FAQ’s on Sciatica
Sciatica (AKA sciatic neuritis, sciatic neuralgia, or lumbar radiculopathy), is a condition of pain, weakness, tingling, numbness of the legs and feet, feeling of “pins and needles” (commonly referred to as “asleep”), difficulty controlling the legs, and/or pain in the lower back and buttocks.
The condition is caused by pressure on one or more of the five sciatic nerve roots in the spine or one or both of the sciatic nerves extending into the legs by bulging or herniated intervertebral discs in the lumbar region, or lower back. Pain in the lower extremities (legs) usually occur only on one side or the other, but may affect both sides. Leg pain can extend below the knee and into the foot but does not always do so (Back pain’s association with vertebral end-plate signal changes in sciatica 2014).
What is the most common condition that causes sciatica?
A common misconception is that sciatica is a condition. This is not the case. Sciatica is not a disorder but rather a symptom of a condition. The condition associated with sciatica is most often compression of a sciatic nerve root in the spine by an intervertebral disc that has been injured and become bulging or herniated. This cause makes up about 90% of sciatica cases. Specifically the area of the spine that is affected to produce the symptom of sciatica are the L3, L4, and L5 (lumbar nerves), or when the S1.S2.and S3 (sacral nerves) are affected. A sciatic nerve itself can also be irritated or damaged to produce the symptoms Associations between physical therapy and long-term outcomes for individuals with lumbar spinal stenosis in the SPORT study.2013).
What other conditions can cause sciatica?
Another cause of sciatica is spinal stenosis. This is a condition that occurs when the spinal canal narrows and compresses the cauda equine, spinal cord, or nerve root. Spinal stenosis is often caused by bone spurs or again, by a degenerated disc.
Still another potential, yet controversial cause of sciatica is Piriformis syndrome. Piriformis syndrome is a condition in which it is believed to happen when a sciatic nerve runs through the piriformis muscle rather than under it and when the muscle contracts it causes pressure to be applied to the nerve and pain ensues (Piriformis syndrome: a case with non-discogenic sciatalgia 2014).
A temporary form of sciatica may develop during pregnancy. It is likely caused by the weight of the baby. This condition has no know treatment but usually subsides after birth.
Sciatica may also be a symptom of tumors in the spinal region that impinging the nerve or nerve root. Victims of auto accidents may suffer sciatica due to spinal injury.
How do you treat sciatica?
Treatment for sciatica can include spinal manipulation such as by a chiropractor. Evidence shows that sciatica does not show improvement by the use of drug therapy. Typical medications such as NSAIDS, muscle relaxers, and opioid analgesics have not shown to relieve pain from the condition significantly (Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses 2013).
For cases of Piriformis syndrome some benefit has been shown by using botulism toxin injections. As a last resort to find relief from chronic pain of sciatica, the affecting conditions must be addressed, sometimes surgically. Procedures such as a discectomy, surgical removal or part of the intervertebral disc, may be necessary.
If you are experiencing the pain of sciatica, our team of specialists can help identify the possible causes and best path of treatment.