A spine surgeon reveals how to distinguish sciatica from regular back pain

From msn.com/en-us

By Kelsey Kryger

Sciatica is a growing problem, with up to 40 percent of people experiencing it at some point in their lives. While it's often lumped in with general back pain, sciatic nerve pain goes a bit further. In fact, about 5 to 10 percent of people dealing with low back pain actually have sciatica. The condition causes a sharp, radiating pain that starts in the lower back and travels down the leg, making it difficult to sit, stand, or walk comfortably. 

"The terms low back pain and sciatica are often used as interchangeable terms, but they describe different problems," says Paul Gause, M.D., an orthopaedic spine surgeon at Spine Institute of Arizona. "There are a multitude of conditions that can cause compression or irritation of nerves in the spine, but the result is the same: pain radiating down your leg."

We tapped Gause to learn more about what causes sciatica, symptoms to watch for, and when it's time to seek medical attention. If you're dealing with such pain, understanding the source of your symptoms could be the first actionable step towards finding relief.

What is Sciatica?

Sciatica is nerve pain from an injury or irritation to your sciatic nerve, which is the longest nerve in the body. Many conditions can result in sciatic nerve pain, but the most common is a herniated disc, which occurs when the soft inner portion of a spinal disc pushes through its outer layer and presses on a nerve.

Spinal stenosis is another common cause of sciatic nerve pain, which is a degenerative narrowing of the spinal canal that puts pressure on nerves. Spondylolisthesis is another condition where one vertebra slips out of place and pinches nearby nerves. A less common cause is piriformis syndrome, where a muscle in the buttock compresses the sciatic nerve as it travels down the leg.

Sciatica Symptoms

The main symptom of sciatica, Gause says, is leg pain. Because the sciatic nerve is irritated or compressed, people may also experience numbness, tingling, or muscle weakness along the affected side. Above all, duration of symptoms should be paid close attention to. Often, the causes of sciatic nerve pain heal themselves, but symptoms lasting longer than a month without improvement should be evaluated by a healthcare professional.

"I generally worry more about nerve dysfunction and particularly, weakness," he adds. "It’s not that pain is unimportant to treat, but weakness, particularly if severe or progressive, can lead to a permanent loss of function in the affected leg."

Low Back Pain vs. Sciatica

Low back pain is a common experience for many, with a multitude of underlying conditions, including muscle soreness, injuries, and even degenerative changes of ligaments, joints, or discs. Low back pain is usually an achy, stiff, or tight feeling that is isolated to the lower back area. It may radiate slightly to the buttock, but it doesn't radiate down the leg.

Sciatica, on the other hand, is when someone experiences pain along the distribution of the sciatic nerve, which runs from the buttocks down the posterior thigh and into the lower leg, usually affecting one side. Back pain can be a component of sciatic nerve pain, but the main symptom is usually a sharp, burning, or shooting sensation down the leg, often down to the foot.

"A useful question to ask yourself is: 'Is the pain staying in my back or is it traveling down my leg?' If it's radiating down the leg, particularly below the knee, then you're likely experiencing sciatica," Gause says.

Sciatica Treatment

Sciatic nerve pain can be intense, but treatment with medications and physical therapy can help diminish the severity of pain while the back tries to heal. The time to seek immediate medical care, however, is if the pain is accompanied by significant or progressive leg weakness, loss of bowel or bladder control, or numbness in the groin or saddle area. A new loss of bowel or bladder control can be permanent if not treated right away.

"Associated symptoms can also be an important red flag to seek urgent care," Gause adds. "Sciatic nerve pain in someone with a history of cancer, with significant fevers or chills, or with unexplained weight loss should be evaluated right away. If the pain is a result of a significant fall or trauma, it's best to seek more urgent care."

https://www.msn.com/en-us/health/other/a-spine-surgeon-reveals-how-to-distinguish-sciatica-from-regular-back-pain/ar-AA24Fv9N?cvid=6a21622225694a1d83611038566498e9&ei=11

Sciatica acting up? These self-care treatments calm lower back pain fast

From msn.com/en-us

By Kara Wahlgren and Ann Green 

When you're in the middle of a sciatica flare-up, your top priority is getting relief ASAP. Sciatica is a type of pain that travels along the sciatic nerve, which runs from the lower back through the heel of each foot. When there's excess pressure on this nerve, it can cause a tingling, burning or shooting sensation that radiates from the lower back through the buttock or leg. While the pain can be debilitating, the good news is that up to 95 percent of people recover within a year without surgery, according to French research. And you can speed up healing with these simple sciatica self-care strategies.

AsiaVision/Getty

5 sciatica self-care tips to ease pain

In addition to physical therapy or any treatment your doctor recommends to provide relief from pinched nerves, consider these simple sciatica self-care remedies you can do at home to feel better faster. 

