Decoding Sciatica - Your Path to Pain Relief!

Medically reviewed by Aaron L Weigmann MD., MS Plastic Surgeon March 28, 2024| Written by Godfrey Makonere Wesutsa

Decoding Sciatica - Your Path to Pain Relief!

Over 40% of Americans experience sciatica in their lifetime.Sciatica refers to the paresthesia and excruciating pain along the sciatic nerve, extending from the lower back down your thigh. The pain occurs when your sciatic nerve is compressed or stretched, often with movement. 

Since the sciatic nerve is not only the main but also the largest nerve in your body, any discomfort will likely affect thequality of your life. 

Despite not being a serious health condition, it can go on for weeks if you do not get the right self-care treatment. Thus, in severe cases, you might need surgery. 

People often mistake sciatica for radicular leg or lower back pains. Sciatica is divided into two categories:

1) True Sciatica: Any injury or discomfort directly affects the sciatic nerve.

2) Sciatica-like conditions: mimic sciatica-like pain but are caused by other reasons related to the sciatic nerve or those nerves that form this nerve.

Only a medical professional can determine if you have true sciatica or not. That said, medical practitioners tend to refer to both of these types as Sciatica. 

A physician may perform blood tests, magnetic resonance imaging (MRI), nerve conduction studies, electromyography, and X-ray to determine whether it is sciatica pain. These tests entail making images of your internal bones, tissues, and organs and analyzing the electrical impulses of muscles and may show the followingissues:

  • Numbness
  • Weak reflexes
  • Difficulty bending your foot inward or down
  • Weakness bending your knee
  • Pain while lifting your leg straight up when lying on the examination table
  • Difficulty when bending forward or backward
  • Difficulty when walking on your toes

Signs and Symptoms

The most common signs and symptoms of Sciatica include:

  • Numbness occurs because the signals from your leg or back are unable to reach your brain. As a result, there is aloss of sensation on the skin covering your leg or back.

  • Fecal incontinence orurinary incontinence is a sign that your sciatica has worsened. It happens because the signals that control bowel movement and bladder are no longer functional. 

  • Paresthesia is the pins, needles, ortingling that marks the loss of sensation in your leg.

  • Muscles grow weak as signals controlling your leg muscles have difficulty reaching your back. This results indifficulty bending forward or backward.

  • Pain results from pressure and compression on the sciatic nerve. It feels like a burning sensation. The pain starts in the lower back and then moves downwards to the leg.  

What is the Main Cause of Sciatica?

1. Pressure on the Sciatic Nerve

Sciatica is caused by damage or compression of the sciatic nerve. The pressure causes pain that affects the thigh, lower back, and leg. You will feel the pain whenever you try to bend backward or forward. The pain will be accompanied by paresthesia and numbness, negatively impacting your life quality. 

2. Conditions Affecting the Sciatic Nerve

Sciatica can also occur because of some conditions that affect the five spinal nerves of the sciatic nerve. These conditions include:

  • Injuries
  • Herniated disks
  • Spinal stenosis
  • Osteoarthritis
  • Foraminal stenosis
  • Degenerative disk disease
  • Cauda equina syndrome
  • Conus medullaris syndrome
  • Cysts, tumors, and related growths
  • Spondylolisthesis

3. Risk Factors

Several risk factors can lead to Sciatica. They include:

  • Wear and tear on the spine: As you age, your spine will undergo some wear and tear that causes osteoarthritis, herniated discs, and pinched nerves, which may lead to Sciatica.

  • Nature of your job: If your job subjects you to heavy lifting, working in unusual positions for a long time, and bending, it increases your risk of developing Sciatica. Besides, jobs that entail sitting for a long time might cause discomfort to your lower back. Such discomfort is a recipe for sciatica.

  • Being physically inactive: If you do not engage in physical activities, you will likely develop sciatica. Physical inactivity can include sitting for an extended period without any movement.

  • Obesity: If you are overweight, your spine must work harder to support your body. Your back muscles will strain more to enable you to stand straight. As a result, you are likely to experience back pains. This kind of pain is what is referred to as Sciatica.

  • Awkward posture while lifting: You must always maintain good posture while lifting weights. An awkward posture will impose too much pressure on your lower back muscles, leading to excruciating pain.

