Sciatica is a painful condition that affects the lower back, buttock and the leg. Experienced when the sciatic nerve becomes irritated, sciatica leads to pain that is typically felt on just one side of the body. The sciatic nerve is the longest nerve in your body. Besides discomfort, sciatica is known to cause numbness in the affected regions of the body, as well as trouble with controlling the leg.
A troublesome sciatic nerve resulting in sciatica can cause acute pain anywhere from the lower back and hips to the feet and toes. Sometimes the sciatic nerve can become pressed or crushed because of a herniated disc in the lower spine. In rare cases, a tumor might cause a compressed sciatic nerve. In these severe cases, sciatica can result in a loss of feeling or reflexes, and/or weakness in the hips and legs.
There are two types of sciatica:
acute sciatica, which lasts up to six weeks
persistent (chronic) sciatica, which lasts longer than six weeks
Most cases of acute sciatica will pass without the need for treatment. A combination of self-help measures such as over-the-counter painkillers, exercise and hot or cold packs can usually relieve the symptoms.
For persistent sciatica, you may be advised to try a structured exercise programme under the supervision of a physiotherapist. In very rare cases, surgery may be needed to control the symptoms.
Symptoms of sciatica can include pains such as cramping, burning, or shooting sensations in the hip and thigh, though the pain can extend all the way to the foot and toes. These symptoms can be aggravated by simple movements such as coughing, bending, or squatting, all of which put pressure on the sciatic nerve.
Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg is the hallmark of sciatica. You may feel the discomfort almost anywhere along the nerve pathway, but it's especially likely to follow a path from your low back to your buttock and the back of your thigh and calf.
The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating discomfort. Sometimes it may feel like a jolt or electric shock. It may be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms. Usually only one lower extremity is affected.
Sciatica symptoms include:
Pain. It's especially likely to occur along a path from your low back to your buttock and the back of your thigh and calf.
Numbness or muscle weakness along the nerve pathway in your leg or foot. In some cases, you may have pain in one part of your leg and numbness in another.
Tingling or a pins-and-needles feeling, often in your toes or part of your foot.
A loss of bladder or bowel control. This is a sign of cauda equina syndrome, a rare but serious condition that requires emergency care. If you experience either of these symptoms, seek medical help immediately.
Most people find their sciatic pain goes away naturally within a few days or weeks. However, see your doctor if:
you experience any other symptoms together with your back and leg pain, such as weight loss or loss of bladder or bowel control
you experience increasingly more pain and discomfort
your pain is too severe to manage with self-help measures
In these cases, your doctor should check whether there is a more serious problem causing your pain.
Sciatic nerve pain, or sciatica, occurs when at least one of the five nerve roots in the lower back are compressed. Sciatica can be caused by anything from a back injury to poor posture. The condition is rare in people under 30. There are several different lumbar disorders that can lead to compression of the sciatic nerve. Anything that irritates or compresses the sciatic nerve or sciatic nerve root will cause pain. The most common causes of sciatica include:
Lumbar bulging. A common cause of sciatic nerve pain is lumbar bulging. Lumbar bulging is swelling of a lumbar spine disc. The outer shell of the disc remains intact, and the gel-like nucleus is contained within the disc. The swelling disc can apply pressure to the nerve root and result in sciatic pain.
Herniated disc. A herniated disc is similar to lumbar bulging and also causes sciatic nerve pain. The herniated disc occurs when the fluid inside the lumbar spine disc expands out of the disc shell. This fluid can cause nerve compression. The fluid also contains a chemical that causes sciatic nerve irritation.
Lumbar spinal stenosis. Lumbar spinal stenosis is a common cause of sciatic nerve pain in the elderly population. This disorder occurs when the sciatic nerve roots are compressed in the narrow passageways, called neural foramina, in the hips between the bones and ligaments. The sciatic nerve roots use these passageways to travel from the lumbar to the legs. It is not uncommon for them to become clogged or blocked with age.
Spondylolisthesis. Sciatic nerve pain is also associated with displaced or slipped lumbar vertebrae. This condition is called spondylolisthesis. Sometimes spondylolisthesis is present at birth and develops during childhood. Physical stress, such as weight lifting, trauma, or spinal degeneration, are also causes of lumbar vertebrae slippage.
