Sciatica: Signs, Symptoms, and Complications

From verywellhealth.com 

Common sciatica symptoms include pain on one side of the body and in the back, buttocks, hips, and legs, pain that gets worse with sitting or standing, and pain that burns and stabs. 

This article will cover common sciatica symptoms, rare symptoms, complications, and when to seek medical attention. 

NickyLloyd / Getty Images

Frequent Symptoms

Pain associated with the sciatic nerve typically starts in the spine at the low back. The sciatic nerve is the widest and longest nerve in the body. It attaches to your spine and travels down to the buttocks, leg, and foot.

The term sciatica commonly describes radiating pain that inflammation or lumbosacral (lower back) compression of the nerve roots pushing into the sciatic nerve may cause. Any condition that causes trauma, damage, or compression in that region can lead to sciatica. 

Symptoms on One Side of the Body

Sciatica typically affects one side of the body. This is because damage or trauma causes are confined to one nerve root, so you will feel pain going down to one side of the buttocks, the hip, or the leg.

Pain Down the Back, Buttocks, and Legs

Radiating pain is the hallmark of sciatica pain. It often presents as a shooting pain radiating in the lower back and down the leg.  

Hip Pain  

Hip pain might affect both sides of the body. It is especially common with conditions that affect the piriformis muscle beneath the gluteal (butt) muscles. 

Hip pain also occurs when pain on one side forces you to shift your weight to the other side. This might lead you to experience pain in both hips.

Pain That Worsens With Sitting and Standing 

Many people with sciatic pain might experience pain with sitting or standing for long periods. Sciatic pain worsens the longer you sit or stand. Movement or changing positions can sometimes reduce this.

Burning, Sharp Pain, or Pins-and-Needles Sensations

You may experience a burning feeling in the back, hip, or down the back of your leg. That feeling might be minor and disappear or spread. If it is not addressed, it will worsen. 

You might also feel sharp or stabbing pain sensations down the lower back, hip, or leg. Some people also experience a pins-and-needles feeling or tingling or stinging anywhere along the sciatic nerve. 

Numbness and Weakness

As sciatica pain increases, you might feel numbness anywhere along the sciatic nerve, from your back down to your feet. Severe numbness can affect the way you move your leg.

Weakness from sciatica can be felt anywhere along the leg—the entire leg, the knee, etc. The weakness might worsen if the underlying cause is not treated correctly.

Sciatica Causes

The symptoms of sciatica may vary based on the underlying cause. 

Some causes of sciatica are:

• Herniated disc: The soft material in the centre of a spinal disc leaks and presses on a nearby spinal nerve root.
• A pinched nerve: A nerve is compressed.
• Piriformis syndrome: The piriformis muscle (behind the hip joint in the buttocks) irritates the sciatic nerve.
• Spinal stenosis: The spinal canal containing the spinal cord and nerve roots narrows.
• Spondylolisthesis: A spinal vertebra moves out of place.
• In rare cases, tumours and severe infections.

Types of Sciatica Pain 

Sciatica pain has four types: neurogenic, referred, alternating, and bilateral.

• Neurogenic sciatica is often caused by nerve compression or a pinched nerve that leads to pressure along the spine. 
• Referred sciatica is not related to a spinal condition. It is typically related to a muscle or joint problem. 
• Alternating sciatica alternates between the legs when one side of the body is affected. It might be caused by arthritis of the sacroiliac (SI) joint. You have two SI joints connecting the spine to the pelvis.  
• Bilateral sciatica is when both sides of the sciatica nerve are affected, leading to pain and symptoms in both legs and the buttocks. It is rare and typically affects one side more. It occurs when more than one disc is herniated or if there is disc degeneration.
  

Rare Symptoms

There are some rare symptoms of sciatica. These symptoms are typically more severe and may require immediate or emergency medical treatment. 

Loss of Bladder and Bowel Control 

In some cases, sciatica related to severe disc herniation in the lumbar spine may progress into a condition called cauda equina syndrome (CES).

You should contact a healthcare provider if you have sudden, unexplained bowel or bladder changes because these are early signs of CES. This could include involuntary bowel and bladder movements and difficulty passing urine.

CES also causes sudden pain and weakness of the legs, numbness of the groin, buttocks, genitals, and inner thighs (called saddle anesthesia), and sexual dysfunction.

CES occurs suddenly and can quickly get worse. It is a medical emergency for which you should seek immediate care. It typically requires emergency surgery to prevent neurological symptoms. 