  • Tobacco usage: Tobacco contains a component known as nicotine that affects blood circulation and, hence, can lead to chronic pain.

  • Type 2 diabetes: If you are suffering from diabetes, you risk developing diabetes-related peripheral neuropathy that can damage the sciatic nerves, hence causing Sciatica.

  • Injuries:If your injury affects your spine or buttocks, you will likely develop Sciatica.

What Are the 4 Types of Sciatica?

Sciatica is a condition that goes through various stages. Mostly, the condition lasts for up to 6 weeks, but it can quickly shift from bad to worse to the point you need surgery. Below are the different types of Sciatica:

1) Acute Sciatica 

It lasts 4 to 8 weeks, whereby you experience pain due to pressure imposed on the sciatic nerve. You can relieve the pain through self-management.

So, no need to seek any form of treatment from the hospital.

2) Chronic Sciatica

If the sciatic nerve pain persists for the past eight weeks despite embracing the self-management remedy, then you have chronic Sciatica. You might need medical treatment or undergo surgery.

3) Alternating Sciatica

This type of Sciatica results from degenerative issues in the sacroiliac joint. You will experience alternating sciatic nerve pain in both legs.

4) Bilateral Sciatica 

This rare type of Sciatica may result from cauda equina syndrome and degenerative changes in the spine or disc at various spinal levels. The pain is felt in both legs at once.

What is the Best Way to Relieve Sciatica?

Treatment for sciatica focuses on alleviating the sciatic nerve pain. One can capitalize on three types of treatments depending on the extent of the pain. The most common one is self-care treatment. Since Sciatica does not last long, you can alleviate the pain yourself. 

However, if the pain worsens, then medical treatment and surgery will be required.

a) Home Remedies

You can manage or treat acute sciatica with home-based remedies. Some of the remedies you can use include:

1. Cold packs

Cold can help alleviate sciatic pain and reduce swelling at the onset of sciatica. You can wrap the cold packs in a towel before using them to avoid injuries to your skin. Apply the cold packs to the affected area for about 15 minutes. 

Do this for three days, and you will notice a reduction in sciatic nerve pain.

2. Hot Packs

After three days, you can now start usinghot packs. Apply these packs to the affected area for about 20 minutes. The heat calms tense muscles and spasms, hence minimizing stress and pain. Alternate between cold and hot packs to achieve better results.

3. Stretching

Stretching will minimize lower back pain by reducing pinching on your sciatica nerve and working your muscles. The simple stretches you do will strengthen your core muscles and prevent sciatica flare-ups.

Some of the stretches include:

  • Sitting pigeon pose
  • Standing hamstring pose
  • Knee to the opposite shoulder
  • Reclining pigeon pose
  • Scissor stretch
  • Standing piriformis stretch
  • Forward pigeon pose
  • Basic seated stretch
  • Groin muscle stretch
  • Sitting spinal stretch

4. Over-The-Counter Medications

Use over-the-counter medications such as NSAIDs, Naproxen sodium,Aspirin, and Acetaminophen to reduce inflammation, swelling, and pain. However, ensure you get guidance from a doctor before purchasing these anti-inflammatory drugs, as they can cause issues such as gastric ulcers.

B) Medical Management

If the self-care treatment options fail to alleviate the sciatic nerve pain, you can upgrade to conservative management. Under this treatment plan, you will need to work hand in hand with a medical practitioner to help you deal with Sciatica. 

You can use various treatments while being guided by a medical professional to reduce sciatic nerve pain. They include:

1. Spinal Injections

Spinal injections alleviate sciatic nerve pain for about three months. Before receiving these injections, for instance, corticosteroids, the healthcare provider will subject you to local anesthesia to minimize potential discomfort. 

Therefore, you cannot inject yourself without the guidance of a healthcare provider.

2. Physical Therapy

Physical therapy comprises workouts to strengthen your core, improve the range of motion, promote neurological restructuring, and correct your posture to offer pain relief and prevent triggers of sciatic nerve pain, flare-ups, and injuries. 

The doctor will prescribe a physical therapy program that involves exercise movements like stretching and other remedies such as hot packs and ice packs. 

