Sciatica : Causes-Symptoms-Diagnosis-Treatment

 What Is Sciatica?

Sciatica is nerve pain from AN injury or irritation to the nerve that originates in your buttock/gluteal area. The sciatic nerve is the longest and thickest (almost finger-width) nerve within the body. It’s truly created of 5 nerve roots: 2 from the lower back region referred to as the body part spine and 3 from the ultimate section of the spine called the sacrum. The five nerve roots close to make a right and left sciatic nerve. On both sides of your body, one sciatic nerve runs through your hips, buttocks and down a leg, ending slightly below the knee. The nerve then branches into alternative nerves that continue down your leg ANd into your foot and toes.

True injury to the sciatic nerve “sciatica” is really rare, however the term “sciatica” is usually wont to describe any pain that originates within the lower back and radiates down the leg. What this pain shares in common is an injury to a nerve -- an irritation, inflammation, pinching or compression of a nerve in your lower back.

What Is Sciatica?

If you've got “sciatica," you experience delicate to severe pain anyplace on the trail of the sciatic nerve – that is, anyplace from the lower back, through the hips, however stocks and/or down your legs. It may cause muscle weakness in your leg and foot, symptoms in your leg, and an unpleasant tingling pins-and-needles sensation in your leg, foot and toes.Back pain comes altogether in shapes and sizes. It can flare up at once once an injury or seem slowly and cryptically over a amount of months. it'd be explosive and fugacious (acute) or long (chronic).

Over-the-counter medicines facilitate some varieties of back pain, but solely powerful medicine and surgery can fix others.

typically it’s exhausting to spot the supply of your back pain, however alternative times you'll be able to pinpoint it easily. Neuralgia is one amongst those that’s pretty straightforward to identify. Home remedies can work fast, therefore you may not even have to be compelled to decide by a doctor.Sciatica typically affects only 1 leg at a time. However, it’s attainable for sciatica to occur in each leg. It’s merely a matter of wherever the nerve is being pinched on the spinal column.Sciatica could be a quite common complaint. regarding 40% of individuals within the U.S. expertise sciatica someday throughout their life. Back pain is the third most typical reason folks visit their attention provider.

  1. Nervous system
  1. Peripheral nervous system

The nervous system is an important part of the human body. It controls and coordinates all the activities of the body. The nervous system is divided into the central nervous system (CNS) and the peripheral nervous system (PNS). The CNS includes the brain and the spinal cord.

  1. Nerves

  2. Cranial nerves

  3. Spinal nerves

  4. Ganglia

  5. Enteric nervous system

Medical terms

  • Sciatica refers to pain that radiates on the trail of the sciatic nerve, that branches from your lower back through your hips and buttocks and down every leg. Typically, neuralgia affects only 1 aspect of your body. neurology most ordinarily happens once a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses a part of the nerve. This causes inflammation, pain and infrequently some symptoms within the affected leg. Though the pain related to sciatica is severe, most cases resolve with non-operative treatments in a very few weeks. People that have severe neuralgia that's related to important leg weakness or gut or bladder changes may be candidates for surgery. 
  • Symptoms When a client comes in with lower back pain it is often not just a back issue It is rare that there is only one cause for the pain and more often than not there are other factors involved With this particular situation you will want to look at two things: lumbar spine motion and pelvic motion In this case check the hip flexors and hamstrings first as they are usually tight in these types of cases Then evaluate the lumbar spine for restrictions or muscle spasms present on an exam or x-ray if warranted from your findings from palpation With these two parameters in mind (motion) then you can treat accordingly with manual release techniques.

Symptoms The sciatic nerve is the longest and widest nerve in your body It starts at the lower back passes through the buttocks and thighs and ends in the lower leg (foot) The sciatic nerve controls movement of the muscles in your lower body It often causes pain when it is compressed or irritated near where it leaves the spine This could be due to a herniated disc or hip joint arthritis A tension headache or other muscle spasm can also irritate this nerve causing pain along its pathway from your back down your leg.

