When your sciatic nerve causes pain and irritation in your body, we call it sciatica. But what causes it, and how can you fix it?
Up to 40% of the population experience sciatica at some point in their lifetime.
Sciatica is no joke either. It’s debilitating – and can last for decades. Some patients get so bad that they can no longer walk, stand, or perform simple daily tasks.
Like brushing their teeth or tying their shoelaces – without excruciating pain. Patients report that they “feel like their legs are on fire” or that “somebody ran over the bottom half of their body.”
“They go back and forward to the doctor, in and out of the emergency room. Still, most of the time. They’re just given pain meds and told to watch and wait until the pain forces them to consider nerve block, steroid injections, or dangerous spinal surgeries.
The type of pain accompanying sciatica can also be worrying and anxiety-inducing because its nerve pain that shoots through your body like an electric shock. Or like someone is digging out the back of your legs with an icepick.
But the good news is that you can avoid these things with good physical therapy that works on the root cause – sciatic nerve compression.
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What Is Middle Back Pain A Symptom Of?
Various factors can cause sciatica, leading to mild or severe pain and everything in between. In most cases, the primary cause of the condition is compression of a nerve in the lower part of the spine, in your lower back. But although many people associate general back pain with sciatica, this analysis is incorrect.
The sciatic nerve doesn’t just affect the back. It’s the widest and longest nerve in the human body, beginning in the lower back and running through the buttocks and into the legs, right down to the lower section of the knee.
It controls many of our lower leg muscles and the sensations in our lower legs and skin on the feet. So, sciatica isn’t just back pain, and it’s not a standalone medical condition.
Instead, it is symptomatic of other problems relating to the sciatic nerve. For example, sciatica can occur because of a herniated or slipped spinal disc.
What Are The Symptoms of Sciatica?
The most common symptom of sciatica is an acute pain radiating along the path of the sciatic nerve – anywhere from the lower back, buttocks, or back of the leg.
The pain ranges from mild to severe and worsens with extended periods of sitting. In some cases, there are other symptoms, too (although not always), including:
- “Tingling” or a pricking sensation felt in the toes and feet
- A feeling of numbness along the sciatic nerve region
What Causes Sciatica?
While sciatica may occur due to various underlying medical conditions, most cases are due to a slipped/herniated spinal disc.
The spine is made of three sections:
- Vertebrae
- Nerves
- Discs
The discs in the spinal cord are made from flexible, cartilaginous material that works as a cushion within the vertebrae (spinal bones) and give the spine flexibility.
A “slipped” or “herniated” disc is when one of these discs shifts out of its normal position, causing strain on the sciatic nerve.
Other Causes Of Sciatica Are:
- Spondylolisthesis: when a vertebra (spinal bone) slips, which is different from a slipped disc when the cartilage “bulges” out of position.
- Lumbar Spinal Stenosis: when the spinal cord in the lower back narrows
- Tumors: can cause the sciatic nerve root to compress in the spine
- Spinal Infection: when abscesses and the body’s natural inflammatory response can compress the sciatic nerve.
- Cauda Equina syndrome: a rare condition that causes sudden compression and narrowing in the spine and requires immediate medication attention.
- Spinal injury of any type: where the sciatic nerve is either directly damaged or suffers compression due to the injury.
In many patients, there is no single reason for sciatica occurring, but there are some common risk factors, including:
- People in their mid-30s and 40s have a greater probability of the condition
- A sedentary lifestyle and not staying active can put you at greater risk
- Carrying heavy weights for extended periods at work can also contribute
- Pregnancy: Pregnant women are more likely to experience sciatica during their pregnancy, with more than 50% of women having back pain. This propensity may be due to the release of hormones like relaxin that help the ligaments to stretch and loosen during pregnancy. Despite that, a common reason for sciatica in pregnant women is a slipped disk.
How We Diagnose Sciatica
To diagnose sciatica, your doctor or physical therapist will start with a thorough physical examination to examine your muscle strength and reflexes.
Then, we may ask you to perform specific movements such as lying on your back and raising your legs, one at a time, walking on your heels, or standing on your toes.
These activities aim to confirm whether the sciatic pain increases while performing these movements. We can usually diagnose sciatica and the root cause at this point. Still, you may need further tests to confirm the diagnosis, such as:
- Imaging tests
Some sciatica patients may suffer from bone spurs or slipped discs without apparent symptoms. Therefore, we sometimes recommend various imaging tests to check whether this is the case for you. Generally, however, these tests are only recommended in chronic cases with severe pain that doesn’t improve with physical therapy.
- X-ray: The most basic imaging test we recommend is an X-ray/s to determine if extra bone growth (like a bone spur) is compressing your spinal nerve.
- CT scan: In cases where your doctor feels a CT scan may be more helpful, we recommend a CT Myelogram. During this scan, a dye is inserted via an injection into the spinal canal. The dye spreads around the nerves and spinal cord so abnormalities can be easily seen.
- EMG (Electromyography): The EMG test examines electrical impulses generated by the nerves and the muscle response to them. This process helps confirm if any of your nerves are compressed due to spinal stenosis or a slipped disk.
- MRI: An MRI scan involves using a strong magnet with radio waves to create cross-sections images of the back and spine. It offers a clear picture of tissues and bone, including slipped discs.
How To Get Relief From Sciatica
Specialized treatment under the guidance and supervision of a physical therapist is the most effective treatment for mild to moderate cases of sciatica.
The therapeutic movements and stretching exercises we guide you through, along with hands-on joint and soft tissue manipulation, help release sciatic nerve stress. This type of treatment provides the following benefits:
- It enables you to reduce your intake of medication
- It helps to alleviate pain and swelling
- Relieves pain and other symptoms without surgery or nerve blocks
If your symptoms are mild, we still recommend a consultation with a Physical Therapist. Still, there are some things you can try at home to reduce the pain if you can’t get to an appointment with a PT right away. They include:
- Using hot or cold packs to alleviate swelling and pain several times daily. Choose that one that feels best to you or do it alternately. Both help to reduce pain and inflammation.
- Taking an anti-inflammatory medication such as Advil
However, if the pain and discomfort persist for more than two to three weeks, it is best to seek professional assistance from your doctor or physical therapist. We offer all new patients a free 30-minute consultation with a physical therapist.
Intecore Physical Therapy: The Sciatica Experts
At Intecore Physical Therapy, we have successfully treated sciatica for over 20 years. We help people find relief from chronic pain that they thought they would have to live with forever – whether it’s lower back pain and sciatica, upper back and neck pain, or pain in the middle of the back.
We quickly identify the root cause and work with you to overcome it once and for all. We help you stop the vicious cycle of rest (that makes you seize up) and medication (that causes even more problems), so you can restart your life and get back to doing all the things you love.
We help you wake up in the morning feeling fresh and energized for the day ahead – instead of depressed and sore. In pain, from the moment you open your eyes: no more shooting or stabbing pains, muscle weakness, or fear of further injury. After treatment with Intecore, you’ll feel even better than before the pain started.
Don’t waste another day in pain. Instead, take action and book your free consultation with one of our Sciatica Specialists.
