What is sciatica?
Sciatica encompasses all symptoms resulting from damage to the sciatic nerve. For this reason, the symptoms of sciatica are varied, ranging from unbearable sharp pain to numbness and tingling. Usually sciatica occurs in one leg at a time or in the lower back. The sciatic nerve runs from the lower back, to the buttock down the leg to the foot. Pressure or injury to any of these areas may affect the sciatic nerve. Injury to the sciatic nerve causes, but is not limited to, numbness, tingling, pain or weakness. Signs of sciatica include weakness in the knee, decreased reflex speed, and difficulty rotating ankle. Seek immediate medical attention if these symptoms are coupled with loss of bowel or bladder control as this may suggest severe nerve damage is taking place.
What causes sciatica?
Sciatica results from compression of the sciatic nerve. Prolonged bed rest can cause sciatica. For those already suffering from sciatica, a reduction of pressure on the buttock is recommended. Sciatica has both chronic and acute causes. Acute causes are muscular in nature and include laughing, coughing, sneezing and muscular hypertension. In women, increased pressure on the sciatic nerve due to pregnancy can cause acute sciatica. A lack of exercise coupled with long periods of sitting or lying down may exacerbate or cause sciatica.
Chronic cases of sciatica result from tumors, pelvic injury, slipped pelvic disks and lumbar spinal stenosis (a shrinking of the spinal canal at the lower back). Piriforis syndrome (PS) occurs when the sciatic nerve is encompassed by the piriforis muscle. This disorder causes an increased risk of developing sciatica, even if the sciatic nerve is otherwise normal.
What are the treatments for sciatica?
Sciatica is a symptom, not a disease. Numbness, tingling, pain or weakness in the legs suggests the existence of a medical condition that is causing sciatica. Once this condition is identified, the symptoms of sciatica can be alleviated. Spinal disc hernias, one of the most common causes of chronic sciatica, resolve themselves in 90% of cases. For pain relief, steroids are used to alleviate swelling. Muscle relaxers are used to alleviate pain. In most cases, sciatica occurs due to a rather benign condition and will subside on its own. Treatment for acute sciatica pain includes the use of heat pads, ice and over the counter pain relievers. Spinal stimulation (massage therapy) has been successful in treating acute, but not chronic, sciatica.
Sometimes opiates, such as hydrocodone, oxycodone and, rarely, morphine are used to reduce pain, especially in the elderly when sciatica is caused by an incurable condition. For those with tumors causing compression to the sciatic nerve, a removal of the tumor is the only effective way to alleviate symptoms. Surgery is a last resort for those suffering from sciatica. Surgery is performed almost exclusively to remove tumors because other surgeries, such as the repositioning a herniated disk, have been found to beneficiary only in the first year and symptoms usually return.