Sciatica is a condition in which pain radiates along the sciatic nerve. The sciatic nerve travels from the back, through the buttocks and down the leg
Sciatica is a condition in which pain radiates along the sciatic nerve. The sciatic nerve travels from the back, through the buttocks and down the leg. It is the longest nerve in the body. Sciatica is not a medical condition, but a symptom of a medical condition that causes this nerve to be pinched. Herniated spinal discs are the most common cause of sciatica. Sciatica can cause acute or chronic pain, depending on the cause. When the pain is acute, it typically subsides in approximately four to eight weeks with little or no medical intervention. When the pain is chronic, medical intervention is often necessary to alleviate it.
Usually sciatica affects one side of the body. The pain may be dull, sharp, burning, or accompanied by intermittent shocks of shooting pain beginning in the buttock traveling downward into the back or side of the thigh and/or leg. Sciatica then extends below the knee and may be felt in the feet. Sometimes symptoms include tingling and numbness. Sitting and trying to stand up may be painful and difficult. Coughing and sneezing can intensify the pain.
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The Cause: Nerve Compression
Compression of the sciatic nerve can cause any of the above-cited symptoms. Rarely is nerve damage permanent and paralysis is seldom a danger as the spinal cord ends before the first lumbar vertebra. However, increasing trunk or leg weakness, or bladder and/or bowel incontinence is an indication of Cauda Equina Syndrome, a serious disorder requiring emergency treatment.
Lumbar spine disorders known to cause sciatic nerve compression include the following:
Herniated Discs are the most common cause of sciatica in the lumbar spine.
Degenerative Disc Disease, a natural biological process associated with aging, is known to cause disc weakness that can be a precursor to a disc herniation.
Lumbar Spinal Stenosis is a narrowing of one or more neural passageways due to disc degeneration and/or facet arthritis. The sciatic nerve may become impinged as a result of these changes.
Isthmic Spondylolisthesis results from a stress fracture often at the 5th lumbar vertebra (L5). The fracture combined with disc space collapse may allow the vertebra to slip forward on the first sacral segment (S1). The slippage may cause the L5 nerve root to become pinched as it leaves the spine.
Sciatica is a painful condition that affects each person in a different way. It is important to get the cause of sciatica diagnosed. Different treatments are used if your symptoms are due to muscular pressure on the nerves or if the pressure is due to inflammation or bone changes. Treatments can involve medications, stretching and surgery. The first step is learning to recognize the signs and symptoms of this condition, so that you can get the right care as soon as possible.
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Sciatica signs and symptoms vary from person to person. In some cases, it is localized to the hip and lower back. In other cases, the symptoms can radiate into the buttocks, legs and feet. The symptoms may be worse when sitting or standing for long periods. Depending on the situation, there may be certain movements that set the symptoms off and certain ones that make a person feel better. No two patients experience sciatica the same way. Before seeing a physician, people who suspect they have sciatica should make sure that they make a journal of their symptoms, including when they are at their worst and what helps to relieve them.
According to the American Academy of Orthopedic Surgeons, if a person has sciatica, he may experience pain that is dull and achy or it can be sharp and stabbing. He may also feel a burning sensation. In some cases, numbness, tingling or weakness in the back, hips or legs will occur. These symptoms can come on quickly and last for days, weeks or be chronic.
If sciatica is more severe or continues untreated, complications may develop. This includes loss of function or sensation in the legs and or feet, and an inability to control bowel movements and urination. A person may develop a burning sensation or the presence of blood when urinating. Other signs can include an unexplained fever or redness and swelling in the back.
A doctor will need to do a complete medical exam as well as order tests to help diagnose what is causing the symptoms. X-rays, MRIs and CT scans can show where pressure is on the nerve and what is causing the pressure. These tests can also show how severely the nerves are compressed, which will help your doctor determine the best course of treatment.
Since sciatica affects each person differently, someone suffering with the condition will need to work with a health care team to find the right treatment program. Physical therapy, ice, heat, bracing, medication, injections and leaning proper body mechanics are all techniques that can help to calm the symptoms. If conservative treatment does not help, a doctor may explore surgical techniques to take pressure off the nerves. A lifetime plan of using good ergonomics and regular exercise to keep symptoms under control may also be required.