What You Need to Know About Sciatica

Pain in the lower back, weakness, numbness, or tingling that goes down to your legs and feet are symptoms of sciatica that can affect your work and routine life. Persistent or frequently occurring pain may be a sign of some underlying condition that needs medical attention. Visit Redefine Healthcare to learn more about the causes of sciatica pain, how it develops and what are the most effective ways to treat it. Dr. Eric Freeman is New Jersey’s best pain management doctor and leading pain relief specialist and helps you find a solution that works for you depending on its causes. With his team of specialists, Dr. Freeman uses the most cutting-edge therapies to alleviate pain and ensure a stable spine for long-term health.

What Is Sciatica?

The sciatica nerve originates in the lower back, from the spinal cord, runs deep through the hips and buttocks, and then branches down each leg. It is one of the most crucial nerves in the body and the longest nerve too. This nerve has a direct effect on your ability to control and feel your legs.

If this nerve is irritated, compressed, pinched, or inflamed you will experience sciatica pain. You will feel a sensation that manifests itself as moderate to severe pain in your back, buttocks, and legs. Some experience sharp, shooting jolts of pain, while others suffer burning, electric, or stabbing pain. You may also feel weakness, burning, sharp pain, or numbness in these areas.

Sciatica symptoms are often caused by an underlying injury to the sciatic nerve or the area that affects this nerve, such as the vertebrae, and the bones in the neck and back. Most cases of sciatica get better on their own with time and self-care treatments.

What Does Sciatica Feel Like?

Pain that radiates from the lower back down the buttock and back of one thigh is classified as sciatica. Sciatica usually only affects one side of the body at a time, but it can also occur along both sides, depending on where the nerve is affected along the spinal column.

Symptoms of sciatica range from infrequent and irritating to severe and debilitating. It depends on the specific spinal nerve root that is irritated or compressed at the origin of the sciatic nerve. In some cases, one or more roots may be affected together.

Symptoms of sciatica include:

• Pain – People describe sciatica pain in different ways, which mainly depend on its causes. It typically feels like a burning sensation or a shooting pain anywhere along the sciatic nerve from the lower back, through the buttocks, that radiates down the front or back of either leg.
• Numbness – Sciatica pain may be accompanied by numbness in the back of the leg. In some cases, people also reported tingling and weakness in the affected areas.
• One-sided symptoms – Sciatica often affects one leg. This condition results in a feeling of heaviness in the affected leg. Both legs are rarely affected together.
• Symptoms induced by posture – Sciatica symptoms feel worse while sitting, trying to stand up, behind the spine forward, twisting the spine, and lying down. A sudden or forced body movement, like a cough or sneeze, can worsen the pain.

Sciatica pain may be constant, or it may come and go. It is also essential to note that all types of lower back pain or radiating leg pain do not indicate sciatica. Sciatica is specific to pain that originates from the sciatic nerve. These symptoms get better by walking or applying a heat pack over the rear pelvic region.

While some symptoms are specific to nerve roots, others are common and occur in all sciatica types. If you are unable to determine the causes behind your painful symptoms, consult a healthcare professional as soon as possible, as it may be a sign of some serious health condition.

Is Sciatica a Symptom of Some Underlying Medical Condition?

It is significant to understand that sciatica is not a medical condition on its own. Rather it is a nonspecific term used to describe a variety of leg or back symptoms caused by an underlying medication condition.

Some common medical conditions that may lead to sciatica include:

• A herniated lumbar disc
• Lumbar spinal stenosis
• Lumbar degenerative disc disease that causes general degenerative changes in vertebrae or discs
• Spondylolisthesis
• Muscle spasm and/or inflammation of the lumbar and/or pelvic muscles
• Sacroiliac joint dysfunction

These conditions may develop over time or spontaneously due to trauma or physical stress injury. Motor vehicle accidents, sports injuries, or falls may cause direct damage to the sciatic nerve, resulting in pain. Conditions such as spondylolisthesis and herniated discs may develop from physical stress injuries, such as weightlifting.