Symptoms Sciatica

Pain that radiates from your lower (lumbar) spine to your body part and down the rear of your leg is the hallmark of sciatica. you would possibly feel the discomfort nearly anywhere on the nerve pathway, however it particularly seems to follow a path from your low back to your buttock and therefore the back of your thigh and calf. The pain will vary widely, from a gentle ache to a sharp, burning sensation or agonizing pain. generally it can want a jolt or electrical shock. It is often worse after you cough or sneeze, and prolonged sitting can aggravate symptoms. Sometimes just one facet of your body is affected. Some folks even have symptoms, tingling or muscle weakness within the affected leg or foot. you would possibly have pain in one part of your leg and numbness in another part. 

The symptoms of sciatica include:

  • Moderate to severe pain in lower back, buttock and down your leg.

  • Numbness or weakness in your lower back, buttock, leg or feet.

  • Pain that worsens with movement; loss of movement.

  • “Pins and needles” feeling in your legs, toes or feet.

  • Loss of bowel and bladder control (due to cauda equina).

When to see a doctor

Mild neuralgia sometimes goes away over time. decide your doctor if self-care measures fail to ease your symptoms or if your pain lasts longer than a week, is severe or becomes increasingly worse. Get immediate medical aid if:

  • You have sudden, severe pain in your low back or leg and numbness or muscle weakness in your leg

  • The pain follows a violent injury, such as a traffic accident

  • You have trouble controlling your bowels or bladder

Causes Sciatica

Sciatica happens once the nervus ischiadicus becomes pinched, typically by a herniated disk in your spine or by Associate in Nursing overgrowth of bone (bone spur) on your vertebrae. Additionally, rarely, the nerve will be compressed by a tumor or broken by sickness or diabetes. A herniated or slipped disk that causes pressure on a nerve root. this is often the foremost common explanation for sciatica. concerning 1% to 5% of all folks within the U.S. can have a slipped disk at one purpose in their lives. Disks are the padding pads between every vertebrae of the spine. Pressure from vertebrae will cause the gel-like center of a disk to bulge (herniate) through a weakness in its outer wall. once a herniated disk happens to a vertebrae in your lower back, it can go on the nervus ischiadicus.Degenerative disk sickness is that the natural traumatize of the disks between vertebrae of the spine. The carrying down of the disks shortens their height and ends up in the nerve passageways changing into narrower (spinal pathology). Spinal stenosis can pinch the sciatic nerve roots as they leave the spine. Spinal stenosis is the abnormal narrowing of the spinal canal. This narrowing reduces the available area for the neural structure and nerves.Spondylolisthesis may be a slippage of 1 bone in order that it's out of line with the one on top of it, narrowing the gap through that the nerve exits. The extended spinal bone will pinch the sciatic nerve. Osteoarthritis. Bone spurs (jagged edges of bone) can kind in aging spines and compress lower back nerves. Trauma injury to the body part spine or sciatic nerve. Tumors within the lumbar channel that compress the sciatic nerve. Piriformis syndrome is a condition that develops once the piriformis muscle, an attiny low muscle that lies deep within the howevertocks, becomes tight or spasms. This will place pressure on and irritate the sciatic nerve. Piriformis syndrome may be an uncommon fiber bundle disorder. Anatomical structure equina syndrome is a rare but serious condition that affects the bundle of nerves at the tip of the neural structure known as the cauda equina. This syndrome causes pain down the leg, symptoms around the asshole and loss of internal organs and bladder control. 

Sciatica results from irritation of the root(s) of your lower lumbar and lumbosacral spine.

Additional common causes of sciatica include:


  • Lumbar spinal stenosis (narrowing of the spinal canal in your lower back)

  • Degenerative disk disease (breakdown of disks, which act as cushions between the vertebrae)

  • Spondylolisthesis (a condition in which one vertebra slips forward over another one)

  • Pregnancy

  • Muscle spasm in the back or buttocks

Other things that may make you more likely to have sciatica include:

  • Aging (which can cause changes in the spine, like bone spurs or herniated disks)

  • Diabetes

  • Being overweight

  • Not exercising regularly

  • Wearing high heels

  • Sleeping on a mattress that is too hard or too soft

  • Smoking

  • Your job, especially if it involves driving for long periods of time, twisting your back, or carrying heavy things

Risk factors Sciatica

Risk factors for sciatica include:

  • Age. Age-related changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica.

