Pain experienced along the pathway of sciatic nerve is called sciatica. Sciatic nerve is a long nerve which originates from the lumbar spine. It runs from the lower back, buttocks and throughout the posterior aspect of the leg. When sciatic nerve is irritated and inflamed, it causes pain in the tissues and muscles where it innervates.
Sciatica pain is sharp and shooting. The pain is usually in one leg. The pain is intolerable and the person is unable to stand or even sit. Most of the time pain alleviates with conservative treatment.Rest, hot fomentation, analgesics and physiotherapy relieve the symptoms after a period of time.
What Causes Sciatica?
The most common cause of sciatica is pinched nerve or compression of the nerve originating from the lower lumbar spine. Compression can occur in the spinal canal or outside. Following are the conditions that may cause it.
- Herniation of lumbar disc which is also called slipped disc, may put pressure on the roots of the nerve from where it originates.
- Sciatica nerve is irritated when the deep muscles situated in buttocks put pressure on the sciatic nerve when it passes below it.
- Narrowing of the spinal canal.
- Infection, tumor, hemorrhage in the spinal canal irritating the sciatic nerve roots.
- Compression of the nerve between the muscles of thigh.
- Bony conditions such as arthritis, ankylosing spondylitis and bone tumor of spine.
- In many women sciatica occurs as a result of irritation of the nerve during pregnancy.
Nobody is certain why people are prone to sciatica. Most often the pain begins after an injury to the spine, after lifting a heavy object, or after making an abrupt movement. Growing age, people who have to sit for a long time and those having sedentary lifestyle are at a risk of suffering from sciatica as compared to an active person.
Symptoms Of Sciatica
- Pain along the path of the sciatic nerve is the prominent symptom of sciatica. It can be an acute pain or slow and progressive. The pain may be mild tingling or may be severe. It is shooting pain all along from the back to buttocks and in the posterior part of the lower limb.
- Sciatica usually occurs in one leg. The sharp shooting pain increases after standing or sitting for prolonged period of time. Pain may aggravate after sneezing, coughing and laughing.
- If the cause is spinal stenosis, the pain may be experienced after bending backwards or walking few steps.
Diagnosis Of Sciatica
Sciatica is diagnosed after taking proper medical history and clinical examination. A simple straight leg raise test helps to diagnose whether the pain is of sciatica. In this test the patient lies down on his back keeping both his legs straight. The physician will raise the affected leg and note at the angle where the pain begins. In sciatica the patient is not able to elevate his leg up to 90 degrees.
Other diagnostic tests recommended are: X-ray of the lumbar spine, MRI of spine to detect root lesion, or traumatic fracture or an infection of the spine.
EMG (electromagnetic test) is used to evaluate the nerve conduction defect.
How To Relieve Sciatica Pain?
The main aim is to reduce pain and increase the range of motion. Conservative treatment in most cases is successful.
- Patient is advised to take bed rest for few weeks. He should lie down on a hard surface or a mattress.
- Lying on the side or back with bent knees supported by a pillow relieves the stress on lower back.
- Heating pads kept for 15 minutes relieves the pain.
- Supportive back belts and braces may be useful to alleviate pain. They should be used for a short period of time as long use can reduce muscle tone.
- Anti inflammatory and analgesics reduces pain.
- Adequate sleep plays a vital role in recovery from back pain and sciatica.
- Rhustox, Arnica and other homeopathic medicines are beneficial for relieving symptoms of sciatica.