Sciatica: Symptoms, Causes, Treatment, Exercises | Ms. Thula Chelvan

Key Takeaways:

Sciatica refers to pain in the sciatic nerve, which extends from the lower back down the legs.
It is commonly caused by a herniated disc, lumbar spinal stenosis, and degenerative disc disease.
Lower back pain, hip pain, and a burning or tingling sensation down the legs are some of the symptoms.
If you have severe pain, numbness, or muscle weakness, you should seek medical attention.
Exercises, including stretching and strengthening routines, can help manage and alleviate sciatica pain.

What Is Sciatica

Sciatica is a specific type of pain that affects the sciatic nerve, the longest nerve in your body. The sciatic nerve transcends from the lower back, through your buttocks, and down each of your legs. If the sciatic nerve is irritated, it can result in pain that can be anything from a minor ache to an intense sensation that makes it difficult to walk or stand. Usually, sciatica can bring you to a standstill.

Causes of Sciatica

What's causing that annoying, persistent pain? There are several possible causes of the annoying persistent pain known as Sciatica, and they include:

Herniated Disc Affects Sciatica

Spinal discs act as cushions between your vertebrae. A herniated disc occurs when the soft inner core bulges through a tear in the tougher outer shell. It can be painless, but sometimes presses on nerves causing pain, numbness, or weakness in an arm or leg. This is one of the leading causes of that intense, stabbing pain down your leg. One's disc may herniate when they lift a heavy object incorrectly, a sudden twist, or simply due to the wear and tear of everyday life.

It's so crucial to lift correctly and look after your back because when a disc slips out of place and pushes on the sciatic nerve, it can lead to swelling, discomfort, and occasionally a lack of feeling in the impacted leg.

Lumbar Spinal Stenosis as a Cause

Sciatica can also be caused by lumbar spinal stenosis, which is just a complicated way of saying the spinal canal in your lower back has become narrower. This narrowing can press on the nerves, including the sciatic nerve, and cause pain. It's like when a tunnel becomes too narrow for cars to pass through easily, causing a traffic jam.

Sciatica: Symptoms, Causes, Treatment, Exercises

Additional Causes of Sciatica

While herniated discs and spinal stenosis are common causes, other conditions can also lead to sciatica. This includes degenerative disc disease, which is when the discs between the vertebrae start to deteriorate, and spondylolisthesis, which is when one vertebra slips over another. Both of these conditions can result in the agonizing pain that is characteristic of sciatica.

Symptoms of Sciatica

The pain can be different for everyone, from a dull pain to a sharp, fiery sensation or unbearable pain. It can also feel like a sudden shock. It can get worse when you cough or sneeze, and sitting for a long time can make it worse. Usually, it only affects one side of your body and can make sitting or standing for extended periods of time a real challenge

There are also individuals who feel a lack of sensation, a prickling feeling, or a decrease in muscle strength in the leg or foot that's affected. You may feel as if you're being pricked by "pins and needles" or find it difficult to move your leg or foot. This is an indication that your sciatic nerve is in desperate need of some tender loving care.

For the majority of people, sciatica pain can persist from a few days to a number of weeks. It usually gets better with self-care actions. But if the pain continues for a longer time or is accompanied by symptoms like significant leg weakness, then it's time to seek the help of the health practitioner.

When to Seek Help for Sciatica

If you're experiencing symptoms of sciatica such as a loss of control over your bowel or bladder, intense pain that gets worse instead of better over time, or noticeable leg weakness, you should seek medical help right away. These symptoms could indicate a more serious condition like cauda equina syndrome, which needs to be treated immediately to avoid permanent harm.

Moreover, if you're experiencing sciatica on both sides, have been unintentionally losing weight, or if your pain began after a traumatic injury, like a car accident, these are all warning signs that you should get checked out by the health practitioner.

How is Sciatica Diagnosed?

When diagnosing sciatica, your doctor will first conduct a comprehensive medical history check and a physical examination. As part of the physical examination, you may be asked to do some exercises to test your muscle strength and reflexes such as walking on your toes or heels, standing up from a squatting position, and lifting your legs one at a time while lying on your back. These exercises allow the healthcare provider to evaluate your muscle strength, nerve function, and response to pain.

Doctors use imaging tests such as X-rays, MRIs, and CT scans to get a clear view of your back's structure. An MRI, in particular, can provide a detailed look at both bone and soft tissues, including muscles and the sciatic nerve. This is especially helpful in diagnosing sciatica, as it can reveal where the nerve is being compressed.

Treatment for Sciatica

Sciatica can often be treated with a series of simple, non-invasive steps. Most people find that their symptoms improve within a few weeks or months with conservative treatment like exercise, physical therapy, and over-the-counter pain relievers.

First Steps to Take

When you first start experiencing sciatica, one of the best things you can do is apply heat or ice packs. You should apply these for 20 minutes at a time and do this multiple times throughout the day. It's best to start with ice for the first few days to help with any swelling and then switch to heat. The heat will help relax your muscles and increase blood flow.

However, while it might seem like a good idea to rest when you're hurting, staying in bed for more than a day or two can actually make your sciatica worse too. As a remedy, light activity helps reduce inflammation and pain.

Medication Choices for Pain Management

Non-prescription pain relievers like ibuprofen or naproxen can alleviate inflammation and pain caused by sciatica. If needed, the doctor might prescribe more potent drugs, like muscle relaxants or anti-seizure medications, which can also help reduce nerve pain.