  • Obesity. By increasing the stress on your spine, excess body weight can contribute to the spinal changes that trigger sciatica.

  • Occupation. A job that requires you to twist your back, carry serious masses or drive a motorcar for long periods could possibly play a role in sciatica, however there' no conclusive proof of this link. 

  • Prolonged sitting. People who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are.

  • Diabetes. This condition, which affects the way your body uses blood sugar, increases your risk of nerve damage.

You are at greater risk of sciatica if you:

  • Have an injury/previous injury: An injury to your lower back or spine puts you at greater risk for sciatica.

  • Live life: With normal aging comes a natural wearing down of bone tissue and disks in your spine. Normal aging can put your nerves at risk of being injured or pinched by the changes and shifts in bone, disks and ligaments.

  • Are overweight: Your spine is like a vertical crane. Your muscles are the counterweights. The weight you carry in the front of your body is what your spine (crane) has to lift. The more weight you have, the more your back muscles (counterweights) have to work. This can lead to back strains, pains and other back issues.

  • Lack a strong core: Your “core” are the muscles of your back and abdomen. The stronger your core, the more support you’ll have for your lower back. Unlike your chest area, where your rib cage provides support, the only support for your lower back is your muscles.

  • Have an active, physical job: Jobs that require heavy lifting may increase your risk of low back problems and use of your back, or jobs with prolonged sitting may increase your risk of low back problems.

  • Lack proper posture in the weight room: Even if you are physically fit and active, you can still be prone to sciatica if you don’t follow proper body form during weight lifting or other strength training exercises.

  • Have diabetes: Diabetes increases your chance of nerve damage, which increases your chance of sciatica.

  • Have osteoarthritis: Osteoarthritis can cause damage to your spine and put nerves at risk of injury.

  • Lead an inactive lifestyle: Sitting for a long period of time and not exercising and keeping your muscles moving, flexible and toned can increase your risk of sciatica.

  • Smoke: The nicotine in tobacco can damage spinal tissue, weaken bones, and speed the wearing down of vertebral disks.

Complications Sciatica

Although most people recover fully from sciatica, often without treatment, sciatica can potentially cause permanent nerve damage. Seek immediate medical attention if you have:

  • Loss of feeling in the affected leg

  • Weakness in the affected leg

  • Loss of bowel or bladder function

Is walking good for sciatic nerve pain?

Although walking is not a cure for sciatica pain the exercise can help Walking can reduce stress and muscle tension which in turn lessens pain If you already have a regular walking routine then it's best to continue with it Walking will also strengthen your leg muscles and help in recovery from back surgery.

Does sciatica go away on its own?

Some research suggests that while the majority of people experience some degree of improvement within a year, sciatica pain may persist for several years. In severe cases symptoms may continue on an intermittent basis throughout your life.

Is bed rest good for sciatica?

Bed rest is usually prescribed to treat sciatica Patients are asked to lie down until the pain subsides This may seem strange because lying down can make you feel more tired which will cause your muscles to get weaker so that you don't have enough strength to stand upright However doctors believe that the extra rest can help relieve pressure on the affected nerves and lead to a faster recovery Bed rest may also help if your sciatica pain is caused by another condition such as constipation or hemorrhoids It will enable you to avoid straining yourself when using the bathroom or trying to reach for something above your head However bed rest should not be used.

How long does sciatica last on average?

Depending on the type of sciatica it may last anywhere from a few days to several months. The most common symptom of sciatica is pain that starts in the lower back and travels down one or both legs. The pain is often severe and can be quite debilitating.

What should you not do with sciatica?

