Lowe back and leg pain?: Sciatica causes and treatment
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. The term sciatica can also be used interchangeably with other terms such as lumbosacral radicular syndrome, ischia, 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, it may also be accompanied with other symptoms 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 being felt in both legs.
- Tumours/malignancies – sciatica can also be caused by an abnormal tissue growth in the spine area. It might affect one or both legs.
How can I treat sciatica pain?
First, treatment depends on the cause of your sciatic pain. For the majority of cases where only one side is affected conservative, a non-operative approach is recommended 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 invasive operation is needed.
In other words, according to the cause and the severity of your pain your therapist will tailor the best treatment for you.
What operation is available for sciatica?
There are two most common operations performed 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. Operation is usually performed under a general anaesthetic and recovery time varies from few days to several weeks.
How long does it take for sciatica to go away?
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. If your sciatica is caused due to a more serious condition, 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 the exercises must be prescribed by a qualified healthcare professional such as an osteopath, sports therapist or physiotherapist. The list of activities to avoid can include:
- Heavy lifting.
- Excessive bending of the lower back.
- Bed rest.
- Certain exercises.
- Being sat for long periods of time.
- Sudden twisting and turning.
Keep in mind…
Click here to stretch your sciatic nerve. It will help you to keep pain away!
We hope this information is useful. 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 glad to help. If you like this blog, please share!
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References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1895638/pdf/bmj-334-7607-cr-01313.pdf
https://my.clevelandclinic.org/health/diseases/12792-sciatica
