What you need to know about Sciatica

What is sciatica?

Sciatica is pain which is referred to the back and outside of a leg due to a compression of the Sciatic nerve. The nerve is located in the lower back known as the lumbar and sacral region of the spine. It is made of L4, L5, S1, S2 and S3 nerve roots. Health practitioners may use the term sciatica interchangeably with other terms such as lumbosacral radicular syndrome, ischias, nerve root pain and nerve root entrapment.

What are the symptoms of sciatica?

Main symptoms of sciatica is pain which can feel sharp or achy radiating down a leg. Symptoms usually affect one leg, but in severe occasions can be present in both. However, other symptoms may accompany it such as:

• Tingling.
• Pins and needles.
• Lower back ache.
• Loss of muscle strength (usually not very prominent).
• Loss of sensation in the area of pain (usually not very prominent).

What causes sciatica?

There are several conditions that can cause sciatica:

• Disc bulge – bulging disc can compress the nerve root causing sciatic symptoms. Most of the time disc bulge affects one side, however, if the bulge is central, it might compress the spinal cord and cause symptoms to radiate in both legs.
• Foraminal stenosis – is narrowing of the foramen due to arthritic changes. Foramen is the space on each side of the vertebra where nerve roots are coming out. Symptoms usually affect one leg.
• Piriformis syndrome – is the tightening or a spasm of piriformis muscle which is located under the glutei which are located at your buttocks. Piriformis spans the sciatic nerve, hence, when in spasm, can produce sciatic symptoms. It usually affects one side.
• Lumbar stenosis – is narrowing of the spinal canal where the spinal cord is located. Narrowing of the spinal canal will compress on the spinal cord and most likely result in symptoms in both legs.
• Spondylolisthesis – is a condition where one of the lumbar vertebra slips forward compromising the space of the spinal canal. This may result in sciatic symptoms, patients may feel it in both legs.
• Tumours/malignancies – another cause of sciatica is an abnormal tissue growth in the spine area. It might affect one or both legs.

What treatment is available for sciatica?

This depends on why you have sciatica in the first place. For the majority of cases where only one side is affected conservative, experts recommend a non-operative approach such as physiotherapy, osteopathy, massage, acupuncture and more. Most of the time it produces very good outcomes, however, in cases where symptoms radiate in both legs or when conservative treatment is unsuccessful, minimally it needs invasive operation.

What operation is available for sciatica?

There are two most common operations to treat sciatica:

• Diskectomy – is the procedure where a surgeon removes a portion of the intervertebral disk which is pressing onto the sciatic nerve causing symptoms. Operation is usually performed under a general anaesthetic. Recovery time after the surgery usually varies between 1 – 4n weeks.
• Laminectomy –is the procedure where a surgeon removes/shaves off the back of the vertebrae to increase space of the spinal canal and remove the nerve compression. The surgeon usually performs the operation  under a general anaesthetic and recovery time varies from few days to several weeks.

How long does it take for sciatica to heal?

Symptoms usually affect one leg, but in severe occasions can be present in both.

Healing time very much depends on the cause of the sciatica. If you have symptoms radiating in one leg and they are not caused due to a serious condition, it is likely that your symptoms will improve significantly within 4 – 6 weeks. When a more serious condition is the cause of your sciatica, it might take several months for full recovery.

What to avoid if I have sciatica?

Try to avoid anything that exacerbates the symptoms. You might still be able to do some form of exercises, but  a qualified healthcare professional must prescribe the exercises for you such as an osteopath or physiotherapist. The list of activities to avoid can include:

• Heavy lifting.
• Excessive bending of the lower back.
• Bed rest.
• Certain exercises.
• Sitting down for long periods of time.
• Sudden twisting and turning.

We hope this information is useful for you. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always happy to help. If you like this blog, please share!

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 References:

https://mfprac.com/web2021/07literature/literature/Orthopedics/Sciatica_Ropper.pdf 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1895638/pdf/bmj-334-7607-cr-01313.pdf