Sciatica is a condition wherein something is pinching the sciatic nerve, a nerve that runs through the leg, connecting to the pelvis and lower spine (lumbar spine). When this massive nerve is pinched, sharp pains can be felt throughout the lower back, and in certain regions of your leg. Other symptoms include numbness, or loss of bowel/bladder control.
Sciatica nerve pain is quite common in the general population, with the risk factor increasing with age. It is estimated that about 5%-10% of patients who report having lower back pain in fact have said the pain is due to sciatica, and that 40% of the population has suffered or will suffer from sciatica. When one looks at the numbers, it’s clear that the condition affects millions of Americans. Sciatica is also usually easily treated, if identified early on. Most people who are diagnosed with sciatica move on to make a full recovery. There are also several prevention measures that can greatly reduce the risk of another occurrence, or a first-time occurrence.
However, sciatica is not a disease with a single, identifiable cause. There are many ways to pinch a nerve, and treatment depends on the cause, any underlying conditions, and factors such as fitness and age. In most cases, relief is almost immediate, and treatment is not only possible, but usually widely available. However, in some cases, sciatica may be a sign of worse things to come, or it may hint at a deeper, darker, and greater problem.
How and Why Sciatica Occurs
The sciatic nerve is the human body’s largest and longest nerve, originating in the lower back (particularly on the lumbar spine and sacral plexus, L4-S3) and spanning the entire length of the leg, all the way to heel, connecting to the tibial and common fibular nerve in the process.
Due to its massive length, it is also responsible for the sensation of touch and other stimuli on the skin on the entire leg, save for the inner side, while innervating (moving) several muscles throughout the leg through the tibial and common fibular nerve, in particular the muscles responsible for extending the toes, flexing the ankle (toes towards shins), and raising the heel.
Because it attaches on several points throughout the lower back, and the lower back is one of the most injury-prone areas of the spine, it’s natural that many lower-back issues can lead to or cause sciatica. In general, sciatica is caused by pressure on the sciatic nerve through the lumbar spine or sacral plexus. Disc herniation or another form of spinal injury/spinal degeneration is usually the cause. On the flipside, lack of sensation or sharp pains felt in regions around the lower leg or around the hips may point towards sciatica as a possible cause.
Sciatic Nerve Pain Causes and Symptoms
The leading causes of sciatic nerve pain are:
- Age – the greatest factor associated with sciatica nerve pain is aging. We only get one body, and after the spine finishes growing, it eventually begins to deteriorate year after year. An active, injury-free lifestyle can slow the deterioration, but age catches up to everyone, increasing the risk of spinal diseases including sciatica.
- Weight – being overweight greatly increases the burden of the spine, especially if said weight is fat. Muscles can help move the body around and help offset loads during movement and lifting, but excess bodyfat simply stresses the spine, further contributing to the chance of a herniated disc later in life.
- Occupation – a life spent doing manual labor or spent in a bent-over position greatly increases the risk on the spine. Other jobs that keep the body out of shape, including driving or sitting by an office desk, also increase the risk of spinal deterioration.
- Improper Lifting – moving furniture or lifting heavy weights with improper form can lead to spinal injury, or compound stress eventually turning into a herniated disc or fracture.
- Degenerative Disc Disease – while most of the above causes involve causing a slipped or herniated disc, a degenerative disc disease can also lead to sciatic pain. Disc degeneration is a natural part of the aging process, but certain diseases speed up the process, weakening the disc and irritating the nerve roots in the area.
- Spondylolisthesis (Stress Fractures) – a small fracture may allow one vertebra to slip forward over another, causing a cascade of problems and imbalances, not the least of which is a nerve pinch.
However, the common (yet often overlooked) causes of sciatic nerve pain include:
- Pregnancy – the lumbar region can be put under a great amount of stress over the course of pregnancy, especially in women with weaker lower backs, leading to an increased risk of spinal damage.
- Epidural Fibrosis (Scarring) – scarring around the lower back and spine can cause sciatica by way of compressing the root of the sciatic nerve.
- Excessive Sitting – for numerous reasons, including posture, weight gain, and muscular weakness, people who live entirely sedentary lives are much more likely to develop sciatica at an earlier age.
- Tumors – as with scar tissue, tumors around the spinal area can push on the sciatic nerve – alongside many other nerves – causing pain and numbness, and a host of other symptoms.
Simple Lifestyle Changes for Sciatica Pain Relief
Lifestyle changes can have a tremendous impact on a patient’s overall health, and their sciatica. Even just minor changes to a patient’s day-to-day in the form of recovery measures and low-impact, short-duration exercises can bring a patient massive amounts of relief and help them feel genuinely better very quickly, very fast. Examples of effective lifestyle changes for sciatica nerve pain relief includes (but is not limited to):
- Regular healthy exercise, starting with slow walking.
- Strength training.
- Losing excess weight.
- Going on an anti-inflammatory diet.
- Using heat therapy, low-impact flexibility exercises, and saunas to increase recovery.
- Using ice packs to bring down inflammation temporarily.
- Conscious posture adjustment and stretching breaks for desk jobs.
When to Seek Treatment for Sciatic Nerve Pain
It’s important not to rely on exercises as the only way to recover from sciatica nerve pain or consider lifestyle changes alone to be sufficient in addressing whatever may have caused the incident to begin with. While surgery is rarely ever necessary, and surgical interventions often bring the same long-term benefits as non-surgical options in cases of sciatica, every case is different and requires professional insight and a thorough investigation. Speak with your doctor to find the underlying cause of your sciatica nerve pain – if relief, recovery, and muscle strengthening can help you resolve your problem and lead a better, more pain-free life, then that’s great news.
But in cases where the underlying cause is something that requires more of an invasive or aggressive approach, be sure to discuss your options and explore your next few steps. Sometimes, what may appear to be sciatica might not be sciatica at all, despite the symptoms. There are several conditions that mimic sciatica, exhibiting leg pain and numbness originating around the spine.
Problems with the piriformis muscle or sacroiliac joint come to mind. However, problems with both of these can also lead to sciatica. Only a thorough diagnosis by a professional with the right equipment will be able to tell you exactly where your pain is coming from, and why.