1. What is Sciatica?
Sciatica is a term used to describe nerve pain in the leg that is caused by a problem in the lower back. The sciatic nerve is a large nerve that starts in the buttock and travels into the leg. The sciatic nerve is formed by smaller nerves the exit the spine in the lower part of the back. Irritation of these nerves can cause pain in the buttock, thigh, calf, and foot.
2. What are symptoms of sciatica?
As well as pain traveling down the leg, people with sciatica can experience burning pain, electric shock type sensations and pins and needles. Some people may also experience numbness or muscle weakness in the leg. This is because some signals in the nerve can be blocked.
3. What causes sciatica?
Anything that irritates the nerve root (where the nerve comes out of the back) can cause sciatica. A common cause of irritation is compression associated with disc-related changes. The good news is the nerves are resilient, they nearly always have wiggle room and some disc-related changes shrink over time allowing nerve roots to heal.
In some cases, nerve roots are irritated by inflammation without any compression and this can be just as painful. Importantly, not all disc related changes will compress and irritate nerve roots. Many people, of all ages, have disc related changes but do not experience any pain.
Pain can also be influences by general factors such as reduced sleep, stress, and emotional wellbeing.
4. Who gets sciatica and how long does it last?
Sciatica affects people of all ages but is most commonly seen in forty and fifty year olds. Pain is usually worse in the first few weeks and reduces the most over the first few month. At twelve weeks, about half of people with sciatica will have significantly improved. At a year, three quarters of people with sciatica will have recovered. So, the good news is that recovery is highly likely, but the bad news is, it may take a while. Please feel free to reach out to see about treatment that may help your recovery.
5. How painful is sciatica?
Sciatica symptoms can range from mild to severer and can vary from day to day. Symptoms can be intense, unpredictable, and very distressing. This can be very scary (I know I have had it!), but sciatica is rarely dangerous. Symptoms can be all consuming. It can be tough to focus on other things. While being supported to manage pain, try to maintain things that bring value to your life. This might include things like going for a walk, playing with kids or grandchildren, going for a meal with a friend or staying at work. This may be difficult at times, but is can help with coping, emotional wellbeing, and your recovery.
6. Do I need a scan to diagnose sciatica?
Sciatica is a clinical diagnosis based on history, symptoms, and physical exam. In many cases, scans do not influence treatment plans as most sciatica can be treated conservatively. Scans may be appropriate when we suspect a person's pain is due to a serious medical condition. Thankfully, these conditions are rare and assessment done by me can help determine if you require a scan.
7. Is the pain traveling down my leg sciatica?
Only 8-10% of back related problems are thought to be truly nerve related. Pain from sensitive muscles and joints of the back and hip can also cause leg pain. Again, and thorough history and examination can help determine the source of your leg pain.
8. Sitting and sleeping with sciatica.
People with sciatica often find sitting, sleeping, and driving postures painful. Although maintaining these postures are not harmful, in times of intense pain, it can be helpful to explore different postures or move more regularly. As pain becomes more tolerable, it can be helpful to relax, move, and explore a variety of postures as part of your recovery and rehabilitation program.
9. Exercising with sciatica
When pain persists, it os common that nerves become sensitive to movement. While it can be sensible to rest to begin with or during a flare up, exercising in a gradual, progressive way is safe and helpful. For many people it helps to reduce inflammation and maintain function. There is no best exercise for people with sciatica so choose activities which you enjoy. The aim is to perform a tolerable level of activity a number of times per week. Examples include a walking program, swimming, gym or specific rehabilitation program.
10. How is sciatica managed?
There is a range of management options available for people with sciatica. My advice is to alway start with the most conservative option first. This can include giving it time, receiving the right physical therapy treatment for you, exercise, lifestyle advice, and pain relief medicine. In a small group of people, and injection or surgery may be indicated.
I hope that this information is helpful for you if you are experiencing sciatica. Give it time, get an appropriate assessment and treatment if indicated, and maintain a positive outlook for recovery. Reach out if you have any questions.
Reference for this Blog: 10 Sciatica Facts. The James Cook university Hospital. www.southtees.nhs.uk. Oct 2020