Worsening Neurological Symptoms 

If you have damage to your sciatic nerve roots, you might experience worsening neurological symptoms requiring prompt treatment.

Neurological symptoms might affect one or both legs and might include the following: 

• Numbness 
• Tingling 
• Weakness 
• Abnormal sensations, such as a feeling that your skin is crawling
• Sensitivity to pain 
  

Though these neurological symptoms might indicate sciatica is severe and require immediate treatment, you will likely not need surgery to treat the cause.

A healthcare provider will likely suggest epidural steroid injections (into the protective space around the spinal cord) or a nerve block to treat the underlying cause and reduce or stop neurological problems.

Treatment to Stop Permanent Damage

Treatment is essential because progressive neurological symptoms could lead to irreversible nerve damage. 

Complications

Sciatica typically resolves with treatment within a few weeks. Your treatment options for the condition include physical therapy, medicines, and at-home remedies to manage symptoms. But sciatica can return and become chronic and recurrent. 

Some people might experience progressive symptoms and complications. 

Progressive neurological symptoms, such as numbness, tingling, and weakness, might indicate damage to the sciatic nerve roots. Left untreated, the damage can become permanent.

Additional complications of sciatica might include: 

• Chronic pain
• Drop foot: A paralysis of the muscles that lift the front part of the foot
• Gait (walking) troubles 
• Hyperalgesia(heightened pain sensitivity) 
• Loss of bowel or bladder function
• Muscle loss
• Muscle weakness
• Paresthesia(pins and needles) in the affected leg 
• Permanent nerve damage 
• Sexual dysfunction
• Cauda equina syndrome  

When to See a Doctor/Go to the Hospital 

For many people, sciatica improves on its own within a few weeks. For others, it resolves with treatment of its underlying cause. 

You should see a healthcare provider for new or worsening symptoms of sciatica or recurrent episodes. They can recommend treatments if symptoms do not resolve on their own. 

You should seek immediate medical attention if you experience the following: 

• Sudden or severe pain in one or both legs 
• Weakness of one or both legs 
• Trouble standing or walking 
• Saddle anaesthesia
• Loss of bowel or bladder movements 
  

Summary  

Sciatica is pain that radiates along the path of the sciatic nerve. Your sciatic nerve travels from the lower back through the hips and buttocks and down each leg.

Sciatica symptoms include pain on one side of the body and in the back, buttocks, hips, and legs, pain that worsens with sitting or standing, numbness, and weakness. For most people, sciatica pain improves within a few weeks with or without treatment. 

Untreated sciatica can lead to progressing symptoms, severe leg weakness, bladder or bowel changes, or even a severe neurological condition called cauda equina syndrome. Contact a healthcare provider for new or worsening symptoms.

You should seek emergency medical care if you experience severe leg pain or weakness, problems standing or walking, bladder or bowel problems, or saddle anesthesia.

https://www.verywellhealth.com/sciatica-symptoms-7111226

Is Swimming Good For Sciatica?

From 220triathlon.com

Sciatica can be a very painful and disruptive condition on your training. But can swimming help or hinder the symptoms? Brad Beer has the answers… 

Sciatica or sciatic pain refers to pain or neural symptoms (pins and needles, numbness) that travel along the sciatic nerve, and emanates from the gluteal region (lower back, hips and buttocks) into the lower limb (down the back of the leg and into your foot and toes).

It usual affects just one side, and most people experiencing sciatica make a favourable recovery.

While bed rest was once prescribed this has now been replaced with active treatments, such as walking, jogging, cycling and swimming, to name a few.

What causes sciatica? 

When something touches the sciatic nerve, usually a slipped spinal disc or an overgrowth of bone.

How does swimming improve/help sciatica?

Depending on the irritability of someone’s sciatica, swimming will mostly be ‘calming’ for the individual. A reduction in pain intensity and symptoms may occur. The mechanisms of this reduction in symptoms is unknown.

However, we can reason that the very act of ‘moving’ in a ‘supported’ environment such as the water could enhance a sciatica sufferer’s self efficacy. An increase in self efficacy may assist with reducing the symptoms being experienced by the swimming athlete.

How does swimming aggravate sciatica?

The chief mechanism by which swimming may aggravate sciatica is through an increase in neural tension/neural load. When a swimmer tumble turns and places their chin on their chest, this increases neural tension in the spinal tract which can result in heightened irritability of an athlete’s sciatica.