Progressive Approaches for Chronic Sciatica

If sciatica doesn't get better with initial treatments, there are more progressive options. Physical therapy can be customised to fortify the muscles that support your spine and enhance flexibility. Injecting corticosteroids into the area surrounding the spinal nerve can help alleviate pain by reducing inflammation around the inflamed nerve.

For those who experience extreme pain or find that their condition isn't improving, surgery may be an option. This could involve a microdiscectomy, a procedure that removes the portion of the disc causing pressure on the sciatic nerve, or a lumbar laminectomy, which widens the spinal canal.

Exercises to Manage Sciatica

Exercise is a key part of managing sciatica, and it can also help prevent it. Gentle stretches can help to relieve the pressure on the nerve root, and regular, low-impact aerobic exercise helps to increase the flow of blood and oxygen to the disc and nerves.

It's essential to start with a slow pace and gradually increase the intensity, with a particular emphasis on exercises that work out the back and abdominal muscles, which provide support to your spine.

Stretching Routines to Alleviate Sciatica Pain

Sciatica stretching routines aim to loosen the muscles that cause discomfort when they become tense and rigid. Gentle and deliberate hamstring stretches can relieve the pressure on the sciatic nerve and reduce the pain you experience.

Consider the following stretches and exercises to ease sciatica pain:

Knee to Chest Stretch: Lie down on your back and stretch out your legs. Gently pull one knee up to your chest until you feel a stretch, hold for 30 seconds, then slowly lower it back down. Repeat with the other leg.
Seated Spinal Twist: Sit down on the floor with your legs stretched out. Bend one knee and place your foot on the outside of the opposite knee. Twist your upper body towards the bent knee, holding for 30 seconds. Repeat on the other side.
Pelvic Tilt: Lie down on your back with your knees bent and your feet flat on the floor. Tighten your stomach muscles and push your lower back into the floor. Hold for a few seconds, then relax. Repeat a few times.

Strengthening Routines to Prevent Recurrence

Strengthening the muscles in your stomach and back can help keep your spine stable and decrease the chances of sciatica coming back. A physical therapist can guide you through exercises that are safe and effective for your specific condition.

Here are some examples of exercises that can help strengthen your muscles:

Bridges: Position yourself on your back with your knees bent and your feet flat on the floor. Lift your hips to form a straight line from your knees to your shoulders. Hold this position for a few seconds before lowering back down.
Bird-Dog: Begin on your hands and knees. Simultaneously extend one arm and the opposite leg, hold for a few seconds, then return to the starting position. Continue to alternate between sides.
Planks: Position yourself on your stomach, then lift yourself up on your elbows and toes, ensuring your body is in a straight line. Hold this position for as long as you can, gradually increasing your time.

Always consult with the healthcare practitioner before starting any new exercise routine, especially if you are suffering from sciatica. They can ensure that you're doing the exercises correctly and not doing anything that could potentially worsen your condition.

Prognosis for Sciatica

Everyone's experience with sciatica is different, and recovery times can vary greatly. Some people may start to feel better after a few weeks of treatment, while others may need a few months to fully recover. It's important to stick to your treatment plan and not try to rush your recovery, as this can cause further damage to the sciatic nerve.

Managing Sciatica Long-Term and Making Lifestyle Changes

Managing sciatica for the long-term involves maintaining a healthy lifestyle to avoid future episodes. This includes exercising regularly, maintaining good posture, and making ergonomic changes in your everyday activities. Also, managing stress, keeping a healthy weight, and not smoking can help reduce the risk of getting sciatica.

How MSKDoctors Can Help You Manage

MSKDoctors is known for its expertise in handling musculoskeletal conditions, including sciatica. We recognize how nerve pain can significantly affect your life and we are committed to helping you alleviate it.

Our team provides individualized consultations to get to know your unique needs and craft customized treatment plans for you. Our experts will collaborate with you to devise a holistic strategy for managing your sciatica. This could incorporate exercises, modifications to your lifestyle, and treatment options if needed.

Complete Recovery and Rehabilitation Services

Along with treatment, we offer complete recovery and rehabilitation services to help you bounce back and prevent future bouts of sciatica. Our advanced musculoskeletal motion AI platform and tools like exercise guides and self-care tips are designed to empower you on your journey to better musculoskeletal health.

Frequently Asked Questions (FAQ)

What Causes Sciatica?

Sciatica is most commonly caused by a herniated disc that puts pressure on the sciatic nerve. But other conditions such as lumbar spinal stenosis, degenerative disc disease, or spondylolisthesis can also cause sciatica.

Is it Possible for Sciatica to Heal Itself?

Indeed, it is possible for sciatica to heal itself. The human body is quite impressive when it comes to healing, and with the right self-care and exercises, many individuals notice a decrease in their sciatica symptoms over time, often without the need for any invasive treatments.

What Should I Not Do if I Have Sciatica?

If you are suffering from sciatica, you should avoid activities that involve lifting heavy objects or twisting your back. You should also avoid sitting or standing in one position for too long as this can make your symptoms worse.

What is the Duration of Sciatica Pain?

The duration of sciatica pain can vary widely, lasting anywhere from a few days to several weeks. Most people experience relief from their symptoms with conservative treatments within a few weeks, but for some people, it may take longer, especially if the underlying cause is more serious.

Do I Need Surgery for Sciatica?

Most of the time, sciatica doesn't require surgery. It's usually only considered if other treatments haven't helped and the pain is really bad or getting worse. Your doctor will talk with you about the best options for your particular case.