscle may be impinging on your sciatic nerve, your doctor can inject a numbing agent or a corticosteroid to reduce pain and attack the inflammation that’s causing pressure on the sciatic nerve.2
If a short-acting numbing agent reduces your pain, it’s clear that the location targeted by the injection is the culprit.

When to consider surgery for sciatica

As a last resort, surgery is an option for recalcitrant cases.  
While the viability of surgery is a very individual matter, one study did find that, although patients with sciatica who underwent an early surgery recovered more rapidly than those who elected conservative treatment, there was no difference in outcomes after one year, and 95% of both groups considered themselves recovered.  
As such, you should allot plenty of time for conservative treatments before considering surgery.

Sciatica Pain: Will I Ever Run Again?

Though the pain associated with sciatica can hugely impede your ability to run, the good news is that the vast majority of people do recover.  
The recovery process can be lengthy, but with a good rehab program that addresses the root cause of your sciatic nerve pain, you should be able to gradually return to running.  
Unlike other running injuries, like tendonitis or a stress fracture, it’s hard to give definitive guidelines on how much time off you’ll need or how quickly you’ll heal up.  
Here’s the deal:
The recovery program for sciatica caused by a herniated disc is different from that of sciatica caused by piriformis syndrome, for example.  
The diverse causes of sciatica mean that your recovery profile is going to be highly individual.  
You might be back on your feet in a week or two, or it could take several months.  
In any case, your best shot at recovery is accurately determining what’s causing your sciatic nerve pain, finding out if your state allows direct physical therapy access, and tailoring a rehab program to address it.

https://runnersconnect.net/running-injury-prevention/sciatica/