Sciatica

Symptoms:

  • Severe pain that extends from the lower back to the buttock region and runs along one of the legs.
  • Tingling and numbness along the sciatic nerve path.
  • Leg weakness with the possibility of a foot drop.
  • Pain that is aggravated when one is sitting, standing or when he or she coughs.
  • In severe cases urinary and fecal incontinence.

Causes:

  • Herniation or bulging of a disc compressing the nerve roots.
  • Spinal stenosis which results from the narrowing of the spinal column.
  • Spondylolisthesis whereby the vertebra moves forward over the vertebra located beneath it.
  • Piriformis syndrome caused by irritation of the sciatic nerve by the piriformis muscle.
  • Osteophyte or bone spur compressing the nerve roots.

Risk Factors:

  • Work activities involving heavy lifting and long periods of sitting.
  • Overweight people putting stress on their lower spine.
  • A sedentary lifestyle with weak core muscles.
  • Diabetes.
  • Advanced age.

Ways to Manage:

  • Small periods of rest during intense flare-ups followed by slow movements.
  • Anti-inflammatory or neuropathic medications as directed.
  • Physical therapy that involves nerve gliding and core stabilization.
  • Epidural corticosteroid injections or selective nerve root blocks.
  • Hot or cold pack application to reduce muscle spasm around the nerve.

Exercise Recommendations:

  • Light exercise like walking to promote healing of the nerve.
  • Knee to chest exercise to relieve pressure on sciatic nerve.
  • Piriformis exercise to stretch out the tight buttocks muscles.
  • Nerve flossing or gliding exercises under professional supervision.
  • Core stabilization exercises for pain-free individuals.

Sciatica generally resolves within six to twelve weeks of non-surgical treatment. Surgery is opted for when pain is intolerable, incapacitating and progressive weakness is seen along with the pain.

  • Microdiscectomy – Most common surgical procedure performed for sciatica due to disc.
  • Endoscopic discectomy – An alternate minimally invasive procedure.
  • Laminectomy – To decompress the nerves of spinal stenosis.