Sciatica is a condition caused by pressure on the sciatic nerve This nerve runs from the lower part of your spine to both legs Sciatica usually develops after a minor injury such as lifting something heavy or sitting too long in one position Although it causes inflammation and pain that typically starts in your lower back and radiates through your buttock thigh and calf it can also cause tingling or numbness in these areas Besides taking over-the-counter medications for relief you should avoid certain activities to help prevent sciatica from coming back.

What are the stages of sciatica?

According to Mayo Clinic the first stage of sciatica involves pain between the shoulder blades It is described as a sharp shooting pain that travels down one or both legs into the feet The second stage is characterized by leg weakness and numbness in the lower extremities Other symptoms may include muscle cramping tingling and burning sensations in the buttocks and legs.

Prevention Sciatica

It's not invariably potential to stop sciatica, and also the condition could recur. the subsequent will play a key role in protective your back:

  • Exercise regularly. To keep your back strong, pay special attention to your core muscles — the muscles in your abdomen and lower back that are essential for correct posture and alignment. raise your doctor to advocate specific activities. 

  • Maintain proper posture when you sit. Choose a seat with sensible lower back support, armrests and a swivel base. take into account putting a pillow or rolled towel within the little of your back to keep up its traditional curve. Keep your knees and hips level. 

  • Use good body mechanics. If you represent long periods, rest one foot on a stool or tiny box from time to time. Once you carry one thing seriously, let your lower extremities do the work. Move straight up and down. Keep your back straight and bend solely at the knees. Hold the load near to your body. Avoid lifting and twisting simultaneously. realize a lifting partner if the article is heavy or awkward. 

Diagnosis Sciatica

First, your aid supplier will review your medical history. Next, they’ll raise your symptoms. Throughout your physical exam, you may be asked to steer so your healthcare provider will see however your spine carries your weight. you will be asked to walk on your toes and heels to visualize the strength of your calf muscles. Your provider might also do a straight leg raise check. For this test, you’ll lie on your back along with your legs straight.

  1. Percussion

Your provider will slowly raise every leg and note the purpose at which your pain begins. This test helps pinpoint the affected nerves and determines if there's a retardant with one among your disks. You may even be asked to try and do alternative stretches and motions to pinpoint pain and check muscle flexibility and strength.During the physical exam, your doctor may check your muscle strength and reflexes. For example, you will be asked to steer on your toes or heels, rise from a squatting position and, whereas lying on your back, raise your legs one at a time. Pain that results from neuralgia will sometimes worsen throughout these activities.

Imaging tests

Many people have herniated disks or bone spurs that may show au courant X-rays and alternative imaging tests however don't have any symptoms. Thus, doctors don't usually order these tests unless your pain is severe, or it doesn't improve inside many weeks.

  • X-ray. An X-ray of your spine may reveal an overgrowth of bone (bone spur) that may be pressing on a nerve.

  • MRI. This procedure uses a strong magnet and radio waves to provide cross-sectional pictures of your back. Associate imaging produces careful images of bone and soft tissues comparable to herniated disks. Throughout the test, you lie on a table that moves into the MRI machine. 

  • CT scan. When a CT is employed to image the spine, you will have a distinction dye injected into your canalis vertebralis before the X-rays are taken — a procedure known as a CT myelogram. The dye then circulates around your medulla spinalis and spinal nerves, that seem white on the scan. 

  • Electromyography (EMG). This takes a look at measures the electrical impulses made by the nerves and therefore the responses of your muscles. This test will ensure nervous disorder caused by herniated disks or narrowing of your canal (spinal stenosis). 

Treatment Sciatica

The goal of treatment is to decrease your pain and increase your mobility. reckoning on the cause, several cases of neuralgia flee over time with some easy self-care treatments.f your pain doesn't improve with self-care measures, your doctor would possibly recommend a number of the subsequent treatments. 


The types of drugs that might be prescribed for sciatica pain include:

  • Anti-inflammatories

  • Muscle relaxants

  • Narcotics

  • Tricyclic antidepressants

  • Anti-seizure medications

Physical therapy

Once your acute pain improves, your doctor or a physiotherapist will style a programme to assist you stop future injuries. This usually includes exercises to correct your posture, strengthen the muscles supporting your back and improve your flexibility.