If we think about a 30- or 60-minute swim this may involve scores of repeated ‘chin to chest’ neurally loaded positions which may increase symptoms. In tandem with neck flexion on turning, a rounded back (lumbar flexed spinal position) can also serve as a neurally loaded position for the swimmer.

This position adopted in tumble turns and to a lesser extent touch turns can also heighten sciatica symptoms.

Lastly if a swimmer is highly toned in the front of their thighs (quadriceps) and hips (hip flexors), this can require the swimmer to try and ‘swim up and out of their hips’ which increases work being done at the already extended spine.

How can sciatica symptoms be treated?

This tightness pattern can be treated via stretching or manual therapies in order to assist the swimmer and reduce the risk of flaring sciatica symptoms.

Anterior hip tightness can be tested for with an orthopaedic test called the Thomas test. To perform the Thomas test the athlete sits on the edge of a plinth and hugs one knee maximally into their chest. The other leg hangs passively down. If the ‘hanging leg’ is ‘hinging’ above neutral it may be deemed a positive test for anterior hip tightness.

The athlete can then perform stretching or manual therapies to reduce the tone in this region. The result of this intervention being reduced anterior hip tightness and a better position in the water with the pelvis that places less load on the lower back when swimming.

https://www.220triathlon.com/training/swim-training/is-swimming-good-for-sciatica/

Immediate Relief for Sciatica Pain: Exercises and Stretches to Try at Home

From sportskeeda.com

If you're looking for immediate relief for sciatica pain, you know how debilitating it can be and how it can disrupt your daily routine.

From a dull ache to a sharp, burning sensation that radiates down the leg, sciatica pain can be excruciating. While medication, physical therapy, and surgery are some of the treatment options available for sciatica pain, there're also exercises and stretches you can do at home to get immediate relief for sciatica pain.

Understanding Sciatica Pain

Sciatica pain is caused by irritation or compression of the sciatic nerve, which is the longest nerve in the body.

The nerve runs from the lower back through the hips and buttocks and down each leg. The pain is usually felt on one side of the body and can be caused by a herniated or bulging disc, spinal stenosis, or a bone spur.

Immediate Relief for Sciatica Pain at Home

Here are some exercises and stretches that can provide immediate relief for sciatica pain:

Knee-to-Chest Stretch

To get immediate relief for sciatica pain, lie on your back with your knees bent and feet flat on the floor or exercise mat. Bring one knee up to your chest, holding it with both hands, and hold the stretch for 30 seconds. Repeat with the other leg.

Child’s Pose

Child's pose: Immediate Relief for Sciatica Pain (Image via Pexels/Ketut Subiyanto)

To do it, get on your hands and knees, and lower your hips back towards your heels while stretching your arms out in front of you. Hold the stretch for 30 seconds.

Figure Four Stretch

To do this sciatica relief stretch, lie on your back with your knees bent and feet flat on the floor or the exercise mat.

Cross one ankle over the opposite knee, and pull the knee towards your chest. Hold the stretch for about 30 seconds, and repeat with the other leg to get immediate relief for sciatica pain.

Seated Spinal Twist

To do it, straight on the floor or on the exercise mat, with your legs straight out in front of you. Bend one knee, and place the foot on the outside of the opposite knee. Twist your body towards the bent knee, and hold for 30 seconds. Repeat on the other side.

Pelvic Tilt

To do this sciatica relief stretch, lie on your back with your knees bent and feet flat on the floor. Tighten your abdominal muscles, and push your lower back towards the floor. Hold for 5-10 seconds, and release.

Wall Hamstring Stretch

To do it, lie on your back with your buttocks against a wall and legs extended up the wall. Flex your feet, and keep your legs straight while holding the stretch for 30 seconds.

Cobra Stretch

Cobra pose: Immediate Relief for Sciatica Pain (Image via Pexels/Ketut Subiyanto)

Lie on your stomach with your hands pressed to the floor under your shoulders. Press your hands to the floor and lift your chest up while keeping your hips and legs on the floor. Hold the stretch for 30 seconds.

Exercises for Sciatica Pain Relief

In addition to stretches, exercises can also provide relief for sciatica pain. Here are some sciatica relief exercises to try at home:

Hamstring Stretch

Hamstring Stretch: Immediate Relief for Sciatica Pain (Image via Pexels/Elina Fairytale)

To do this sciatica relief exercise, sit on the floor with your legs extended in front of you. Reach forward and try to touch your toes, holding the stretch for 30 seconds.