In rare cases, tumors, blood clots, or other conditions in the lower spine can lead to sciatica. In addition to the terms that identify the underlying pathologies that cause sciatica, the terms lumbar radiculopathy or radicular pain may be used interchangeably with the term sciatica.

The Sciatic Nerve and Sciatica

The sciatic nerve is the largest single nerve in the body. It is formed by the union of 5 nerve roots in the lumbar and sacral spine. There are two sciatic nerves in the body, the right and left nerves that supply the corresponding lower limb.

Characteristics of the sciatic nerve:

• Origin – It starts from the spinal segment L4 and is formed by the merging of spinal nerve roots from L4 to S3. The emerging nerve roots converge into a single, large, bulky sciatic nerve which is up to 2cms in diameter.
• Path – As it reaches the end, the sciatic nerve exits the pelvis through the greater sciatic foreman, below the piriformis muscle. This nerve then runs along the back of the thigh, into the legs, and finally ends in the foot.
• Branches – The sciatic nerves branches into two main divisions behind the knee, the tibial nerve and the common peroneal nerve. The tibial nerve runs down and supplies the back of the leg and the sole of the foot, while the common peroneal nerve supplies the front of the leg and foot.

In rare instances, the sciatic nerve may split into two nerves, and the sciatic foramen merges again into a single nerve. The specific sciatic symptoms largely depend on the nerve root that is pinched.

How Does Sciatica Pain Develop?

It has been observed that a particular event or injury may not cause sciatica right away, rather it develops over time. Research shows that sciatica affects about 10 to 14% of the population, which includes people around 40 years of age. It is also found to be common in certain types of occupations that include physically stressing positions, such as machine operators or truck drivers. People who often bend their spine forward or sideways or raise their arms frequently above the shoulder level are at risk of developing sciatica.

A majority of people experiencing sciatica usually get better within 4 to 6 weeks with nonsurgical, conservative treatments. Recovery time increases in case of severe neurological deficits. Severe nerve compression with progressive symptoms may also require surgery.

When Sciatica Turns Serious?

Sciatica that occurs after an accident or trauma or develops with other symptoms like fever or loss of appetite should not be ignored. Cauda equina syndrome is a rare but serious condition that affects the bundle of nerves at the end of the spinal cord called the cauda equina.

Symptoms may include, but are not limited to:

• Progressive neurological symptoms such as sudden loss of feeling in the lower body that includes the areas between the legs, buttocks, inner thigh, and entire foot
• Pain in one or both legs
• Numbness in one or both legs
• Bowel and/or bladder dysfunction
• Sexual dysfunction
• Stumbling when you try to get up

The presence of certain symptoms indicates a serious medical condition, such as spinal tumors or infections, which requires prompt medical attention. Call your doctor right away if you experience any of these symptoms to avoid further complications.

Treating Sciatica

It is best to treat sciatica as soon as possible to prevent the progression of symptoms. Treatment is aimed to decrease pain and increase your mobility using the least invasive options. Sciatic treatment includes both nonsurgical and surgical methods. Specialists recommend self-care treatment and nonsurgical methods to help you cope with discomfort and manage the pain.

Nonsurgical Treatments for Sciatica

Initial treatment for sciatica includes a combination of the following:

• Applying ice and hot packs – First, use ice packs to reduce the pain and swelling. Apply ice packs or bags or frozen vegetables wrapped in a towel to the affected areas for at least 20 minutes several times a day. Switch to a hot pack or a heating pad after the first several days. Use it for 20 minutes at a time. Continue with whichever method best relieves your discomfort.
• Physical therapy – It incorporates a combination of strengthening, gentle stretching, and aerobic conditioning to strengthen the spine and muscles of the lower back, abdomen, buttocks, and hip.
• Medications – Both prescription and over-the-counter (OTC) medications may be suggested by the doctor to relieve sciatica pain such as nonsteroidal anti-inflammatory drugs, oral steroids, anticonvulsant medications, and opioid analgesics.
• Therapeutic injections – They include injections that treat pain stemming from conditions that affect the sciatic nerve.
• Alternative therapies – They include chiropractic therapy to improve the alignment of the spine and address underlying issues and massage therapy for improving blood circulation and relaxing the tight, painful muscles.

