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What is Sciatica?

When you have sciatica, you experience specific symptoms because of inflammation of your sciatic nerve originating in your buttock/gluteal area. You have a sciatic nerve running through each leg. They begin beside your lower spine, pass through your buttocks, and into your leg before finally ending in your foot. If your sciatic nerve becomes inflamed, it triggers various symptoms, including pain, tingling, and numbness.

It’s easy to recognize sciatica symptoms because they radiate along your nerve, starting in your lower back and moving into your buttock, hip, and leg. Sciatica symptoms affect one side of your body and range from mild to severe. In many cases, they can include sharp, jolting, or burning pain, and doing things like sneezing, coughing, or sitting for long periods can worsen them.

Actual injury to your sciatic nerve “sciatica” involving spinal nerves and the spinal cord is rare. Common sciatica primarily refers to pain related to an injury of a nerve as it travels down your leg. 

What Does Sciatica Feel Like?

People feel sciatica pain in the affected leg differently, with descriptions like sharp, shooting, burning, stabbing, and more. The pain can be constant or ebb and flow while being more severe in the legs or the lower back. A sneeze or sudden movement can worsen the pain, as can sitting or standing for too long.

Usually, it only affects one leg at a time but that depends on where the nerve is being pinched. The same factor determines whether you feel it suddenly or gradually, because sciatica caused by arthritis develops slower than sciatica caused by disk herniation. 

What Causes Sciatica?

There are several direct causes of sciatica to be aware of. Many of these worsen over time if not appropriately treated or given the medical attention required. 

The most common cause of sciatica is a slipped or herniated disk that puts pressure on a nerve root. Sciatica occurs because these disks are supposed to protect the space between the spine's vertebrae but end up pressed by the bone. When these disks are naturally worn down over time, this is referred to as degenerative disk disease. Natural wear down may also lead to spinal stenosis, where sciatic nerve roots are pinched due to narrower nerve passageways. 

Other causes of sciatica include: 

• A severe traumatic injury to the spine or sciatic nerve. 
• Osteoarthritis, where bone spurs form in the spine, compressing lower back nerves as you grow older. 
• Spondylolisthesis, where a vertebra is misaligned with the rest of the spine.
• Tumors on the spine. 
• Rare but serious conditions like cauda equina and piriformis syndrome.

Risk Factors

With sciatica being common, you are likely to be affected by a risk factor and should be careful if you: 

• Have Low Core Strength: The muscles of your back and abdomen count as your "core." So, the stronger this section of the body is, the more support your lower back has. Muscle weakness in this area means your lower back loses support, increasing the risk factors. 
• Stay Inactive Throughout the Day: Prolonged sitting all day without using your muscles can lead to detrimental effects, so you’ll want to avoid going too long without flexing them. 
• Work a Strenuous Physical Job: Conversely, too much flexing while heavy lifting can strain muscles. Finding a balance where you use your muscles without overusing them is best.
• Are Pregnant: Sciatica commonly affects pregnant women, but not for the reasons you may think. Hormones released during pregnancy cause loose ligaments, causing instability for the spine, and may lead to a pinched nerve. 
• Take Care of Your Body in General: Smoking, being overweight, diabetes, improper posture during exercise, and simply getting older can all increase the risk of sciatica. Be sure to take all the self-care measures you need to protect your body, especially when you suffer from an injury or disease. 

All these factors affect the spinal column and may lead to some symptoms of sciatica developing over time. It is essential to maintain your health and talk to medical professionals for an opinion and a physical exam if you believe you may be suffering from sciatica. 

Is Sciatica Common?

Yes, it affects approximately 40% of men and women in the U.S. and is the third most common reason people go to their healthcare providers. While common, it can still cause serious problems if left untreated and may require immediate medical attention if the symptoms become too severe or worsen over time. 

Luckily, with the proper care and treatment, preferably from a physical therapist or pain specialist, sciatica is something most recover from. However, permanent nerve damage may occur if the pinched nerve or nerves are left untreated. More issues are sure to follow, so be sure to plan on meeting a medical professional if you find yourself developing sciatica. 

Symptoms of Sciatica 

The effects of sciatica vary wildly depending on the nerves affected, and the soft tissue is degraded. Sharp pain, numbness, or even a dragging foot can be typical signs to look out for. But the most prominent symptom of sciatica is a pain in the lower body. Pain in the lower body that flares when standing, sneezing, bending over, going through a bowel movement, or walking more than a few yards is a common sign to look out for. 

A physical exam by your health care provider will search for other symptoms like difficulty, bending the foot, walking on your toes, severe leg weakness, numbness, loss of sensation, inability to bend, and slowed reflexes. 

Can Sciatica Be Prevented? 

It depends on the root cause. Some forms of sciatica occur simply because of age, where the disks between vertebrae have endured so much wear and tear that they simply do not function properly anymore. But many forms of sciatica are preventable by undergoing some minor lifestyle changes and practicing self-care. Be sure to take care of yourself and reduce the risk of sciatica by: 

• Exercising regularly: While simple, you should always appreciate the benefits of stretching your joints and flexibly. Your muscles support your spine and its disks, so stronger core strength is crucial in preventing sciatica. It also helps keep your weight down, which keeps the pressure off your spine. Dieting and low-impact exercises like yoga, rowing, or walking can help keep your body limber and weight down.
• Prevent fall injuries: A fall can put severe pressure on the spine and have a mild ache turn into severe pain or leg weakness as your nerves are affected. 
• Keep a good posture: When you have good posture, you minimize the pressure your spine is under. Stand up straight with your shoulders to your back, keep your head level with your body, put your weight on the balls of your feet, and do not lock your knees. The better your posture, the less work your spine has to do, and your disks will be better off. 

What is the Treatment for Sciatica?

The Garden State Pain & Orthopedics team provides several different treatments for sciatica depending on the cause and severity of your symptoms. It is important to note that sciatica can be managed over time with the following: 

• Hot and cold compress therapy: Ice packs are used to reduce swelling for a few days, while hot packs are applied afterward for pain relief. If the pain persists, it is best to switch to the temperature you feel the most relief with. 
• Lifestyle Changes: A healthy diet, regular exercise, and good posture can do wonders to put pressure off your spine. You should also wear fitting shoes and avoid falls to keep this pressure low.
• Stretching: Aerobic exercises and any that involve strengthening your core are great for preventing sciatica. Speak to an instructor to find the proper stretches for you and how to do them correctly. 

For sciatica symptoms that don't respond to conservative treatments, your Garden State Pain & Orthopedics provider might recommend minimally invasive therapies that include:

• Lumbar interlaminar epidural steroid injections - deliver steroid medication directly inside your spinal canal
• Lumbar facet block injections - target pinched nerves associated with your vertebrae
• Lumbar radiofrequency ablation - deactivates the nerve sending pain signals to your brain 
• Spinal cord stimulation - disrupts pain communication between your nerve and brain with mild electrical currents
• Intrathecal pain pump - this small device delivers consistent and steady pain medications directly into the fluid around your spinal canal