Sciatica is a condition caused by the compression of the sciatic nerve, the longest nerve in the human body. Like other forms of nerve compression, sciatica can cause excruciating and long-lasting pain, often followed by total debilitation. Sciatica is the symptom of a long list of different problems, ranging from a herniated disc to osteophytes, arthritis, and more.
Sciatica affects an estimated 5-10 percent of Americans with lower back pain complaints, which amounts to over half of the adult US population. In general, sciatica has an annual prevalence of 2.2 percent. This amounts to large swathes of people, making it a serious concern for millions of Americans every year who struggle with disc-related sciatic pain.
Unlike general back pain, sciatica does not express itself primarily in the back, but rather causes more severe shooting pain in the leg in most cases. This is because the sciatic nerve attaches to the lumbar portion of the spine yet runs down the leg through to a person’s foot. This causes sciatic nerve pain to occur anywhere from the buttock down to the end of the leg.
Signs and Symptoms of Sciatica
While the first and most obvious sign of sciatica cannot be missed – the extreme pain – it does have identifiable characteristics setting it apart from most other spine-related issues. Here are a handful of important signs that often set sciatica apart from other conditions.
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- The pain is centered or only exists in one leg/buttock, rather than both.
- The pain is deep within the leg, rather than on the surface.
- Nerve tingling, pins and needles, and prickling pains rather than a deep ache.
- Your affected leg is particularly weakened and gives way when standing on it at times.
- You feel jolting pain at times.
- Your leg feels numb and unresponsive sometimes.
Sciatica’s key characteristic is the sciatic nerve. While the pain is often debilitating, it is also surprisingly diverse. It can be described as a deep tingle, a numb feeling, a sharp knife-like pain, a cattle prod pain, a jolt, a prickle, and so on. Muscle weakness is also a hallmark of the condition, as a compressed sciatic nerve makes it tougher for the muscles in the leg and buttocks to properly contract. While sciatica almost always affects just one side, pain can occur in both legs in some cases.
All forms of sciatica should be addressed by a professional. Mild, manageable pain levels may suggest mild sciatica, which often goes away over time as the spine heals itself. Not all forms of sciatica occur through a degenerated or injured disc – certain forms of inflammation or swelling in deep muscle tissue can compress the sciatic nerve as well. If basic painkillers and self-care doesn’t do the trick, head to a doctor’s clinic to confirm the diagnosis and figure out what to do. If the pain is severe, sudden, or debilitating, seek professional help right away.
How Sciatica Occurs
Aside from a damaged or herniated disc, other conditions that can cause sciatica include:
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- Spine degeneration
- Facet joint injuries
- Arthritis
- Joint inflammation
- Piriformis syndrome
- Spondylolisthesis
- Sacroiliac dysfunction
- Spinal stenosis
These conditions, one after the other, describe various syndromes, injuries, and disorders that cause compression on the sciatic nerve through swelling, wear and tear, a moved disc, or pressure created by fluid leaking spinal discs. While the result is similar, treatment differs depending on how the condition occurred. It’s typically not possible for most patients to self-identify the cause of their sciatica unless the cause is obvious, such as a recently endured back injury or a history of inflammation, arthritis, or spinal problems.
Certain occupations and hobbies are also more likely to lead to conditions and injuries that may cause sciatica, including heavy/frequent/improper lifting, clinicians and medical personnel who often support their patients’ bodyweight, sedentary people who spend most of their time sitting down, and professions involving a considerable amount of leaning (from surgeons to factory workers).
Sciatica Pain Treatment
If the sciatica is mild, most treatments simply involve managing the pain and working with patients to elicit long-term improvements, often through daily stretching and strengthening exercises. Patients may be encouraged to lose weight or gain muscle mass and flexibility or spend less time seated and standing and spend more time in motion. Over-the-counter medication and simple daily stretches may relieve the pain and eventually lead to total recovery.
While sciatica is often caused by bone spurs or herniated discs, these issues resolve themselves in most cases. If the pain is manageable, a conservative approach will always be preferred. It’s only when the pain is severe or very rapidly escalating that more invasive treatments may be needed. The first step is imaging, which can be pricey but may be necessary to accurately pinpoint where the compression is occurring. EMGs, CT scans, MRIs and X-ray devices can be used to look for the origin of the pain, depending on what doctors think caused the sciatica.
From there, the next step is determining the extent of the damage. If the cause of the pain will reverse itself over time, all a doctor can do is recommend medication and movement to speed along recovery and help combat the pain. Antidepressants, muscle relaxers, anti-inflammatories and anti-seizure medication may help on top of regular OTC painkillers. If the pain is unbearable, one option may be to use a corticosteroid injection to reduce swelling around the irritated nerve.
Physical therapy is an option for patients who need coaching to help regain leg strength, improve the musculature around the spine, and improve flexibility. If the condition is severe enough that movement becomes impossible and the nerve begins to impact other processes in the body (such as bladder control), or if recovery alone isn’t enough for the pain to subside over time, doctors may recommend surgery to remove the portion of the disc affecting the nerve, or to remove the offending bone spurs.
Preventing Sciatica and Recurring Pain
Life can bring unexpected troubles and unfortunate circumstances, but there are ways to get around some of life’s worst curveballs by being better prepared and living a healthier lifestyle. Sciatica prevention largely requires regular physical exercise, enough to keep a person’s back healthy and strong, yet not so much that it further places them at risk of a spine problem.
Aside from strengthening the back, keeping physically trim with a healthy body fat percentage, and staying away from habits that promote disc degeneration (such as smoking and an inflammatory diet) can help reduce the chances of sciatica drastically.
The same goes for individuals who have already experienced sciatica. To avoid recurring pains, focus on a healthier lifestyle. Taking regular breaks from sitting too long can make a big difference already, and you can build a stronger body without a gym membership.
