Sciatica

Friends, have you encountered a medical condition called SCIATICA? I recently read about it and thought of sharing it with you all.

Sciatica happens when irritation, inflammation, pinching or compression affects one or more nerves that run down from your lower back into your legs. It is usually not a serious or dangerous condition, and most people with sciatica get better on their own with time and self-care treatments. But severe cases may need surgery.

Actually, sciatica is a nerve pain from an injury or irritation to your sciatic nerve. In addition to pain, it can involve tingling or numbness in your back or butt that may also radiate down your leg. More severe symptoms are also possible. The sciatic nerve is the longest and thickest nerve in the body. It is up to 2 cm wide. Despite its name , it is not just one nerve, actually it is bundle of nerves that come from five nerve roots branching off from your spinal cord.

We have two sciatic nerves, on eon each side of your body. Each sciatic nerve runs through your hip and buttock on one side. They each go down the on their side of our body until they reach just below your knee. Once there, they split into other nerves that connect to parts further down, including your lower leg, foot and toes.

Having sciatica means, you can experience mild to severe pain anywhere with nerves that connect to sciatic nerve. The symptoms can affect your lower back, hips, buttocks or legs. Some symptoms may extend as far down as your feet and toes, depending on the specific nerve(S) affected.

Types of sciatica:                    

• True sciatica-This is any condition or injury that directly affects your sciatic nerve.
• Sciatica-like conditions- These are conditions that feel like sciatica, but happen for other reasons related to the sciatic nerve or nerves that bundle together to form it.

Sciatica is a very common condition. About 30 % of world’s population experience some form of sciatica during their lifetime. It rarely happens before age 20 unless, it’s injury-related.

Symptoms and Causes

• Pain– Sciatica pain happens because of pressure on the affected nerve(s). Most people describe sciatica pain as burning or like an electric shock. This pain also shoots or radiates down the leg on the affected side. Pain commonly happens with coughing, sneezing, bending or lifting your legs upward when lying on your back.
• Tingling or “pins and needles”- This is similar to the feeling you have when a leg falls asleep because you sat cross-legged.
• Numbness– This is when you can’t feel sensation on the skin in the affected areas of your back or leg. It happens because signals from your back or leg are having trouble reaching your brain.
• Muscle weakness– This is more severe symptom. It means that muscle command signals are having trouble reaching their destinations in your back or leg.
• Urinary or fecal incontinence– This is very severe symptom. It means signals that control your bowels are not reaching their destinations.

Conditions that can cause sciatica include- Herniated disks; Degenerative disk disease; Spinal stenosis; Spondylolisthesis; Osteoarthritis; Injuries; Pregnancy; Tumours, cysts or other growths.

Risk factors

There are many potential risk factors, which include, but aren’t limited to-

• Having a current or previous injury– An injury to your spine or lower back increases your risk of developing sciatica.
• Normal wear-and-tear– As you get older risk increases due to wear and tear. Age related conditions like osteoarthritis can also play a role.
• Having excess weight or obesity– Your spine is like a construction crane when you stand up. The weight you can carry in the front of your body is what your spine has to hoist. Muscles in your back are like the winch and cable, pulling to keep you vertical. The more weight you have, the more your back muscles have to work. That can lead to back strains, pain and other issues.
• Your job-Jobs that require heavy lifting, a lot of bending, or working in awkward or unusual positions may increase your risk of low back problems.
• Not using good posture when lifting.
• Having Diabetes– type 2 diabetes increases your risk of diabetes –related peripheral neuropathy. That damages your nerves, including any of the nerves that can cause or contribute to sciatica.
• Physical inactivity– Sitting for long periods and a lack of physical activity can contribute to an increased risk of sciatica.
• Using tobacco– Nicotine use can affect circulation and increase your risk of chronic pain

Complications

Most people recover fully from sciatica. Possible complication can be chronic pain. If there is serious damage to an affected nerve, chronic muscle weakness might happen.

Diagnosis

A healthcare provider can diagnose sciatica using a combination of methods.

• Walking– Sciatica often causes visible changes in how you walk.
• Straight leg raise test– This involves having you lie on an examination table with your legs straight out. They will slowly raise your legs one at a time toward the ceiling and ask when you start to feel pain. This can help pinpoint the cause of sciatica.
• Other tests– spine x ray, CT scan, MRI, Nerve condition velocity studies, Electromyography, myelogram.

Treatment

Self treatment– It includes Hot and cold therapy to reduce pain, anti-inflammatory drugs to reduce pain, stretching activity.

Conservative treatment– This involves  proscription medicines like painkillers, muscle relaxers, physiotherapy, spinal injections.

Alternative therapies-these include seeing a chiropractor for spine adjustments, acupuncture, acupressure, massage therapy.

Surgery options- It may be the best option when sciatica is severe. Surgery options include

• Diskectomy- this is a surgery that removes fragments or small sections of a herniated disk.
• Laminectomy- Each vertebra has a rear section called lamina. This surgery involves removing a section of the lamina that is pressing on spinal nerves.

Prevention

Some causes of sciatica are preventable, such as

• Follow good posture techniques while you are sitting, standing, lifting objects and sleeping.
• Quit using tobacco.
• Reach and maintain weight that is healthy for you.
• Stay active and protect yourself from falls.

Generally sciatica doesn’t last longer than six weeks. When it does, your healthcare provider may recommend more involved treatments including surgery.

Waiting for your feedback on this blog.

Anil Malik

Mumbai, India

24^th April 2025