Understanding Sciatica: Symptoms, Causes, and How to Find Relief

If you've ever experienced a sharp pain that starts in your lower back and shoots down one of your legs, you might have wondered, "What is going on with my body?" The answer could be sciatica, a common condition that affects millions of people worldwide.

In this blog post, we’ll break down what sciatica is, what causes it, and how to tell if you have it.

What is Sciatica?

Sciatica is not a condition itself, but rather a symptom of an underlying issue. It refers to pain that radiates along the sciatic nerve, the longest nerve in your body. The sciatic nerve starts in the lower back, runs through the hips and buttocks, and extends down each leg. When something irritates or compresses this nerve, it can cause a variety of uncomfortable sensations, most commonly pain that can feel sharp, burning, or electric.

Sciatica typically affects only one side of the body, but the severity and type of pain can vary greatly. In some cases, the pain is mild, like a dull ache. In other cases, it can be so severe that it’s difficult to sit, stand, or walk.

What Causes Sciatica?

Sciatica is most commonly caused by a herniated or slipped disc in the spine. A disc is like a cushion between the vertebrae in your spine, and if one of them bulges out or ruptures, it can put pressure on the sciatic nerve. This pressure leads to pain and discomfort.

However, sciatica can also be caused by other conditions, such as:

• Spinal Stenosis: A narrowing of the spinal canal, which can compress the sciatic nerve.
• Degenerative Disc Disease: As we age, the discs in our spine can start to wear down, potentially putting pressure on nearby nerves.
• Piriformis Syndrome: The piriformis muscle, located in the buttocks, can sometimes irritate or compress the sciatic nerve.
• Spondylolisthesis: This occurs when one vertebra slips forward over the one below it, which can pinch the sciatic nerve.

In rare cases, sciatica can be caused by a tumor, infection, or other medical condition, but these instances are much less common.

How Do You Know if You Have Sciatica?

If you’re wondering whether you’re experiencing sciatica, pay attention to the following signs:

1. Pain Radiating Down One Leg: The hallmark symptom of sciatica is pain that travels from your lower back through your buttocks and down one leg. It may feel like a sharp, burning, or shooting pain. You may also experience numbness, tingling, or a sensation of "pins and needles."
2. Pain That Worsens with Certain Movements: Sciatica pain tends to worsen with actions that put pressure on the lower back or increase tension on the sciatic nerve, like sitting for long periods, standing up after sitting, bending, or lifting heavy objects.
3. Muscle Weakness: In some cases, sciatica can cause weakness in the affected leg, making it difficult to move or even stand.
4. Pain on One Side of the Body: Sciatica usually affects one side, though in rare cases, it can affect both legs. The pain often starts in the lower back and radiates down the back or side of one leg.
5. Numbness or Tingling: You might feel a sensation of numbness, or "pins and needles," in the leg, foot, or toes on the side affected by the sciatica.

When Should You Seek Medical Help?

Most cases of sciatica can be managed with self-care methods, such as rest, heat or ice therapy, and over-the-counter pain relievers. However, if you experience any of the following, it’s important to seek medical attention immediately:

• Severe or worsening pain that doesn’t improve with rest.
• Loss of bladder or bowel control (which could indicate a more serious condition like cauda equina syndrome).
• Numbness or weakness that is spreading or interfering with your ability to walk.

Treatment Options for Sciatica

The good news is that sciatica is treatable. In fact, most people experience significant improvement within a few weeks with conservative treatments. Here are some options:

1. Physical Therapy: A physical therapist can guide you through exercises that improve posture, strengthen muscles, and relieve pressure on the sciatic nerve. This is one of the most effective ways to manage sciatica long-term.
2. Medications: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain. In some cases, stronger medications or muscle relaxants may be prescribed.
3. Heat and Ice Therapy: Applying ice to the affected area during the first 48 hours can reduce inflammation, while heat therapy (after the first few days) can relax tight muscles and improve blood circulation.
4. Surgical Intervention: In rare cases where the pain is severe or doesn't improve with conservative treatments, surgery may be necessary to address the underlying cause of the sciatica, such as removing a herniated disc.

Prevention Tips

While not all cases of sciatica can be prevented, there are steps you can take to reduce your risk:

• Maintain a Healthy Weight: Extra weight can put pressure on your spine and discs, increasing the risk of sciatica.
• Exercise Regularly: Strengthening the muscles of your back, core, and legs can provide better support for your spine and help prevent pressure on the sciatic nerve.
• Practice Good Posture: Avoid slouching and practice proper posture when sitting, standing, or lifting.
• Use Proper Lifting Techniques: Bend at the knees, not the waist, when lifting heavy objects, and avoid twisting your body as you lift.

Final Thoughts

Sciatica can be a frustrating and painful condition, but with the right treatment and care, most people find relief. If you're dealing with lower back pain that radiates down your leg, it's important to identify whether sciatica is the cause so that you can get the appropriate treatment. Consult with a healthcare professional or physical therapist to determine the best course of action and to get back to your daily activities without pain.

Remember, you don’t have to live with sciatic pain—help is available, and relief is possible.

If you think you might be dealing with sciatica or have questions about your symptoms, reach out to our clinic. Our team of physical therapists is here to help you understand your condition and guide you on the path to recovery!

Written by Tiago Oliveira, Master's of Physiotherapy Student, in collaboration with River East Physiotherapy

Reference:

Ostelo, R. W. (2020). Physiotherapy management of sciatica. Journal of physiotherapy, 66(2), 83-88