3. Alternative Therapies

Apart from physical therapy, you can try out alternative therapies to minimize sciatica pain. Some of the therapies under this option include:

  • Stress management: Stress creates tension in the body and makes the muscles sore, thus causing sciatica pain. In this regard, biofeedback may come in handy as it helps relieve stress and ultimately manage pain by relaxing the supporting anatomical structures that comprise the sciatic nerve.

  • Acupuncture reduces muscle tension, regulates the nervous system, enhances blood circulation, and produces neurotransmitters that alleviate sciatica pain. It is regarded as one of the most effective remedies for sciatica.

  • Yoga: entails stretching, easing compression on the sciatic nerve, thereby minimizing sciatic pain. You can also learn mindfulness to reduce sciatica.

  • Massage: minimizes muscle spasms and stress and improves circulation, minimizing sciatica.

4. Taking Prescribed Drugs

Medicines such as Corticosteroids, Antidepressants, Painkillers, Anti-seizure drugs, Muscle relaxers, Opioids, and Anti-inflammatories can treat sciatic pain and its associated symptoms.

C) Surgery

If the first two treatments are no longer effective and sciatic pain is worsening. Then, you should considersurgery which is recommended for chronic pain, severe weakness, and loss of bladder or bowel control.

There are two types of surgery for Sciatica: 

  • Discectomy: The surgeon removes sections of theherniated disc, pressing the nerve and causing pain.

  • Laminectomy: Laminectomy entails getting rid of the rear section of the spine, known as the lamina, that may be pressing the spinal nerve.

Can Lifestyle and Diet Prevent Sciatica?

A lifestyle change and balanced diet can help prevent Sciatica. A sedentary lifestyle is a risk factor for Sciatica. If you sit for long hours, you impose too much pressure on the sciatic nerve, thus causing lower back pain. The pain can also extend to your feet, legs, and hips. 

So, engaging in physical activities such as exercising, stretching, yoga, and lifting weights will prevent pinching and irritation of the sciatic nerve, hence minimizing the risk of developing Sciatica.

What you are eating can influence the development of sciatica. For instance, a diet that makes yougain unhealthy weight will subject your spine to too much work while hosting your body. It’s because the weight strains your back muscles, hence causing back pain.

So, you must watch what you eat to avoid sciatica pain. But,

What Foods to Eat for Sciatica?

Here is a list of foods that can help you prevent or manage Sciatica: 

  • Whole Grains such as whole-wheat bread, quinoa, and brown rice offer anti-inflammatory effects that may help reduce inflammation resulting from Sciatica. 

  • Berries contain anti-inflammatory properties and antioxidants that scavenge free radicals. The anti-inflammatory properties found in all berries will alleviate pain caused by Sciatica.

  • Cold Water Fish such as mackerel andsalmon contain omega-3, anti-inflammatory properties that alleviate sciatic nerve pain.

  • Cruciferous Vegetableshave anti-inflammatory properties and antioxidants that minimize pain and inflammation. So, they are a good source of preventing and managing Sciatica. The most common types of cruciferous vegetables are cauliflower, turnips, kale, cabbage, and broccoli.

 

FAQs

1. Which Leg Does Sciatica Affect?

Sciatica pain can affect both legs, whether it is in an alternating manner or altogether at once. You will feel a shooting, stabbing, or burning pain in the back of the legs.

2. Can Sitting Cause Sciatica?

Sitting for long hours puts too much pressure on your lower back, increasing the risk of developing Sciatica.

3. What Makes Sciatica Worse?

Anything that causes compression, pinching, or exerts too much pressure on the sciatic nerve is geared to make Sciatica shift from bad to worse. This can be a sedentary lifestyle or eating foods that make you overweight.

4. Is Walking Good For Sciatica?

Yes. It promotes the production of pain-fighting endorphins, minimizes inflammation, and supports weight loss, flexibility, and muscle strength. Therefore, it is an effective remedy for sciatica pain.

Conclusion

Sciatica is the excruciating pain that affects the sciatic nerve. It results from compression and pinching of the sciatica nerve, causing numbness, weak reflexes, and bending pain. To best treat this condition, you can employ self-care treatment, conservative management strategies, or surgery.

However, surgery is only viable when Sciatica becomes severe. But you can manage this condition at home since it lasts up to 6 weeks.