Pregnancy. Pregnant women often suffer from sciatica as the sciatic nerve runs directly under the uterus from the spine to the legs. The developing baby puts pressure on the sciatic nerve, resulting in mounting pain through the course of the pregnancy.
Trauma. Sciatic nerve pain can also come from blunt force trauma to the lumbar region. An outside object can hit and compress the sciatic nerve or nerve root. Bone fragments can break loose from an injury and cause nerve compression. Injuries from sports or vehicle accidents are often associated with sciatic nerve pain.
Piriformis syndrome. Another cause of sciatic pain is a disorder called piriformis syndrome. Pirformis syndrome is caused by muscle spasms in the pirformis muscle, which runs directly above the sciatic nerve. When the muscle spasms, it irritates the nerve.
Sciatic nerve tumor or injury. Sometimes, the sciatic nerve itself may be affected by a tumor or injury.
Other causes. In some cases, your doctor may not be able to find a cause for your sciatica. A number of problems can affect your bones, joints and muscles, all of which could potentially result in sciatic pain.
Treatment for a painful sciatic nerve begins with an anti-inflammatory such as ibuprofen. Often, once the inflammation subsides, so does the pain; this is usually the time that a doctor will prescribe stretches, exercises, and even physical therapy to build up the muscles around the sciatic nerve. Recovery can take anywhere from one to three months. Sometimes the sciatic nerve is so compressed that surgery is required to make more room for the nerve. This can include prying up the bone around the nerve or removing a ruptured disc. Most people recover completely from sciatica without surgery.
For most people, sciatica responds well to self-care measures. These may include use of alternating cold packs and hot packs, stretching, exercise, and use of over-the-counter (OTC) medications. Beyond the self-care measures you may have taken, your doctor may recommend the following:
Physical therapy. If you have a herniated disk, physical therapy can play a vital role in your recovery. Once acute pain improves, your doctor or a physical therapist can design a rehabilitation program to help prevent recurrent injuries.
Rehabilitation typically includes exercises to help correct your posture, strengthen the muscles supporting your back and improve your flexibility. Your doctor will have you start physical therapy, exercise or both as early as possible. It's the cornerstone of your treatment program and should become part of your permanent routine at home.
Prescription drugs. In some cases, your doctor may prescribe an anti-inflammatory medication along with a muscle relaxant. Narcotics also may be prescribed for short-term pain relief. Tricyclic antidepressants and anticonvulsant drugs also can help ease chronic pain. They may help by blocking pain messages to the brain or by enhancing the production of endorphins, your body's natural painkillers.
When conservative measures don't alleviate your pain within a few months, one of the following may be an option for sciatica treatment:
Epidural steroid injections. In some cases, your doctor may recommend injection of a corticosteroid medication into the affected area. Corticosteroids suppress inflammation around the irritated nerve, thereby helping to relieve pain.
Their usefulness in treating sciatica remains a matter of debate. Some research has found that corticosteroids can provide short-term symptom relief but that these medications aren't a long-term solution. In addition, corticosteroids can have side effects, so the number of injections you can receive is limited. If your doctor recommends corticosteroids, he or she will determine a safe course of injections for you.
Surgery. This is usually reserved for times when the compressed nerve causes significant weakness, bowel or bladder incontinence or when you have pain that gets progressively worse or doesn't improve with other therapies.
Surgical options include diskectomy and microdiskectomy. In diskectomy, surgeons remove a portion of a herniated disk that's pressing on a nerve. Ideally, most of the disk is left intact to preserve as much of the normal anatomy as possible. Sometimes a surgeon will perform this operation through a small incision while looking through a microscope (microdiskectomy).
Success rates of standard diskectomy and microdiskectomy are about equal, but you may have less pain and recover more quickly with microdiskectomy. Discuss which option might be best for you with your doctor, and carefully weigh the potential benefits of surgery against the risks.
Sciatic nerve pain relief often includes the use of ice, heat, pain relief through medication, hot baths, proper support, and bed rest. Certain types of exercises and stretching may also be used to relieve and treat a pinched sciatic nerve. A few causes of sciatica may require surgery.
A pinched sciatic nerve is typically caused by something putting pressure on some part of the sciatic nerve, the body's longest. The pain associated with it is known as sciatica. There are many causes for sciatica; most of them are relatively mild and typically resolve in a little more than a month.
