On Your Health

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What is Sciatica?

If you suffer from sciatic nerve pain, you know it can feel so debilitating and excruciating you don’t even want to get out of bed.

Some experts estimate that up to 40 percent of Americans suffer from sciatica at some point in their lives. The condition can disrupt normal life in agonizing ways. The sciatic nerve is the largest and longest nerve in the human body. Every person has two sciatic nerves, the right and left nerves — supplying each lower limb. Sciatic nerve pain is often lumped in with all back pain, but sciatica is very different.

"A lot of patients misunderstand sciatic pain and attribute any pain in the back to sciatica, but that’s not necessarily true," says Dr. Michael McLaughlin, an INTEGRIS pain management specialist. "Sciatic pain is pain that occurs from the compression of the sciatic nerve and is usually pain that shoots down the back of the leg."

We spoke with Dr. McLaughlin to learn more about sciatica and find out what he recommends to treat and prevent sciatic nerve damage.

What is sciatica?

"Sciatica usually occurs on one side of the body and is a pain that radiates from the sciatic nerve in the back down through the lower back and into the hips, buttocks, leg, calf or foot," says Dr. McLaughlin. Pain strikes when a root that forms one of the sciatic nerves, or the nerve fibers themselves, become irritated. 

He adds, "Pain that radiates down the front of the leg is associated with femoral pain, which is not the same thing." The nerve pain ranges from a dull ache to a burning and excruciating pain. Sometimes, the pain hits like a sudden shock when you sneeze or cough, and some patients may experience numbness, muscle weakness or tingling along the affected leg.

Sciatic nerve pain causes

The main culprits of sciatica include herniated, bulging, and degenerative discs, bone spurs and a narrowing of the spine, which can all affect the sciatic nerve. "Sciatica pain happens when the sciatic nerve becomes pinched or injured," says Dr. McLaughlin. "Sciatica can also be caused by arthritis that builds up pressure against the nerve, or even by some sort of trauma or fracture. Sometimes sciatica is caused by simple wear and tear as you age or simply being sedentary," he continues.

People who smoke are more likely to suffer from degenerated discs as smoking can cause the spinal discs to dry out, Dr. McLaughlin says, and obesity also increases the risk of bulging discs that can cause sciatica. In addition, "Pregnancy and the expanding of the uterus can also press on the nerve and cause sciatica," he says.

On occasion, sciatic pain can be the result of something called "piriformis syndrome," in which the piriformis muscle, which rotates the hip, has a spasm that irritates that nerve. 

Treating sciatica

In some cases, your doctor will use tests to determine if the sciatic nerve is being damaged. Damaged disks and bone spurs show up on X-rays and other imaging tests, although doctors don’t usually order them unless your pain is severe or doesn’t go away for weeks. MRI, CT scans and electromyography (a test that can confirm nerve compression by measuring the electrical impulses produced by the nerves) are common tests used.

According to Dr. McLaughlin, most sciatic pain will go away with simple treatment. "Anti-inflammatory drugs like ibuprofen and acetaminophen, along with simple rest, can often resolve the pain," he says.

However, if the pain continues, "You may require medication, injections or surgery," says Dr. McLaughlin. Corticosteroid injections into the area around the nerve root can suppress the inflammation and provide relief, and the effects usually last a few months.

Surgery is only required when the compressed nerve causes significant weakness, loss of bowel or bladder control, or when the pain worsens or doesn't improve with other therapies. Surgery may be used to remove the bone spur or the portion of the damaged disk that's pressing on the pinched nerve.

It’s also important for you to keep moving as the pain starts to subside. Some people also find that hot or cool compresses will work to soothe the aching spots.

Other sciatic pain remedies

Once you are in pain, you want it gone as soon as possible. In addition to the treatments listed above, your doctor may prescribe a physical rehabilitation program to offer relief and help you prevent future injuries. Exercises and stretches can correct your posture, strengthen the muscles supporting your back and improve your flexibility.

woman lying on back stretching

Sciatic nerve stretches for relief (be sure to get the OK from your doctor first)

  1. Lie on your back with both knees bent. Pull your left knee to your chest and hold this position for five to 10 seconds. Repeat on the other side. Do five to 10 times with each leg.
  2. Lie with your knees bent. Pull both knees to your chest and hold this position for five to 10 seconds. Rest and repeat. Do five to 10 times.
  3. Lie with your knees bent, and cup your hands behind your head or stretch your arms to the side. Flatten your lower back to the floor. Hold this position for five to 10 seconds. Rest and repeat. Do five to 10 times.

Sciatica prevention

"The best way to prevent sciatic pain and to keep the sciatic nerve healthy is to maintain a healthy weight, eat a healthy diet and don’t smoke," says Dr. McLaughlin. In addition, "Older patients should make sure their bones are healthy. Osteoporosis and bone fractures can cause complications with the nerves, too."

Dr. McLaughlin also cautions that patients should make sure they are in shape before starting a new exercise regimen or activity. "Don’t try CrossFit if you’re in your 40s or 50s and have never exercised," he says. "If your body isn’t conditioned, you can injure yourself and add quick insult to the nerve. Talk to your doctor about what exercises are good for you."

Once you have your sciatica under control, you will probably be able to resume your normal lifestyle and keep pain at a minimum. However, it is always possible for your disc to rupture again, so be sure to consult with your doctor about your condition and additional physical therapy he or she may recommend.

At INTEGRIS Pain Management in Oklahoma City, interventional pain management physicians will help you manage, reduce or relieve your pain so you can get back to the things in life that matter most.