The treatment of sciatica is complex as the signs and symptoms of this condition associated with sciatic nerve irritation can be caused by a variety of causes. In most cases, an experienced healthcare professional will be able to recognise the signs and symptoms of sciatica and will recommend medical imaging (X-ray and/or MRI) which will be necessary to establish a clear diagnosis and to enable the exact cause of the sciatica to be treated.
What is sciatica?
Sciatica describes symptoms associated with pain that originates in the lower back and radiates down the leg. It is not a diagnosis per se, but rather a symptom of an underlying lower back problem, such as a herniated disc, bulging disc, degenerative disc disease (e.g., pinched disc), spondylolisthesis, or spinal stenosis.
Sciatica usually accompanies lower back pain, but can be more severe and can occur on its own. Therefore, hip or knee pain does not necessarily mean that there is a condition causing the pain there: it may indeed be caused by a pinching or irritation of the sciatic nerve that causes this pain to radiate away from its point of origin.
Sciatica and its 46 synonyms
Numerous synonyms (46) for sciatica; a very sharp pain which, fixing on the path of the sciatic nerve, occupies the posterior part of the thigh and leg; are found in the scientific literature as follows
- Osteoarthritis with sciatica
- Sciatic nerve damage
- Disc bulge with sciatica
- Burn of the sciatic nerve
- Disc disease with sciatica
- Pain in the thigh
- Pain in the buttock
- Pain in the leg
- Sciatic nerve pain
- Pain on the underside of the foot
- Pain in the heel
- Numbness of the sciatic nerve
- Sciatic hernia
- Herniated disc with sciatica
- Sciatic nerve injury
- Injury to the external popliteal nerve
- Injury to the medial popliteal nerve
- Lumbago with sciatica
- Ischiatic nerve
- Sciatic nerve
- Great sciatic nerve
- Small sciatic nerve
- External popliteal sciatic nerve
- Medial popliteal sciatic nerve
- Sciatic nerve neuropathy
- External popliteal sciatic nerve neuropathy
- Neuropathy of the medial popliteal nerve
- Sciatic nerve neuralgia
- Sciatica neuralgia
- Bilateral sciatic nerve neuralgia
- Sciatic nerve neuritis
- Sciatic neuritis
- Sciatic nerve paralysis
- Pinched disc with sciatica
- Pinching of the sciatic nerve
- Bilateral sciatica
- Bilateral sciatica
- Sciatica with lumbago
- Sciatica due to intervertebral disc disease
- Stenosis with sciatica
- Lumbosacral root syndrome
What are the symptoms of sciatica?
- Severe pain that can make it difficult to stand or walk
- Constant pain in only one side of the buttock or leg (rarely in both legs except in the case of central disc herniation)
- Pain that is worse when you are sitting
- Pain radiating down the leg and sometimes into the foot and toes (rarely only in the foot)
- Leg pain that is often described as burning, tingling or tightness
- Weakness, numbness, or difficulty moving legs, feet, and/or toes
- Although the symptoms can be painful and potentially debilitating. Permanent damage to the sciatic nerve is rare and involvement of the spinal cord is possible but rare.
- Sciatica pain can range from rare and irritating to constant and disabling.
What is the sciatic nerve?
The sciatic nerve is the largest nerve in the body and is made up of nerve roots that originate in the lumbar region of the spine and then combine further down to form the "sciatic nerve". Symptoms occur when the great sciatic nerve is irritated or compressed at or near its point of origin.
What is the path of the sciatic nerve?
- The pain or symptoms (numbness, tension, heaviness, burning, weakness) follow the path of the sciatic nerve, which originates in the lumbar region of the lumbar spine (e.g. L5-S1) and runs down the leg through:
- The middle part of the buttock,
- The posterior aspect of the thigh,
- The back of the leg (calf),
- The heel and sole of the foot and the toes.
- The pathway may be incomplete, i.e. you may experience pain or symptoms all along the sciatic nerve or only in one part (e.g. pain only in the calf). This will depend mainly on how the nerve is pinched or irritated.
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How does sciatica manifest itself?
- Sciatica rarely occurs before the age of 20 and becomes more common in middle age: it is most likely to develop around the age of 40 or 50.
- Perhaps because the term sciatica is often used to loosely describe leg pain, estimates of its prevalence vary considerably. Some researchers have estimated that it will affect up to 43% of the population at any given time.
- Sciatica is often not caused by an event or injury but rather tends to develop over time.
- The vast majority of people who suffer from sciatica will feel better in a few weeks or months and get relief from their pain with non-surgical treatments such as manipulation or neuro-vertebral decompression. For others, however, sciatica pain can be severe and debilitating.
- It is advisable to consult a doctor if you suffer from sciatica pain, not only to learn how to relieve the pain but also to check for the possibility of a more serious medical problem such as a herniated disc.
Who suffers from sciatica?
There are no exact data on the incidence and prevalence of sciatica. In general, it is estimated that 5% to 10% of patients with low back pain have sciatica, while the lifetime prevalence of low back pain ranges from 49% to 70%. The annual prevalence of disc-related sciatica in the general population is estimated at 2.2%. Some personal and occupational risk factors for sciatica have been reported, including age (more common between 45 and 64 years), height (taller people suffer more), mental stress, smoking, strenuous physical activity (e.g. frequent lifting, especially bending and twisting) and exposure to vehicle vibration (including whole-body vibration). The evidence for an association between sciatica and gender or physical condition is conflicting.
The 25 causes of sciatica pain :
- Herniated disc (responsible in 90% of cases)
- Disc bulge
- Pinched discs
- Spinal stenosis
- Root stenosis
- Piriformis syndrome
- Arthritis - Osteoarthritis
- Poor posture
- Sacroiliac joint dysfunction
- Joint dysfunction of a lumbar vertebra
- Misalignment of a lumbar vertebra
- Misalignment of the pelvis
- Muscle spasm
- Rapid weight gain
- Frequent wearing of high-heeled shoes
- Sitting for too long
- Sitting cross-legged
- Too much jogging on too hard a surface
- Repetitive work requiring lifting heavy objects in a twisting motion
What is the best treatment for sciatica?
There is no single "miracle" treatment for sciatica pain, but many different treatments depending on the cause of the sciatica. And to determine the exact cause of your sciatica pain, X-rays or magnetic resonance imaging may be necessary. This will depend on your history, the presentation of your symptoms and the physical examination.
Treatment of sciatica by neurovertebral decompression
If the sciatica is caused by a disc problem (herniated disc, protrusion, bulging disc, pinched disc or desiccation) that can be diagnosed with a magnetic resonance imaging (MRI) or a computed tomography (CT) scan, or when it is due to stenosis or spondylolisthesis, neurovertebral decompression treatment is one of the most effective treatments.
However, if the neurological symptoms become too severe, such as loss of feeling or almost complete loss of mobility in the leg, these signs should not be ignored and urgent medical attention should be sought before irreversible damage occurs. Your condition may require surgery in the lumbar region of the spine.
To find out more about treating sciatica with neuro-spinal decompression, click here !
Treatment of sciatica with physiotherapy
When sciatica is caused by piriformis syndrome, or muscle spasm, physiotherapy treatment is very effective. In physiotherapy, an exercise programme incorporating a combination of strengthening, stretching and aerobic conditioning is a central part of sciatica treatment.
Osteopathic treatment of sciatica
In cases where sciatica is caused by arthritis, osteoarthritis, poor posture, sacroiliac joint dysfunction, lumbar vertebrae joint dysfunction, lumbar vertebrae misalignment, pelvic misalignment, sprain, or pregnancy, osteopathic treatment offers excellent results.