Sciatica

June 7, 2020

4 min read

Put your hands on your lower back. At this level of your spine, a pair of nerves called the sciatic nerves exit the spinal cord and branch off into the right or left leg. These nerves are the largest nerves in your body and carry important motor and sensory information to and from your lower limbs. Sciatica occurs when one of these nerves becomes pinched, irritated, or inflamed. Sciatica is a syndrome that can lead to a number of uncomfortable issues. Fortunately, a variety of treatment options exist.

Keep reading to learn more about this common condition, including how to recognize it and how to manage it.

What is Sciatica?

Sciatica happens when anything compresses or irritates the sciatic nerve root where it exits the spinal cord. This is often due to underlying issues like lumbar spinal stenosis (narrowing of the spinal canal), degenerative disc disease (narrowing of the spaces between adjacent vertebrae due to age-related thinning and breakdown of the discs), herniated or bulging disc, the biomechanical changes of pregnancy, bony cyst, and more rarely a tumor, fracture, or infection.

About 40 percent of people are thought to have sciatica at least once in their lives. Certain people may be born with an increased risk of developing it due to physical characteristics such as scoliosis, or they may have jobs that place more repetitive strain on the low back and increase the risk of injury there. According to Harvard Medical School, you may also be more likely to develop sciatica if you have a history of chronic back pain, some sort of acute trauma, or if you are obese, sedentary, or a smoker.

5 Key Sciatica Signs and Symptoms

For some people, their sciatica symptoms are mildly annoying. For others, their symptoms can be disabling and highly distressing. Five of the most common signs and symptoms include:

1.
Pain in the lower back but especially one leg (sometimes both legs) that is often described as radiating, shooting, burning, searing, or numb
2.
Pain that gets worse or moves further down the leg (peripheralizes) with certain movements, or after standing or sitting for a long time
3.
The sensation of pins and needles or numbness in the leg or foot
4.
"Drop foot" on the affected leg (the inability to lift the top of the foot toward the shin); this may first be noticed as increased "clumsiness" or tripping
5.
Decreased deep tendon reflex in the knee or ankle (reflexes are little movements that happen when tendons get tapped by something like a small rubber hammer you see in the doctor's office—a decreased or diminished reflex at the knee or ankle suggests the sciatic nerve is compromised)

Cauda equina syndrome (CES) is considered a rare but potentially serious condition, affecting about 1 in 33,000 to 1 in 100,000 people. Like sciatica, it develops when specific nerves in the spine become pinched or irritated. In this case, CES affects the bundle of nerves at the very bottom of the spinal cord (called the cauda equina because it looks a bit like a horse's tail).

CES shares many of the same symptoms as sciatica (such as low back pain), but it also usually presents with additional warning signs such as loss of sensation in the groin (saddle anesthesia) and unusual bladder or bowel incontinence. If left untreated, CES can cause a person to become permanently paralyzed. For this reason, doctors treat CES as a medical emergency.

If you notice any of these symptoms in yourself or a loved one, call 911 and get yourself to an emergency room right away.

What to Do if You Think You Have Sciatica

If you're concerned about your spine health, it's a good idea to modify any preventable lifestyle factors within your control that are related to sciatica and other spine-related problems. Doctors suggest that you:

Stay active
Maintain a healthy weight
Don't smoke
Eat a nutritious diet
Use proper body mechanics for all your work and leisure tasks

If you do have symptoms of sciatica, chat with your doctor or physical therapist. They can diagnose your condition based on your symptoms, physical tests, and in some cases imaging studies like X-rays or MRI of your lower back. Keep in mind that abnormalities in the spine (like herniated discs) don't always lead to sciatica symptoms, and sometimes you can have sciatica even if your imaging studies turn out "normal."

Don't worry—sciatica doesn't always lead to surgery. In fact, people with sciatica are almost always encouraged to explore conservative approaches first, including rest, heat or cold therapy, and physical therapy stretches and exercises. Yoga has also been shown to be helpful for low back pain and sciatica, but you may need to speak with your doctor first before starting this or any other new activity to make sure it's appropriate for your needs and ability.

Surgery may help in severe cases that don't get better with at least 6 to 8 weeks of conservative care. Sciatica surgery often involves the removal of an injured disc or fusion of injured vertebral bones in order to alleviate compression on the sciatic nerve root.

Struggling with sciatica? Ask others who understand what you're going through about what's helping them, and get more information about how to improve your spine health with our resources here at Healthread.com!