Effective sciatica treatment can difficult if the cause of the condition is not precisely determined.
Sciatica, also known as lumbar radiculopathy, is an irritation of a nerve root in the lumbar spine that can result in pain, weakness, numbness or tingling that may travel down from the low back to the legs and feet. People who get sciatica are usually between the ages of 30 and 50 years. Approximately 80% to 90% of people with sciatica recover over time without any surgical intervention.
The spinal cord travels down from the brain to the rest of the body and is encased and protected by the spinal column. Large nerves called nerve roots branch away from the spinal cord, exit the spine and travel out to serve other parts of the body. The sciatic nerves travel from the lumbar spine down through the back of the legs. They are the longest, thickest nerves in the body.
Sciatica may be caused by a misalignment of the vertebra called a subluxation. Contributing factors can include; general wear and tear, piriformis syndrome, bulding or herniated discs, collapsed vertebrae, bone spurs and spinal stenosis (narrowing of the spinal canal). These factors reduce the space around a nerve root in the lower back, interfering with nerve function and causing low back and leg pain.
Symptoms of Sciatica
Symptoms of sciatica may include pain, weakness, numbness or tingling in the low back, buttocks, posterior things, legs and feet. Symptoms often occur only on one side of the body. Symptoms may develop gradually, with a mild, general discomfort that may be felt when walking or when standing up from a seated or laying position. If left unattended it may progress to a sharp, shooting pain or numbness that travels down the legs.
Diagnosing Sciatica Is Paramount To Effective Sciatica Treatment
Before sciatica treatment can initiated, as much information as possible must be collected. The individual is asked to recount the location and nature of the pain, how long it has continued, and any accidents or unusual activities prior to its onset. This information provides clues that may point to back strain or injury to a specific location.
Back pain from disc disease, piriformis syndrome, and back strain must be differentiated from more serious conditions such as cancer or infection. Lumbar stenosis, an overgrowth of the covering layers of the vertebrae that narrows the spinal canal, must also be considered. The possibility that a difference in leg lengths is causing the pain should be evaluated; the problem can be easily be treated with a foot orthotic or built-up shoe.
Often, a straight-leg-raising test is done, in which the person lies face upward and the healthcare provider raises the affected leg to various heights. This test pinpoints the location of the pain and may reveal whether it is caused by a disk problem. Other tests, such as having the individual rotate the hip joint, assess the condition of the hip muscles. Any pain caused by these movements may provide information about involvement of the piriformis muscle, and piriformis weakness is tested with additional leg-strength maneuvers.
Further tests may be done depending on the results of the physical examination and initial pain treatment. Such tests might include magnetic resonance imaging (MRI) and computed tomography (CT) scans. Other tests examine the conduction of electricity through nerve tissues, and include studies of the electrical activity generated as muscles contract (electromyography), nerve conduction velocity, and evoked potential testing. A more invasive test involves injecting a contrast substance into the space between the vertebrae and making x-ray images of the spinal cord (myelography), but this procedure is usually done only if surgery is being considered as an option. All of these tests can reveal problems with the vertebrae, the disk, or the nerve itself.
Effective Sciatica Treatment and ManagementWhile it may seem counter intuitive, exercise is usually better for relieving sciatic pain than bed rest. Patients may rest for a day or two after their sciatic pain flares up, but after that time period, inactivity will usually make the pain worse. Without exercise and movement, the back muscles and spinal structures become deconditioned and less able to support the back. The deconditioning and weakening can lead to back injury and strain, which causes additional pain. In addition, active exercise is also important for the health of the spinal discs. Movement helps exchange nutrients and fluids within the discs to keep them healthy and prevent pressure on the sciatic nerve.
Chiropractic care can be a safe, non-invasive and effective method for relieving sciatica. Spinal adjustments can correct the misalignment of the spinal joint and release the stress on the sciatic nerve, reducing or alleviating the discomfort and optimizing health. A chiropractor may also suggest options such as traction, stretches, and exercises, laser or ultrasound therapy, and muscle work.
Exercises are an effective Sciatica Treatment
• Core muscle strength. Many sciatica exercises focus on strengthening the abdominal and back muscles in order to provide more support for the back. Stretching exercises for sciatica target muscles that cause pain when they are tight and inflexible. When patients engage in a regular program of gentle strengthening and stretching exercises, they can recover more quickly from a flare up of sciatica and are less likely to experience future episodes of pain.
• Specific diagnosis. Most exercise programs will be tailored to address the underlying cause of the patient’s sciatic pain, such as a lumbar herniated disc or spinal stenosis. Doing the wrong type of exercise can worsen the sciatic pain, so it is important to get an accurate diagnosis prior to starting a program of sciatica exercises.
• Hamstring stretching. Regardless of the diagnosis, most types of sciatica will benefit from a regular routine of hamstring stretching.The hamstrings are muscles located in the back of the thigh. Overly tight hamstrings increase the stress on the low back and often aggravate or even cause some of the conditions that result in sciatica.
• Exercise correctly. As an adjunct to the above point, doing the right exercises but doing them without proper form can make the exercises relatively ineffective, and possibly may lead to continued or increased pain. It is generally advisable to learn the exercises under the guidance of an appropriately trained health practitioner.
• Aerobic exercises. In addition to specific sciatica exercises, aerobic conditioning may also be encouraged for general body fitness. Walking is an excellent form of exercise for the low back because it is relatively low impact but can provide all the benefits of an aerobic workout.If possible, it is best to gradually progress to doing up to three miles of exercise walking at a brisk pace each day.
Sciatica is typically not a condition requiring emergency care, however, go immediately to the emergency room if you low back pain or sciatica is accompanied by;
- Unexplained fever with back pain
- Back pain after a severe blow or fall
- Redness or swelling on the back or spine
- Loss of control of urine or stool (incontinence)
If you or someone you know is searching for sciatica treatment, you may want to consider chiropractic care as a safe and effective option.