Sciatica is characterized by one or more of the following symptoms:
- Pain in the region of buttock or pelvis that may radiate to one or both thighs, leg or foot.
- Tingling sensation that may be associated with weakness, burning pain and numbness.
- Limited range of motion at thigh due to stiffness, pain or weakness of leg muscles.
- Impaired sensation around the back of leg or foot
- In long standing, untreated and poorly managed sciatica, bowel and bladder issues are also report
What may cause sciatica?
Sciatica is a symptom of an underlying problem in 90% of the cases. Any pathological process that increases the pressure on sciatic nerve anywhere along its course can lead to inflammation of nerve fibers manifesting as sciatica.
Notable causes of sciatica include:
Damage to Sciatic nerve as a result of inflammation due to nerve entrapment at the level of sciatic foramen or above (in case of lumbar disc herniation or intervertebral disc prolapse in the lumbar region.
History of pelvic injury or surgery is one of the recognized causes of sciatica
Degeneration of bones due to pelvic tumors
Piriformis syndrome is a condition marked by abnormalities of Piriformis muscle that may exert pressure on the nerve fibers leading to injury or inflammation.
What may increase your risk of developing sciatica pain?
- About 12% of all pregnant mothers experience sciatica pain during pregnancy as a result of excessive fluid accumulation, rapid weight gain and shifting of the center of gravity.
- Long standing constipation as a result of tumor of large gut press upon the sciatic foramen leading to inflammation of sciatic nerve.
- Degenerative bone diseases, osteoporosis and disorders of bone mineral density that leads to formation of bony spurs
- Damage to nerves as a result of metabolic syndromes like diabetes or uremia.
- History of steroid abuse or intravenous drug abuse (that increases the risk of septic arthritis and leads to weakening of bones)
What are some treatment options for sciatica?
In most cases, sciatica involves one limb; however, it can also involve both limbs. Treatment modalities depend on identification of the primary etiologic event. Current treatment of sciatica includes:
- Pain relief medications: Analgesics and narcotics are frequently used by individuals to treat acute cases of sciatica. For much severe cases of pain, nerve blocking agents like gabapentin, tricyclic antidepressants and anti-seizure medications can be employed.
- Steroid injection: Steroid injections also provide early relief in acute sciatica by decreasing inflammation and tissue swelling around nerves. Steroid injections are employed when recurrent episodes of sciatica are interfering with normal daily activities. In most cases, the effect of one steroid injection last for months; however, this is not a definite therapy and long term treatment with steroid injections should be strictly avoided
- Physical therapy: Physical therapy and chiropractic therapy are most popular therapies that help in relieving both primary and secondary cases of sciatica. Physical therapy helps in improving the posture and strengthening muscles that can better support back and limb tissues.
- Chiropractic care: Chiropractic therapy aims at traction of tissues to relieve pressure from the nerve; thereby improving the symptoms of sciatica and long term relief. Most chiropractors realign or readjust spinal vertebrae that relieve the pressure from the intervertebral discs.
- Surgery: Surgery is required only in cases when sciatica affects bladder or bowel functioning or if sciatica is progressive and refractory to other treatment modalities discussed above. Surgical treatments aim at removing bony spurs or correction of disc prolapse that is causing nerve inflammation.
What are other management options to treat sciatica at home?
Mild to moderate cases of sciatica can be managed in home setting by:
- Hot and cold compresses that helps in relieving tissue swelling and inflammation of nerve.
- Stretching exercises helps in preventing recurrent attacks of sciatica by realignment of tendons, ligaments and muscles.
- Soft tissue massaging techniques help in strengthening of muscles, ligaments and soft tissue around sciatic nerve and also provide nourishment to bones and joints by increasing the blood flow across the limb.