The sciatic nerve is the longest single nerve in the human body. It extends from each side of the lower spine, runs through the buttocks and back of the thighs, down the legs and into the feet and toes. The term “sciatica” refers to an irritation or inflammation of the sciatic nerve that can result in a number of symptoms, including buttock or thigh pain, and pain or weakness in the lower leg or foot. Symptoms can also include numbness, burning, tingling, or a “pins and needles” sensation along the leg.
Approximately 40 percent of all adults will experience sciatica at some point in their lifetime, though only 10 to 25 percent of those cases will last longer than six weeks. Chronic sciatica refers to sciatic pain that persists for longer than three months. For those living with chronic sciatica, everyday activities like sitting at a desk or climbing stairs can be agonizing. History tells us that sciatica has persisted through the ages. Thousands of years ago, the ancient Celts called sciatica “the elf’s arrow” to describe the terrible pain that shot down their leg and early Germans called the sharp pain “the witch’s slot.”
What causes sciatica?
Though the exact source of a person’s sciatica can be difficult to determine, it is often caused by pressure on the sciatic nerve from a herniated disc, bone spurs, or muscle strain or trauma. Specific conditions that irritate or compress the sciatic nerve include stenosis, which is a narrowing of the bony canals in the spine; piriformis syndrome, which is a tightening of the piriformis muscle—located in the buttock—that presses on the nerve; and spondylolisthesis, a weakness in the facet joints that allows vertebrae to slip out of position and pinch the sciatic nerves.
Diagnosing chronic sciatica generally includes a physical exam, imaging scans, and tests to check muscle strength and reflexes. It may also include nerve conduction tests to determine how well electrical impulses travel through the sciatic nerve and/or a myelogram, which consists of dye being injected between vertebrae to pinpoint whether a vertebrae or disc is causing the pain.
Finding relief from the pain
Like most chronic pain, chronic sciatica requires pain management and coping strategies to keep the situation under control. Quite often, one of the best ways to get relief is to stay physically active and engage in moderate exercise. Quite often, people with chronic sciatica feel better when walking than they do when sitting or standing in place.
Pain management options include controlling inflammation and irritation of the nerve with epidural steroid injections delivered to the nerve roots or piriformis block injections delivered to the piriformis muscle that may be compressing the nerve.
Other pain management options that may prove helpful are spinal cord stimulation (SCS), a pain-relief technique that uses low-voltage electric current to interrupt how pain signals are sent to your brain, and radiofrequency ablation (RFA), a procedure that uses electric current to heat up small areas of nerve tissue and prevent transmission of pain signals from that area.
Complementary and alternative medicine (CAM) options like physical therapy, massage therapy, biofeedback and acupuncture may also prove helpful in the treatment of chronic sciatica.
If you’d like to learn more about options for addressing chronic sciatica, call Pain Management and Injury Relief at (877) 724-6349 to make an appointment today.