One day you wake up and you have pain and numbness running from your low back all the way down through your leg. You think it will go away but it doesn’t for days. Walking doesn’t help, sitting doesn’t help, and sleeping is nonexistent. What is going on? What you may be suffering from is called sciatica. Sciatica is a condition where you have symptoms of pain, numbness and sometimes weakness in your legs. Commonly, sciatica can result from low back conditions such as a herniated disc or disc generation that can put pressure on or cause irritation to the nerves coming out of your spine in your low back (more on those conditions later). The symptoms that occur usually occur on one side of the body, and the pain is often described as a searing or sharp pain that may make it difficult to stand up or walk. The symptoms can range from infrequent and irritating to so much pain that you can’t get up and move. They can also be intensified during sudden movements, such as sneezing, coughing or when changing positions (sitting to standing). So what part of the body is the culprit of this pain? The answer: the sciatic nerve. The sciatic nerve is the largest nerve in your body and it is about as big as a man’s thumb at its largest point! This nerve branches off your lower back through your hips at buttocks and down into the toes. It supplies sensation and strength to the leg and it connects the spinal cord with the outside of the thigh, hamstring muscles in the back of the thigh and muscles in the lower leg and feet.
Back to the low back conditions, there are a few conditions that can increase the symptoms of sciatica. One is a herniated disc in your low back. Herniated discs happen when the soft material inside the disc between your vertebrae leaks out and pinch the associated nerve close to that area. Other terms used that refer to a herniated disc are: bulging disc, ruptured disc, protruding disc, or a pinched nerve. Another condition, commonly in the older population is degenerative disc disease (DDD). DDD can take place in the neck, mid or low back. Degenerative disc disease is part of the natural aging process where the disc between the vertebrae become thinner and weaker, or “degenerate” and progressively reduces the amount of stability in the in the low back. The discs can eventually become inflamed and cause muscles in the surrounding area to tighten up or “spasm”. These muscle spasms associated with the instability of your low back are thought to cause the pain to radiate down into the legs.
Another such condition that is correlated with the natural aging is lumbar spine stenosis. Lumbar spine stenosis is a fancy term for the narrowing of the spinal canal in your back —where your spinal cord runs through—that compress the nerves coming out of your low back and cause pain in your low back and into your legs. One last example of a condition that can cause sciatica is known as piriformis syndrome. The piriformis is a strip of muscle in your buttock in which the sciatic nerve runs under. Think of a piriformis as a bridge and the sciatic nerve as water going under the bridge.
Sometimes the piriformis muscle can become tight and compress the sciatic nerve, therefore causing either pain or numbness down the leg. So what are some of the nonsurgical ways we can rid sciatica? You can use heat or ice, over-the-counter pain medications or prescribed muscle relaxants, or an epidural steroid injection. If pain is severe an epidural injection can reduce inflammation however is only a temporary pain reliever and may not work for everyone. With these strategies, you will be relieved of pain but only temporarily. So what is a great long-term strategy for sciatica? The answer? Physical therapy. Physical therapists have spent much time and effort studying and researching effective methods to relieve patients for all sorts of pain. They will educate you various types of strategies to alleviate your pain and give your exercises and stretches to take home with you to continue to perform. The importance of applying these exercises is crucial in reducing your overall pain. The more you can do on your own, the more you confident you will become in knowing that you are doing everything in your power to rid your sciatica pain for good.