What is sciatica?
It’s a word that is widely used when it comes to describing back and leg pain, but what exactly is sciatica? And how different is it from back pain?
Sciatica gets it origin from the sciatic nerve which begins at the roots of the last three vertebrae of the lower back, L3 to L5, the roots come together in your gluteal or buttocks area and then travels down back of the leg, slits again behind the knee and continues to the feet. It is considered the biggest single nerve in the body. The term sciatica means that this nerve is inflamed or irritated medically know n as neuritis which can cause pain that can radiate from your spine to the back of the leg or feel like the pain is just in the leg itself. Whenever back pain radiates to the back of the legs, the term sciatica is used. Sciatica is not a diagnosis but just a symptom. In the majority of cases, the cause of sciatica is a herniated disk- meaning that the nerve is being pinched by the vertebra in the spinal column.
The symptoms of sciatica are pretty straight forward. The majority of individuals will complain of sudden sharp pain shooting from the mid back into the back of the thigh. This pain may radiate all the way below the back of the knee and end at the ankle. The pain is quite intense and uncomfortable. At the first sign of sciatica, most individuals will be disabled. There are some fortunate individual who only get a mild ache or a sharp pain in the buttock area. At other times, the sciatic nerve when compressed can present like a sudden electric shock which is painful. The pain of sciatica is generally worsened with any posture or condition that compresses the nerve. Sitting on a chair or lifting weights can worsen the pain. On the other hand, lying on flat surface eases the pain. In most cases, only one leg is affected. It is very rare for sciatica to occur in both legs at the same time.
Besides pain, some individuals may complain of numbness at the back of the calf or foot. In other cases, the numbness may alternate with the pain.
Often at night, there may be a tingling sensation in the toes or near the ankle area. This tingling is not pleasant and most individuals will toss and turn to be in a comfortable position to decrease this sensation.
When sciatica is severe, one may even have loss of bladder or bowel control. This is an acute emergency often known as cauda equina syndrome. These individuals need emergency care in a hospital setting. At this stage the vertebral column has completely compressed the nerve and one needs to get urgent relief with some type of surgery.
Causes of Sciatica pain
Causes of sciatica include damage to the joint, daily wear and tear, muscle spasms, cartilage damage, tendon and ligament tears, herniation of the disc, or a fracture of the joint. Even though herniated disc is one of the most common causes of sciatica, there are other causes that can cause similar symptoms.
Lumbar spinal stenosis is essentially narrowing of a segment of the spine. The narrowing is usually in the lower back, and often compresses the nerve that exits the spinal cord. In most cases only one side of the body may be affected.
Spondylolisthesis occurs when one vertebra slips slightly forward over another vertebra. The displaced bone fragment can then pinch or compress the sciatic nerve when it exits the spine.
Piriformis syndrome is a rare disorder when one of the muscles in the lower back goes into spasms and compresses the sciatic nerve. Piriformis syndrome can occur from prolonged sitting, motor vehicle accidents, and traumatic falls.
Trauma is a common cause of lumbar pain. The injury may lead to fractures or sprain which can injure the lumbar nerves.
In some individuals no cause of lumbar pain is ever found despite exhaustive work up.
Most people who develop sciatica are in their 2nd or 3rd decade of life. Individuals, who are obese, lift weights or have trauma to the back are more to developing sciatica. The lumbar spine is a common site of back pain in many people. Of all the causes of lumbar spine problems, sciatica is the most common. Sciatica essentially refers to pain that radiates along the path of the sciatic nerve. The pain in this case travels from the back, into the buttocks and down the back of the leg up to the ankle or foot. In most cases the pain of sciatica affects only one leg. Consumers should understand that sciatica is not a disease but only a symptom of lumbar spine disease. The most common causes of lumbar spine disease are is arthritis, osteoporosis, cancers, herniated discs, infections and a sedentary lifestyle.
Sciatica tells the physician that there is something in the lumbar spine that is compressing a nerve. The most common cause of lumbar disc disease is a herniated disc. Lumbar pain is very uncomfortable and can limit one’s lifestyle. In some cases the lumbar pain disappears on its own in a few months but in other cases, it may persist for many months. In some cases, self-care measures at home can help relieve the lumbar disc pain, but in many cases a visit to a physician is necessary as the pain can be excruciating.
The pain from lumbar spine can vary in intensity. In some cases it may be mild and localized but in others it can be very painful and may feel like an electrical jolt. Often the pain can be worsened by sitting for too long in one position, sneezing, coughing or sleeping on the stomach.
Besides pain, other features of lumbar spine disease include numbness or muscle weakness along the path of the nerve. Other individuals may feel tingling or a sensation of pins and needles in the back of the leg and foot. If the nerve compression is serious, it can also lead to bowel and bladder incontinence.