This term refers to pain which radiates along the path of the sciatic nerve, which branches the lower back through the hips and buttocks and down each leg. We know that the longest nerve in our bodies is the sciatic nerve. In the most cases sciatic is affecting only one side of the body. This condition in the most cases is happening when a herniated disk, bone spur on the spine or narrowing of the spine, spinal stenosis, is compressing a part of the nerve. This is causing pain, inflammation and in many cases numbness in the affected leg. The pain which is associated with sciatica can be severe, but most cases resolve with non – operative treatments in a period of few weeks. The pain is usually felt in the legs and buttocks. Candidates for surgery are people who have severe sciatica that is associated with bladder or bowel changes or significant leg weakness. The sciatic nerve pain can be so debilitating and excruciating that you do not even want to get off the couch. Injury, a narrowing of the spine canal (called spinal stenosis) and ruptured disk are the most common causes for sciatica. [1,2]
Symptoms of sciatica
Pain which radiates from the lower (lumbar) spine to the buttock and the down the back of the leg is the main symptom of sciatica. Also you can feel the discomfort almost anywhere along the nerve pathway but it is especially likely to follow a path from the low back to the buttock and the back of the thigh and calf. You should know that this type of pain can vary widely, from a mild ache to a sharp and burning sensation or excruciating pain. In some cases it can feel like a jolt or electric shock. Also it can be worse when you sneeze or cough and also the prolonged sitting can aggravate the symptoms. In the most cases only one side of the body is affected. There are some people who have muscle weakness, tingling or numbness in the affected leg or foot. Also you can have pain in one part of your leg and numbness in another part. You should know that the mild sciatica usually goes away over time. If you have noticed that the self – care measures fail to ease the symptoms or if the pain lasts longer than a week, then call your doctor. Also you should call your doctor if the pain is severe or becomes progressively worse. If you have trouble controlling your bowels or bladder, then you should seek immediate medical help. Also you should seek immediate medical help if the pain follows a violent injury such as a traffic accident or you have sudden, severe pain in your low back or leg and the numbness or muscle weakness in the leg.
Causes of Sciatica
This condition is happening when the sciatic nerve becomes pinched and usually it is a herniated disk in the spine or by an overgrowth of the bone, bone spur, on the vertebrae. There are very rare cases when the nerve can be damaged by a disease such as diabetes or compressed by a tumor.
Risk factors: Here are some ricks factors for sciatica:
- Diabetes: This condition is affecting the way your body uses the blood sugar and it is increasing the risk of nerve damage. [3]
- Prolonged sitting: People who have a sedentary lifestyle or who sit prolonged periods are having increased chances of developing sciatica compared to people who are active. [4]
- Occupation: A job which requires driving a motor vehicle for long periods, carry heavy loads or to your back can play an important role in the sciatica but there are not conclusive evidences of this link.
- Obesity: When you are increasing the stress on your spine, then the excess body weight can contribute to the spinal changes which can trigger this condition. [5]
- Age: The most common causes for sciatica are the age – related changes in the spine, such as bone spurs and herniated disks. [1]
Complications: In the most cases people fully recover from the sciatica and often this is happening without treatment but on the other hand, there are some cases when sciatica can permanently damage the nerve. You should seek immediate medical attention if you have:
- Loss of bowel or bladder function
- Weakness in the affected leg
- Loss of feeling in the affected leg
References:
[1] Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007;334(7607):1313–7.
[2] Emary PC. Evidence-based prognostication in a case of sciatica. Journal of the Canadian Chiropractic Association. 2015;59(1):24–9.
[3] Freeman OJ, Unwin RD, Dowsey AW, et al. Metabolic dysfunction is restricted to the sciatic nerve in experimental diabetic neuropathy. Diabetes. 2016;65(1):228-38.
[4] Lis AM, Black KM, Korn H, Nordin M. Association between sitting and occupational LBP. European Spine Journal. 2007;16(2):283–98.
[5] Shiri R, Lallukka T, Karppinen J, et al. Obesity as a risk factor for sciatica: A meta-analysis. American Journal of Epidemiology. 2014;179(8):929-37.
