by Kimberly Allen R.N.
Sciatica is a term used to describe a set of symptoms caused by some type of irritation to the sciatic nerve, not a diagnosis for the cause of the irritation. The sciatic nerve is the largest nerve in the body and is comprised of five spinal roots that branch out from the spinal cord. The sciatic nerve begins at L-3 of the lumbar spine in the lower back it splits and runs down the back of each leg.
Sciatica is one of the most common forms of low back pain. The pain from the irritation can range from periodic episodes to constant debilitating pain. Sciatic pain usually originates in the lower back radiating down through the buttocks into the back of the thigh and all the way down the leg to the bottom of the foot. Leg pain commonly accompanies the low back pain and it is typically much more severe than the back pain. The pain typically improves when you lie down pr walk and worsens when sitting or standing in place. The pain has been described as very sharp or burning, others complain of feeling like there’s a “pins-and-needles” type of sensation sown the leg. As sciatica usually affects only one side of the body the pain is also frequently described as being a severe, shooting pain in the affected leg making it difficult to stand or walk. There can also be pain in the foot or toes depending on where the nerve is affected.
The most common cause of sciatica is a herniated disc in the lumbar region of the spine. Spinal discs are made of cartilage that is soft on the inside surrounded by fiberous cartilage. These discs cushion and separates the individual vertebrae. Herniation results when the discs are weak or there is some type of injury that causes the soft center of the disc to leak out forcing the outer ring of fiberous cartilage to tear and bulge into the spinal canal compressing the nerve root.
Lumbar spinal stenosis is a condition in which there is a narrowing of the spinal canal. Spinal stenosis is an age related condition and usually results from a combination of factors including enlarged facet joints and over growth of soft tissue or a bulging disc. Typically patients with sciatica from lumbar stenosis are over 60 years. Another related cause is degenerative disc disease and despite the use of the word “disease” it is actually part of the natural aging process not a “disease.” Also, the changes that a body goes through during pregnancy as well as the position of the baby can cause sciatica during pregnancy. When I was pregnant with my son he laid on my sciatic nerve for 6 months. I walked around dragging my right leg behind me for 6 months and then when I went into labor the contractions traveled down my leg instead of across my abdomen making for a very long period of labor before giving birth. As soon as my son was born the sciatica resolved itself.
People with degenerative arthritis involving the spine, or that have experienced trauma or injury to the lumbar spine are at greater risk for sciatica. Treatment depends on the underlying cause. Exercise is usually better for relieving sciatic pain than bed rest. Active exercise is beneficial in many ways, it prevents the muscles from weakening which can lead to further injury, it maintains and keeps the the spinal discs healthy promoting the movement of nutrients and fluids with in the spinal canal.
There are a variety of sciatic exercise programs know to relieve sciatica, these programs are specific to the underlying cause and should be set up by a physical therapist as doing the wrong type of exercise can worsen the sciatic pain. Other treatments involve reducing the inflammation and managing the pain. Frequently the doctor will refer you to a pain management specialist if the condition is chronic.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at email@example.com.