Sciatica

Sciatica is the term given to pain down the leg, which is caused by irritation of the main nerve into the leg, the sciatic nerve. This pain tends to be caused where the nerves pass through and emerge from the lower bones of the spine.

What is it?

The longest nerve in your body, the sciatic nerve runs from your pelvis through your buttock and hip area and down the back of each leg. It controls many of the muscles in your lower legs and provides feeling to your thighs, legs and feet. The term “sciatica” refers to pain that radiates along the path of this nerve — from your back into your buttock and leg.

Sciatica isn't a disorder in and of itself. Instead, it's a symptom of another problem involving the nerve, such as a herniated disk. Depending on the cause, the pain of acute sciatica usually goes away on its own in six weeks or so.

In the meantime, heat and cold applications and exercise or physical therapy can help ease the discomfort of sciatica and speed recovery. Surgery to relieve pressure on the nerve may be an option when symptoms of sciatica don't respond to conservative treatment and pain is chronic or disabling.

What causes it?

Sciatica frequently occurs when a nerve root is compressed in your lower (lumbar) spine — most often as a result of a herniated disk in the low back. Disks are pads of cartilage that separate the bones (vertebrae) in your spine. They keep your spine flexible and act as shock absorbers to cushion the vertebrae when you move.

But as you grow older, the disks may start to deteriorate, becoming drier, flatter and more brittle. Eventually, the tough, fibrous outer covering of the disk may develop tiny tears, causing the jelly-like substance in the disk's center to seep out (herniation or rupture). The herniated disk may then press on a nerve root, causing pain in your back, leg or both. If the damaged disk is in the middle or lower part of your back, you also may experience numbness, tingling or weakness in your buttock, leg or foot.

Although a herniated disk is by far the most common cause of sciatic nerve pain, other conditions can also put pressure on the sciatic nerve, including:

  • Lumbar spinal stenosis.
  • Spondylolisthesis.
  • Piriformis syndrome.
  • Spinal tumours.
  • Trauma.
  • Sciatic nerve tumour or injury.

What are the symptoms?

  • Pain in the rear or leg that is worse when sitting.
  • Burning or tingling down the leg.
  • Weakness, numbness or difficulty moving the leg or foot.
  • A constant pain on one side of the rear.
  • A shooting pain that makes it difficult to stand up.
  • Low back pain may be present along with the leg pain, but usually the low back pain is less severe than the leg pain.

Are there any natural therapies?

The mineral magnesium is anti-spasmodic and may help to relieve muscle spasm and restore proper nerve function. The Recommended Daily Intake is 320 mg for men and 270 mg for women daily. Higher doeses are required to prevent or treat specific diseases, as well as for women who take oral contraceptives.

Other forms of natural therapies that would be extremely helpful for the treatment of a pinched nerve include:

  • Acupuncture. Originating in China more than 2,500 years ago, this medical system is based on the idea that that health and life depend on a vital energy called qi — pronounced “chee” and sometimes written chi — that flows along 14 pathways in your body. When qi is blocked, disease and pain result. Inserting very fine needles into specific points along the meridians unblocks energy flow and restores your body's healthy balance.

    During an acupuncture treatment, you're likely to have from one to 20 or more hair-thin needles inserted into your skin. Most needles are inserted superficially, although some may go deeper, depending on where they're placed and the problem being treated. In most cases, you won't feel the needles — in fact, many people find the treatments extremely relaxing. The needles may remain in place from a few minutes to half an hour or longer.

  • Acupuressure. This therapy is based on the same principles as acupuncture, but rather than using needles, the practitioner massages or presses specific points along the meridians to effect healing. Although the results may be more subtle than with acupuncture, acupressure may be a good choice if you'd rather avoid needles.

  • Chiropractic. Chiropractic treatment is based on the philosophy that restricted movement in the spine may lead to reduced function and pain. Spinal adjustment (manipulation) is one form of therapy chiropractors use to treat restricted spinal mobility. The goal is to restore spinal movement and, as a result, improve function and decrease pain.

    Chiropractors manipulate the spine from different positions using varying degrees of force. Manipulation doesn't need to be forceful to be effective. Chiropractors may also use massage and stretching to relax muscles that are shortened or in spasm.

What else can I do?

It's not always possible to prevent sciatica, but the following suggestions can play a key role in protecting your back:

  • Regular exercise
  • Maintain proper posture when you sit
  • Use good body mechanics

Did you know?

Risk factors are health problems, lifestyle choices and inherent qualities, such as age or race, that make it more likely you'll develop a particular condition. Major risk factors for sciatica include; age, occupation, physical activity, genetic factors, and diabetes.