Symptoms and Treatment Options for Sciatica

Sciatica is persistent nerve pain that is felt when there is irritation of the sciatic nerve. This is the body's longest nerve and runs from the lower back, through the back into the lower leg. Pain results when the nerve is injured or compressed.


The sciatic nerve comprises individual nerve roots that begin by branching out from the spine before combining to form the sciatic nerve. Sciatica can result from bone enlargement caused by arthritis, displaced disc in the lower spine and body enlargement caused by arthritis.

The occurrence of sciatica increases in people of middle age. It rarely occurs in people below age 20 but is common in people in their 50s.

Sciatica is not caused by a particular injury or event, but rather it develops over time.

Symptoms

Sciatica symptoms occur when there is compression or irritation of the sciatic nerve in the lumbar spine. Patients with sciatica feel a pain that spreads from the lower back to the buttock, leg, calf and may spread to the foot. Usually, the pain feels aching, dull and burning. The pain may start gradually, worsen at night and become more intense during motion. Some sciatica patients feel muscle weakness, numbness or tingling in the affected leg.

The following symptoms characterize sciatica:

• Pain that gets worse when sitting
• Constant pain felt in one side of the leg or buttock
• Leg pain that is described as tingling, burning or searing
• Sharp pain that makes standing or walking difficult.
• Numbness, weakness or difficulty moving the foot or leg

Sciatic pain varies from irritating and infrequent to incapacitating and constant. The symptoms of sciatica can be different in severity and location, depending on the cause of sciatica. The specific symptoms of sciatica-numbness, leg pain, weakness and tingling -depends on where the sciatic nerve is irritated. For example, impingement of a lumbar segment 5 nerve causes weakness in the ankle and the big toe.

Though symptoms can be debilitating and painful, permanent damage of the sciatic nerve rarely results.

Treatment Options

Sometimes the treatment for sciatic pain may not be necessary because the condition improves naturally within a few weeks.

However, there is a number of treatment options for patients with persistent or severe symptoms. These include self-help and conservative treatments such as physiotherapy and medication though the effectiveness of some of these methods in treating sciatica is not clear. In some cases, the doctor may recommend surgery to correct the problem in your spine that is causing the symptoms. Because sciatica results from an underlying medical condition, the treatment seeks to address the root causes of symptoms, such as herniated disc and spinal stenosis.

Self-Help

The things you can do to help reduce sciatica symptoms include living an active lifestyle, using cold or hot presses and taking painkillers such as ibuprofen and paracetamol.

Simple exercises such as gentle stretching strengthen your back muscles and reduce the severity of your symptoms.

Using cold or hot compression packs helps relieve the pain on painful areas.

Painkillers

People with persistent sciatic pain may use painkilling medications such as:

• Opioid medication or morphine in severe cases.
• Tricyclic antidepressants-medications such as amitriptyline help reduce the nerve pain.
• Anticonvulsants-medications such as gabapentin are useful for relieving nerve pain.
• Paracetamol and anti-inflammatory drugs.

Spinal Injections

If other treatment options have not worked, the doctor may refer you for a local anesthetic injection or spinal corticosteroid.

The injection delivers strong painkilling and anti-inflammatory medication directly to the affected area around your nerves. This releases the pressure on the sciatic nerve and relieves the pain temporarily.

Physiotherapy

The doctor may refer the patient to a physiotherapist or recommend an appropriate exercise plan.

The physiotherapist teaches the patient how to reduce any strain on their back and improve their posture. They also teach patients the exercises that enhance the flexibility of the spine and strengthen the back muscles.

Surgery

Surgery is rarely used to treat sciatica. However, it may be recommended if the cause of the condition is identifiable, such as a slipped disc, the symptoms are getting worse, or other treatment methods have not worked.

The type of surgery used depends on the cause of sciatica. The surgical options include:

• Laminectomy-it is the removal of the lamina to treat spinal stenosis.
• Fusion surgery-a vertebra that has slipped is fused using a plastic cage or metal.
• Discectomy-it is the removal of a herniated disc pressing on the nerve.

Though spinal surgery has positive results, it carries risks such as infections and damage to the nerves. You should discuss with your surgeon the benefits and potential complications before you make the decision.