Piriformis Stretch

To do it, lie on your back with your knees bent and both feet flat on the floor or the exercise mat. When ready, cross one ankle over the opposite knee, and pull the knee towards your chest. Hold the stretch for 30 seconds, and repeat with the other leg.

Glute Bridge

To do this pose, comfortably lie on your back with your knees bent and feet flat on the floor. Lift your hips up towards the ceiling, squeezing the buttocks muscles, and hold for 5-10 seconds before lowering back down.

Knee Extension

To do it, sit on a chair, and extend one leg straight out in front of you, holding for 5-10 seconds before lowering it back down. Repeat with the other leg.

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Additional Ways to Get Relief from Sciatica Pain

Medication for Immediate Relief for Sciatica Pain (Image via Pexels/ JESHOOTS)

Here are a few:

Practice Good Posture: Sit up straight, and avoid slouching to avoid sciatica pain. Distribute weight evenly when standing, and use an ergonomic chair to reduce pressure on the lower back.

Use Heat and Cold Therapy: Apply heat or cold therapy to the affected area. Heat therapy can increase blood flow and reduce inflammation, while cold therapy can numb the area and reduce inflammation.

Try Over-the-Counter Medications: Take ibuprofen, aspirin, or naproxen to reduce inflammation and relieve pain. It's important to follow the recommended dosage and consult a healthcare professional for immediate relief for sciatica pain.

Consider Massage Therapy and Acupuncture: A skilled massage therapist can relieve muscle tension and promote blood flow to the affected area. Acupuncture can be effective in reducing sciatica pain by inserting needles into specific points in the body.

https://www.sportskeeda.com/health-and-fitness/immediate-relief-sciatica-pain-exercises-stretches-try-home

Lifting heavy boxes may have triggered sciatica

From dailyherald.com

By Dr. Eve Glazier and Dr. Elizabeth Ko 

Q: I am 33 years old, and I've been diagnosed with sciatica. It's hard to sit at my desk for my job. Sometimes the pain wakes me up at night. Could this have happened from lifting boxes when we moved? My husband says I should see a chiropractor. Is there anything else that can help?

A: When you have sciatica, it means something is putting pressure on, is irritating or has caused damage to the sciatic nerve.

Although it is referred to in the singular, the sciatic nerve is a complex structure that includes two different bundled and branching nerves and multiple nerve roots. Taken together, these form the longest nerve in the body. The sciatic nerve originates in the lower back. It then travels through the pelvis and buttocks, runs down the back of each leg, and ends at each heel. It helps to animate the muscle groups that we use to stand and walk, and it contributes to sensation in the parts of the body that it serves. That's why, in addition to inflammation and pain, sciatica can sometimes result in numbness.

The heavy lifting you did during your move may indeed have led to your case of sciatica. Incorrect lifting can contribute to one of the main causes of the condition, which is a bulging, herniated or misaligned disc in the spine, which presses on the sciatic nerve. Additional causes can include a narrowing of the spinal canal, known as spinal stenosis; tightness or spasms in the muscles that stabilize the spine; and new or pre-existing damage to the structure of the spine.

Pregnancy, diabetes, being overweight, being sedentary and slumping while seated can all add to the risk of developing sciatica.

Symptoms include a sharp and sudden pain in the buttocks, back of the leg or along the outer calf; numbness; tingling or a pins-and-needles sensation in the leg or the foot; and muscle weakness in the leg, ankle or foot. Standing is difficult when you have sciatica, and lying down often eases the pain. In some cases, the symptoms ease a bit when walking.

The first line of treatment often begins with medications. These are to ease inflammation and, if needed, manage muscle spasms and pain. Once those are under control, patients are typically referred to a physical therapist, who works with them on appropriate exercises, improving posture and preventive ergonomics. It's not common, but in some cases surgery may be needed to relieve pressure on the nerve.

Chiropractic care, which involves manipulation of the spine, can be useful in sciatica. It can relieve pain without medication and can help with the alignment issues that triggered the condition. Be sure to find a chiropractor with experience in dealing with sciatica, and ask them how they will approach your case. While chiropractic treatment is considered a safe therapy for sciatica, it's always a good idea to vet your health care provider and be familiar with what the treatment will entail.

Going forward, it's important to avoid heavy lifting, and be careful about maintaining good posture, particularly while spending long hours at your desk.

• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health.

https://www.dailyherald.com/entlife/20230218/lifting-heavy-boxes-may-have-triggered-sciatica