Steroid injections

In some cases, your doctor may advocate injection of an adrenocortical steroid medication into the realm around the concerned nerve root. Corticosteroids facilitate back pain by suppressing inflammation around the irritated nerve. the consequences sometimes wear off in a very few months. The amount of steroid injections you'll be able to receive is restricted as a result of the chance of great side effects will increase once the injections occur too frequently.


This option is sometimes reserved for once the compressed nerve causes important weakness, loss of viscus or bladder control, or once you have pain that increasingly worsens or doesn't improve with alternative therapies. Surgeons will take away the bone spur or the portion of the herniated disk that's pressing on the pinched nerve. 

Lifestyle and home remedies

For most people, neuralgia responds to self-care measures. Though resting for each day might offer some relief, prolonged inactivity can create your signs and symptoms worse.

Other self-care treatments that might help include:

  • Cold packs. Initially, you may get relief from a chili pack placed on the painful space for up to twenty minutes many times a day. Use an associate degree ice pack or a package of frozen peas wrapped in an exceedingly clean towel. 

  • Hot packs. After 2 to 3 days, apply heat to the areas that hurt. Use hot packs, an electric heater or a heater on an all-time low setting. If you still have pain, strive alternating heat and cold packs. 

  • Stretching. Stretching exercises for your low back will assist you feel higher and would possibly relieve nerve root compression. Avoid jerking, bouncing or twisting throughout the stretch, and check out to carry the stretch for a minimum of thirty seconds. 

  • Over-the-counter medications. Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) are sometimes helpful for sciatica.

Alternative medicine

Alternative therapies commonly used for low back pain include:

  • Acupuncture. In treatment, the professional person inserts hair-thin needles into your skin at specific points on your body. Some studies have recommended that acupuncture will facilitate back pain, whereas others have found no benefit. If you {choose} to do acupuncture, choose an accredited practitioner to confirm that he or she has had intensive training. 

  • Chiropractic. Spinal adjustment (manipulation) is one variety of medical aid chiropractors use to treat restricted spinal mobility. The goal is to revive spinal movement and, as a result, improve operation and reduce pain. Spinal manipulation seems to be as effective and safe as normal treatments for low back pain, however may not be applicable for divergent  pain. 

Preparing for your appointment

Not everybody who has neuralgia wants medical care. If your symptoms are severe or persist for over a month, though, build a meeting along with your medical care doctor.

What you can do

  • Write down your symptoms and when they began.

  • List key medical information, including other conditions you have and the names of medications, vitamins or supplements you take.

  • Note recent accidents or injuries that might have damaged your back.

  • Take a family member or friend along, if possible. Someone who accompanies you can help you remember what your doctor tells you.

  • Write down questions to ask your doctor to make the most of your appointment time.

For radiating low back pain, some basic questions to ask your doctor include:

  • What's the most likely cause of my back pain?

  • Are there other possible causes?

  • Do I need diagnostic tests?

  • What treatment do you recommend?

  • If you're recommending medications, what are the possible side effects?

  • For how long will I need to take medication?

  • Am I a candidate for surgery? Why or why not?

  • Are there restrictions I need to follow?

  • What self-care measures should I take?

  • What can I do to prevent my symptoms from recurring?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • Do you have numbness or weakness in your legs?

  • Do certain body positions or activities make your pain better or worse?

  • How limiting is your pain?

  • Do you do heavy physical work?

  • Do you exercise regularly? If yes, with what types of activities?

  • What treatments or self-care measures have you tried? Has anything helped?

General summary

  1. If you have sciatica there are ways to manage and even avoid symptoms. Losing weight exercising regularly and using physical therapy techniques can help reduce the risk of experiencing sciatica-related pain in the future There are also a few things that can be done to ease the pain right now.
  2. Sciatica is caused by inflammation of the sciatic nerve a large nerve that runs from your hips down to your feet The most common causes are trauma or injury such as falling on one's back or sitting too long with bad posture But other causes include infections tumors and degenerative conditions such as spinal stenosis.

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