A person suffering from a pinched sciatic nerve may use ice during the first couple of days of pain. Heat may also be effective at relieving pain caused by sciatica, especially if muscle spasms occur with the pain. Muscle spasms can make the feeling of pain worse and may even be the cause of the pinched nerve. Heat often is able to relax the muscles and lessen the amount of pain that a person experiences.
Certain non-prescription medications may be used to relieve the pain associated with sciatica. These can be anti-inflammatory medications such as ibuprofen or aspirin. If these do not work, a doctor may prescribe prescription-strength pain relievers, prescription anti-inflammatory drugs, or muscle relaxants. For extreme cases of sciatica, a corticosteroid injection may be required.
Those who suffer from a pinched sciatic nerve may find that it is difficult to sit in a soft chair, because it hurts them to do so. This is because a hard, supportive surface is needed to keep a person from aggravating the condition even more. A firm chair and mattress can help to keep the muscles and joints along the sciatic nerve where they should be.
Doctors sometimes recommend bed rest. Lying on a firm mattress with a pillow under the legs can relieve the amount of pain a person feels from a pinched sciatic nerve. Too much bed rest can be hard on the muscles, though, causing them to become weak. For this reason, certain types of exercises and stretches are usually recommended. These exercises and stretches can loosen muscles, correct the positions of the vertebrae, and relieve pain associated with a pinched sciatic nerve.
Acupuncture and massage therapy may help as sciatic nerve pain remedies for some people. These options are relatively low cost, so if your sciatic nerve pain is persistent despite stretching, exercising, physical therapy, or medications, it may be worth a visit to a qualified and licensed acupuncturist or massage therapist. If the compression on the sciatic nerve is due to muscle issues, these two options may end up relieving your sciatic pain.
Surgery is typically a last resort but, in some cases, it is needed. Doctors usually begin to discuss surgery if the problem causing the sciatic is severe and causes other problems, such as loss of bladder control. Another reason for surgery is if all other treatments for sciatic nerve pain have been tried and failed to work.
Sciatic nerve exercises primarily include stretching and strengthening exercises of the muscles of the lower back, abdomen, and thighs. These exercises help to reduce the symptoms of sciatica. Some beneficial stretches that provide sciatic nerve pain relief are given below:
The below given exercises for sciatica are helpful in relieving pain that occurs due to the inflammation of piriformis muscle that lies close to the sciatic nerve.
Stretch #1
Lie on your back on the ground, keep your head down and bend both knees. Keep the ankle of your affected knee on the opposite knee. Now push down the knee of your affected leg, meanwhile pull up behind the thigh of the other leg. Hold this position for 5 - 6 seconds and then repeat.
Stretch #2
In this stretch exercise, you need to stretch out your unaffected leg in front and sit down. Hold on to the ankle of your affected leg and pull inwards towards your chest. Hold this position for 5 - 6 seconds and then repeat.
The below given back exercises help in relieving back pain or aches in the upper as well as lower back region due to an injury or muscle strain.
Stretch #1
Lie
on your stomach and support yourself up on your elbows while
stretching your back. Slowly start stretching your elbows and further
try to extend your back. Continue stretching your elbows until a
gentle stretch is felt and then hold this position for 15 - 20
seconds and relax.
Stretch #2
In
this back stretch exercise, you need to lie on your back. Your knees
should be bent and feet should be placed flat on the ground. Breath
out and press the small of your back against the floor. Hold for 15 -
20 seconds and then repeat.
Hamstring muscles are a group of muscles extending from the back of the thigh to the lower pelvis to the back of the shin bone. Following are some simple sciatic nerve exercises that may cure the tighten hamstring muscles which may pinch the nerve and lead to severe sciatic nerve pain.
Stretch #1
Sit on the ground with both your legs stretched out. Straighten your arms and move forward by bending at the waist as much as possible, while keeping your knees straight. Hold for 10 - 12 seconds, relax and then repeat.
Stretch #2
Sit on the ground with one leg stretched out. Fold the other leg at the knee and place the sole of that foot against your opposite inner thigh. Stretch your arms and reach forward over the leg that is stretched out by bending at the waist as much as possible. Hold this position for 10 - 12 seconds, relax and repeat.
These were some of the simple yet effective sciatic nerve exercises that will help to overcome the pain or inflammation of the sciatic nerve. However, if the pain doesn't subside after a week or so, it is better to consult your doctor to elucidate the case by making some changes in your exercise routine and prescribing certain medications, if needed.