Acute sciatica can be managed with 4 to 6 weeks of nonsurgical treatment but chronic sciatica, which lasts for more than 8 weeks, requires longer treatment time, depending on the underlying cause.

If your sciatica pain cannot be managed with nonsurgical options or the underlying cause is severe and progressive neurological deficits occur, surgery becomes necessary.

Surgical options to relieve sciatica include:

• Microdiscectomy – It is a minimally invasive procedure that removes fragments of a herniated disk pressing on a nerve.
• Laminectomy – In this procedure, the lamina, or part of the vertebral bone causing pressure on the sciatic nerve is removed.

The goal of surgery is to get rid of the pressure on the nerves that are being compressed or pinched, control leg symptoms such as weakness and pain and eliminate the cause of sciatica for a stable spine.

Preventing Sciatica

Some sources of sciatic may not be preventable such as degenerative disc disease or sciatica resulting from pregnancy or accidental falls. However, there are several lifestyle changes and healthy habits to protect your back and reduce your chances of developing it.

The following can help you prevent sciatica:

• Maintain good posture – Follow good posture techniques while sitting, standing up, lifting objects, and sleeping to relieve the pressure on the lower back. Pain is an early warning sign that your spine is not aligned right. If you feel sore or stiff, adjust your posture.
• Avoid smoking – Nicotine reduces the blood supply to the bones, which is not good. It weakens the spine and vertebral discs and puts more stress on the spine and discs, resulting in various problems.
• Maintain a healthy weight – Being overweight and unhealthy eating is associated with inflammation and pain throughout the body. Learn to eat healthily and lose the extra pounds to maintain a healthy weight and lessen the strain on your spine.
• Exercise regularly – Exercise helps to keep your joints flexible and strengthens your core and the muscles of your lower back and abdomen. These muscles play a key role in supporting your spine. Avoid sitting for long periods, as it can also lead to sciatica.
• Choose physical activities that do not hurt your back – Focus on low-impact exercises and activities that are least likely to hurt your back, such as swimming, walking, yoga, or tai chi. Consult a physical trainer before starting any new activity to learn about its impact on the body.
• Keep yourself safe – It is essential to keep yourself safe from falls and accidents that can lead to back problems. Wear shoes that fit and keep stairs and walkways free of clutter to reduce your chances of falls.

Practicing healthy habits, timely preventive measures, and maintaining a strong core can protect your back and legs and reduce the risk of issues associated with sciatica.

When Do You Need to Visit a Doctor for Sciatica?

Mild or acute sciatica usually responds well to self-care treatments like over-the-counter medications and hot and cold packs. However, if your back pain is not getting better after a week or continues to worsen, it is time to visit a doctor. An underlying condition may be the reason behind the painful symptoms that need proper diagnosis and treatment.

Call your doctor immediately if you experience the following:

• Severe pain leg lasting more than a few hours or unbearable pain
• Inability to stand or walk
• Bladder or bowel control loss
• Sudden and severe pain or other sciatic symptoms after an accident, fall, or trauma
• Inability to perform your routine activities

Even if your visit does not turn out to be an emergency, it is best to have it checked.

Do not let sciatica pain interfere with your daily lifestyle. Call Redefine Healthcare now and schedule an appointment with Dr. Eric Freeman, a board-certified Interventional Spine, and Pain Management specialist, to seek quick relief from debilitating pain resulting from various spine and pain disorders. He understands how frequently occurring lower back or leg pain can affect your life and creates a treatment plan that addresses your specific needs using minimally invasive therapies. The pain relief specialists at New Jersey’s most advanced pain management clinic use a combination of advanced technology and a patient-centered approach to help you achieve the best possible outcomes.