Back pain affects many Americans, but can sciatica be cured? Here’s what you should know about this pain, and how it can be treated.
Among all nagging aches and pains, back pain is the most ubiquitous, and arguably the most debilitating. Some 49-70 percent of Americans experience a form of lower back pain every year, often to the point of having an impact on their quality of life and work performance.
Back pain comes in a number of different shapes and sizes. While not all back pain is neuropathic, or related to injured nerves, studies show that about 41 percent of patients with lower back pain are experiencing nerve pain rather than nociceptive, or noxious pain. The difference is that neuropathic pain is related to a damaged or injured nerve, while nociceptive pain is the result of proper nerve signaling from the back to the pain receptors in the brain (such as after a pulled muscle, or other injury).
Neuropathic pain can be difficult to diagnose and treat because of the way nerves relay information. Neuropathic pain related to the lower back, for example, may actually cause symptoms of pain, weakness, and numbness, in the buttocks and legs instead. The same goes for a neck injury causing lack of feeling and loss of fine motor skills in the arms and hands.
Among the different types of neuropathic pain in the back, sciatica is one of the most commonly known and diagnosed. But what is sciatica? Can sciatica be cured? And how is it different from other types of back pain?
What is Sciatica?
Sciatica is a colloquial term for unilateral (one-sided) leg and buttock pain, caused by a pinched sciatic nerve. The sciatic nerve is the longest nerve in the human body and runs through each buttock and leg. It originates at multiple points in the lower back, or lumbar region, connecting to the spinal cord via nerve roots.
When those nerve roots are pinched or compressed by a swollen or herniated spinal disc, a feeling of pain can run through the buttock and leg, accompanied by weakness, tingling, or numbness as compression continues. The kind of nerve pinching a herniated disc can cause is called radiculopathy.
In addition to being one of the larger nerves, one of the reasons sciatica is such a common cause of pain is because the lumbar portion of the spine is the portion most susceptible to injury. This might be because it’s most often subjected to shearing forces due to the way we bend over, poor lifting mechanics, overworking, or the general wear-and-tear of the spine, exacerbated by common sedentary lifestyles.
While disc degeneration or a herniated disc is one of the most common causes of a pinched sciatic nerve, it isn’t the only one. Sciatic pain can also be caused by a compression or pinching under the piriformis muscle, in the buttocks themselves.
This is called the piriformis syndrome. This can give someone the illusion of sciatic pain, via pain and weakness in one leg, but without any associated lower back problems.
Even more interestingly, lower back disc degeneration is not always symptomatic. You can have a mildly herniated or inflamed disc without the associated pain. That means that sciatic pain doesn’t always mean that something is wrong with your lower back, and it also means that just because you don’t feel pain doesn’t mean your lower back might not be at risk for it. Proper precautions, from living a healthier lifestyle, to exercising and moving ergonomically, are always called for.
How is Sciatica Diagnosed?
Doctors use two important tools when diagnosing sciatic pain: a physical examination, and imaging technology. Your doctor will ask you to perform a series of stretches and tasks, and will ask you to do certain things on the examination table, such as lifting your leg up slowly, to determine whether your sciatic nerve might be pinched, and where.
Imaging technology will confirm any suspicions your doctor might have. MRIs, x-rays, and fluoroscopy use different methods to illuminate the inside of the body and generate a 2D or 3D view of your bones and soft tissue, revealing tell-tale signs of sciatica such as a leaking spinal disc, inflammation in the buttocks, or bone spurs in the spine. More extreme causes of sciatica include tumor growths. Imaging tools are useful in helping medical professionals rule out such issues, or identify them as early as possible.
How Sciatica is Treated
Most cases, sciatica can be cured, or treated, conservatively. This means that your doctor may prescribe over-the-counter pain medication, cooling, and movement – from light walks to physical therapy – to reduce pain and help promote healing. The swelling of a herniated disc goes away on its own, as long as the injury isn’t exacerbated.
But some cases of sciatica may require more serious interventions. Bone spurs aren’t very likely to go away on their own, for example, and neither is a tumor – benign or otherwise. Treatments for sciatica will usually involve:
Pain medication can include both opioid and non-opioid medication, while physical therapy options both during and after an episode of sciatica can help reduce symptoms, and reduce the likelihood of recurring pain – by strengthening the supporting muscles of the spine or buttock.
When conservative treatments aren’t enough, non-invasive interventions such as nerve blocks can temporarily remove feeling in the affected area, and provide relief. Surgery is reserved for cases where no other options are effective, usually when removing tissue is the only way to resolve the nerve pain.
Can Sciatica Be Cured?
Sciatica can be treated, as we’ve mentioned. In that sense, yes, sciatica can be cured. But it’s important to note that your mileage may vary – some cases are more severe than others, and treatment may not be immediately effective.
In some cases, pain management plans are enough to reduce discomfort while supporting the body as it resolves the underlying issue. In other, more severe, or chronically recurring cases, you may be looking at surgical intervention or long-term treatment. Surgeries are used to remove bone spurs, fuse an unstable spine, or support fractured and collapsing vertebrae.
It’s important to talk with your doctor about what your options are for treatment, and to get a sense for what you should expect from any given modality. A long-term pain management plan will have a very different approach to long-term sciatica than first-line treatment for acute sciatic pain.
If you or a loved one is struggling with sciatica, know that it doesn’t have to be this way. Explore your treatment options today.