Take a slow walk

Sciatica can make you want to curl up in a ball on the couch. And it's okay to rest when the pain is unbearable. But as soon as you can tolerate it, gentle movement can help improve blood flow and mobility. Exercise also triggers the release of feel-good endorphins.

"While short periods of rest are helpful during sciatica flare-ups-particularly when the pain is severe enough to limit mobility-ongoing periods of rest lead to muscle stiffness and weakness, which can actually worsen sciatica discomfort," says Jennie Stanford, MD, a family medicine physician and medical contributor for Drugwatch. "Gentle exercise can improve pain and mobility."

In fact, a review published in the European Spine Journal suggests that walking may be just as effective as surgery for easing long-term sciatica pain from a herniated disc. And here's incentive to keep it up even after you heal: Researchers reporting in JAMA Network Open found that people who walked a total of 100 minutes a day had a 23 percent lower risk of lower back pain than those who walked 78 minutes. Better yet, walking daily helped no matter how slow or fast they strolled. (Get more tips to ease lower back pain.)

Alternate between hot and cold

When sciatica first strikes, cold packs are a self-care strategy that can help numb the area and get you through the worst of the pain. Apply an ice pack to your lower back for 20 minutes at a time, two or three times a day. (Be sure to put a cloth layer between the ice and your skin to prevent frostbite while taming sciatica symptoms.)

After a day or two, apply heat to promote healing. "Muscle spasms around the inflamed sciatic nerve are common," Dr. Stanford explains. "Heat specifically helps promote muscle relaxation and improves pain that way. Heat may also improve blood flow to those muscles, reducing discomfort." She recommends people with sciatica use a heating pad on a low to medium setting for 15 to 20 minutes at a time. 

No heating pad handy? Sink into a warm bath instead to ease painful areas. A Taiwanese study suggests that heat may reduce inflammation, easing sciatica-like nerve pain. Not only that, the gentle warmth relaxes tense muscles that can make pain worse. Plus, moist heat penetrates deeper than dry heat, according to Loma Linda researchers.

Pay attention to your posture

Poor posture can compress the spine, putting pressure on the sciatica nerve. So it's important to be mindful of your posture, especially if your job requires you to be standing, bending or sitting for long periods at a time. "Improving posture when you are active and at rest can help with spine alignment and related sciatica," Dr. Stanford says.

There are three natural curves in your spine: your neck, the middle of your back and your lower spine. When you're sitting or standing, take stock to make sure you're not bending any of these beyond their natural curve (like slouching at your desk or looking down at your phone). If your job requires you to stand in one spot or sit behind a desk, be sure to take walking breaks or do some gentle stretches for a few minutes every hour as part of your sciatica self-care routine.

Stretch your legs

Gentle stretching is an important part of your sciatica self-care routine, as it can improve blood flow and mobility. Stretching also helps to maintain a healthy spine, lessening your risk of future flare-ups. 

"Stretching exercises should focus on the surrounding muscles, like the gluteus maximus and minimus, piriformis, hamstrings and other hip flexor muscles," Dr. Stanford says. In particular, she recommends the Cat-Cow and Child's yoga poses to release tension in the lower back. (Check out our primer on proper Child's Pose, plus five more stretches to ease sciatica pain.)

One area you might want to pay special attention to: tight hamstrings, which can strain your lower back and irritate the sciatic nerve. Fortunately, just five minutes of stretching three times a week eased pain by 61 percent in three weeks, according to a Korean study. Start by lying on your back, then lift one leg up toward the ceiling (keeping your leg straight) and use a towel to gently pull your foot toward you for 10 seconds. Repeat five times per side.

Tip: Dealing with stubbornly-tight muscles in your legs or glutes? Ask your doctor about using a percussive massager, such as the Rally Orbital Massager, to help relax overworked muscles.

Consider OTC pain relievers

"Anti-inflammatory agents are likely to be most effective for sciatica-related discomfort," Dr. Stanford says. These can include non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen sodium, or topical pain relievers like diclofenac gel. Consider adding them to your sciatica self-care routine.

If sciatica self-care remedies aren't enough, call your doctor

If these home treatments aren't bringing enough relief from your sciatica pain, it may be time to talk to a healthcare provider. Your doctor can help determine what's causing your sciatica (such as a herniated disk or bone spurs) and rule out any other underlying conditions. 

If your sciatica is recurring, a physical therapist can recommend exercises to improve strength and mobility in your lower back. If you experience any worrisome symptoms, like a fever, numbness is your legs or loss of bladder control, seek emergency care.

https://www.msn.com/en-us/health/other/sciatica-acting-up-these-self-care-treatments-calm-lower-back-pain-fast/ar-AA1Vwzw4?cvid=6a1ee549502e459a9d5637e8cad4debe&ei=7