Sciatica is the nerve pain that occurs due to the irritation of the sciatic nerve which is the largest nerve in the human body. This nerve begins in the lower back and ends in the lower limb passing through the buttocks. Therefore, the pain is felt in the lower back which radiates to the lower limb from behind the thigh. Usually, the pain is felt only on one side of the body. In most of the people, the pain goes away within a few weeks but it can sometimes last for several months or even years.
The symptoms which are commonly exhibited by people with sciatica are:
- Pain and discomfort in the lower back and buttocks
- Numbness or tingling sensation in the affected leg
- Difficulty to move the affected leg
- Muscle weakness
Seek immediate medical help if:
- There is severe pain, numbness or weakness in the leg
- Pain that occurs after a violent injury
- Difficulty controlling bowel or bladder movement
Sciatica occurs when the sciatic nerve is compressed due to the herniated disk in the spine or by an overgrowth of the vertebral bone. In rare cases, this compression can result from the tumors and gets worsened with conditions such as diabetes. Coughing or sneezing can also worsen the pain.
Other causes include:
- Degeneration of the disks which provide a cushioning effect between the vertebrae
- Spondylolisthesis, a medical condition in which one vertebra overlaps the other
- Spinal injury or infection
- Tumors in the spine
- Spinal stenosis (narrowing of nerve passages in the spine)
The below factors increase the risk of a person to develop sciatica:
- Obesity which puts pressure on the spine
- Advancing age which involves changes in the spine such as bone spurs or herniated disks
- Sitting for prolonged periods
- Diabetes increases the risk of nerve damage due to the changes in the use of blood sugar
- Occupations such as driving motor vehicles or carrying heavy loads on the back
The doctor performs a physical examination which includes checking the muscle reflexes and strength by performing some activities. A simple test known as passive straight leg raise test is performed to detect sciatica.
If the pain is severe or if it does not improve in some days or weeks then the below laboratory tests may be ordered to know the exact cause:
- Imaging tests such as x-rays, MRI (magnetic resonance imaging), or CT (computed tomography) scans are conducted to get a detailed view of the bone and soft tissues.
- Electromyogram (EMG) is performed to measure the electrical activity of the nerves and checks the response produced by the muscles.
Most of the people with sciatica do not need any treatment as the pain goes away within 6 weeks. Appropriate treatment is provided based on the underlying cause and the intensity of pain. The treatment options include:
- Strong pain-killers
- Injections of pain killers and anti-inflammatory medicines (such as steroids) which are given into the spine
- Manipulation of the spine and massage which is usually carried out by a physiotherapist or an osteopath or a chiropractor
- Psychological treatment and support
- Rarely surgery may be recommended
Some of the self care measures which can improve the symptoms and relieve pain include:
- Use of hot or cold packs
- Performing stretching exercises as suggested by the doctor or staying physically active
- Use of over-the-counter anti-inflammatory pain relievers
Visit the doctor if the symptoms do not improve with self-care measures or if the pain persists for more than a week or if the pain is progressively worsening.