The Rundown on Sciatica

By Brennan McMahon

What is Sciatica?
Sciatica is a condition that is not a disease or sickness in itself, but rather is a symptom of an underlying problem.
Major enervation of the legs, buttocks and lower back are by the sciatic nerve, which is the largest single nerve in the body. It originates from a nerve cluster in the spinal cord that combines in the lower back to run through the buttocks and send branches of nerve endings all through the lower limbs, down to the toes.
When the sciatic nerve is compromised in any way, the resulting pain affects all of the muscles connected to it, causing a radiating pain that originates in the lower back and radiates down the leg to the foot.

Causes and Symptoms
The major cause of sciatica is from a lumbar disc herniation, which is when there is a rupture of the disc supporting the lumbar vertebrae in the lower spine. This can cause the disc to press on the sciatic nerve.

Other causes may include:

• Slipped disc (called isthmic spondylolisthesis) where one vertebrae can slip forward over another due to a small fracture or stress to the disc.
• Spinal and disc degeneration due to age is normal, but it can be severe in some individuals. This can be due to genetics, a lifetime of medication, lack of exercise, or have no cause at all. The degenerated disc and bones can pinch the nerve and cause sciatic pain.
• Arthritis due to age, which may cause spinal stenosis (enlargement of the disc and soft tissue surrounding the disc) and attendant pain due to pressure on the nerve.

Other less common causes are built-up trauma to the leg over time (like with athletes), tumors, infections that affect the lumbar spine, internal bleeding around the sciatic nerve and bone interference in the path of the nerve (like with a fracture or shift), causing irritation and pain.

The symptoms of sciatica are mostly pain related and include:

• Radiating pain that affects the leg and foot.
• Lack of sensation and difficulty in movement of the lower limbs.
• Sharp pain when standing or trying to walk, which gets worse on sitting down.
• Neurological symptoms like progressive loss of sensation in the leg and lack of bowel and bladder control, which are signs of a more serious underlying condition.

Treatment Options

Most times, sciatic pain is not serious enough to warrant a hospital visit, and it goes away after a matter of weeks. However, the pain can become all-consuming for some patients, and they will seek relief. Treatment for sciatica is mostly non-surgical, aiming at reducing and eliminating the pain it causes.

Therapy

• Steroid injections can be given directly into the affected lumbar area to reduce inflammation and pain relief. The effects can be short-lived, but it helps the patient to be able to focus on their daily lives and also take part in other therapy options like exercise.
• Massage can help to increase circulation, release endorphins that cancel out pain, and relax the muscles that may be contributing to the pinched nerve. It is a recommended alternative treatment for sciatica, however short-lived the effects.
• Acupuncture is an approved method of pain relief, not just for sciatica but for other pain-causing conditions too. It would be prudent to employ the services of a registered practitioner.
• Some special exercises can help with lumbar spine alignment and pain relief. Stretching and aerobic exercises are recommended to the patient, with a regimen than can last weeks or months.

Surgery

When sciatic nerve impairment gets so serious that the patient is losing sensation in the lower limbs, or cannot move at all, then surgery might be needed to immediately free the sciatic nerve and prevent permanent nerve injury.
Keep in mind that sciatica surgery is a last resort, only recommended after all other less invasive options have been exhausted.

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