Understanding Sciatica
Sciatica is neuropathy which involves the thickest and longest nerve of the human body, the sciatic nerve. The sciatic nerve is formed from the spinal nerves and runs through buttocks, thighs and legs. When the sciatic nerve is subjected to stress, irritation, compression, inflammation, it produces pain (1). The stabbing pain can radiate throughout the length of the sciatic nerve. The pain that starts in the lower back and radiates down the leg is called sciatica. The pain can be described as numbing, tingling, shooting and/or electrical pain (2). It often occurs in only one leg, but can also be in both legs (3).
Sometimes, sciatic pain can be quite painful. Beyond pain, sciatica can affect our lives in many different aspects. The pain may prevent us from getting a good night’s sleep. It can prevent us from performing our household chores and participating in activities with our friends and families. These consequences can be life altering.
What Causes Sciatica?
Some of the more common causes of sciatica are listed below.
Disc Herniation
The most common cause of sciatica is a disc herniation (6). Disks are cushions which are between the bony vertebrae of the spine. They are shock absorbers which absorb the mechanical stresses of daily life. Sometimes a disc may herniate which means the gel-like center gets pushed outward toward the spinal cord. The herniated part of the disk may push or pinch on the spinal cord or nerve roots. This causes pain which we describe as sciatica.
Spinal Stenosis
Spinal stenosis is a condition in which the canal the spinal cord travels through is tight. This puts pressure on the nerves of the spinal cord and can cause symptoms of sciatica (7).
Piriformis Syndrome
In this syndrome, piriformis muscle which is located in the buttocks near the hip joint, compresses the sciatic nerve. The pinching or pressing of the sciatic nerve shoots electric current-like pain in the thigh, leg, and foot (8).
Conclusions
Sciatica typically gets better on its own after 4-6 weeks (9), however, if the pain is not improving, you are experiencing weakness in your leg or experiencing bowel and bladder incontinence, you should be evaluated by a physician immediately. At Alleviate Pain we offer treatment for sciatica that can help you live pain-free and get back into life.
References
1. Valat JP, Genevay S, Marty M, Rozenberg S, Koes B. Sciatica. Best Practice & Research Clinical Rheumatology. 2010 Apr 1;24(2):241-52.
2. Grøvle L, Haugen AJ, Keller A, Natvig B, Brox JI, Grotle M. The bothersomeness of sciatica: patients’ self-report of paresthesia, weakness and leg pain. European Spine Journal. 2010 Feb 1;19(2):263-9.
3. Kumar M, Garg G, Singh LR, Singh T, Tyagi LK. Epidemiology, pathophysiology and symptomatic treatment of sciatica: a review. Int. J. Pharm. Biol. Sci. Arch. 2011 Aug;2(4):1050-61.
4. van Rijn RM, Wassenaar M, Verhagen AP, Ostelo RW, Ginai AZ, de Boer MR, van Tulder MW, Koes BW. Computed tomography for the diagnosis of lumbar spinal pathology in adult patients with low back pain or sciatica: a diagnostic systematic review. European Spine Journal. 2012 Feb 1;21(2):228-39.
5. Visser LH, Nijssen PG, Tijssen CC, Van Middendorp JJ, Schieving J. Sciatica-like symptoms and the sacroiliac joint: clinical features and differential diagnosis. European Spine Journal. 2013 Jul 1;22(7):1657-64.
6. Peul WC, van den Hout WB, Brand R, Thomeer RT, Koes BW, Leiden-The Hague Spine Intervention Prognostic Study Group. Prolonged conservative care versus early surgery in patients with sciatica caused by lumbar disc herniation: two year results of a randomised controlled trial. Bmj. 2008 Jun 12;336(7657):1355-8.
7. Choudhury AR, Taylor JC. Occult lumbar spinal stenosis. Journal of Neurology, Neurosurgery & Psychiatry. 1977 May 1;40(5):506-10.
8. Durrani Z, Winnie AP. Piriformis muscle syndrome: an underdiagnosed cause of sciatica. Journal of pain and symptom management. 1991 Aug 1;6(6):374-9.
9. Jacobs WC, van Tulder M, Arts M, Rubinstein SM, van Middelkoop M, Ostelo R, Verhagen A, Koes B, Peul WC. Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review. European Spine Journal. 2011 Apr 1;20(4):513-22.
