Sciatica
Sciatica is a condition characterized by painful inflammation of one or both sciatic nerves, which are the largest nerves in the body, running from the lower spine down through the hips and legs. This pain often manifests as shooting discomfort that can extend from the lower back into the hip, thigh, and the back portion of the leg, sometimes occurring intermittently. Common causes of sciatica include vitamin deficiencies, arthritic inflammation in the lower spine, tumors, prolonged constipation, and herniated disks that may compress the nerve roots. Symptoms often begin with mild low back pain that may suddenly escalate with certain movements, such as lifting or bending.
Treatment for sciatica can vary, with some individuals recovering on their own within six weeks. Initial treatment may involve activity modification, ice and heat application for pain relief, and medications tailored to the underlying cause. In more severe cases, surgery may be necessary if the nerve is significantly compromised. Additionally, a therapeutic exercise program aimed at strengthening the trunk muscles is essential for recovery and long-term relief. Understanding sciatica requires attention to its symptoms, causes, and a commitment to appropriate treatment strategies.
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Sciatica
ANATOMY OR SYSTEM AFFECTED: Back, hips, legs, nerves, nervous system, spine
DEFINITION: Painful inflammation of one of the sciatic nerves
CAUSES: Vitamin deficiencies, arthritic inflammation in lower spine, prolonged constipation, tumors, slipped disk, pregnancy
SYMPTOMS: Shooting pain down sciatic nerve and extending into hip, thigh, and back portion of leg
DURATION: Acute to chronic
TREATMENTS: Surgery, heat application, medications, physical therapy
Causes and Symptoms
The two sciatic nerves are the largest nerves in the body. They run from the spine down either leg and connect the nervous system to the tissues of the thigh, lower leg, and foot, as well as the skin covering the leg. The roots of the sciatic nerves are in the lower spinal column. It is here that difficulty is most likely to occur. Inflammation of these nerves is most often caused by the pinching of one or more spinal nerve roots between the vertebrae of the lower back.
Sciatica is characterized by shooting pain that extends down the sciatic nerve into the hip, the thigh, and the back portion of the leg. The pain may occur in all these points at once, or it may skip about from point to point. Sciatica often begins with a long period of intermittent mild low back pain. Then, suddenly, the slightest movement, such as lifting a weight or merely bending over, may bring about intense sciatic pain.
A mild case of sciatica can be brought on by vitamin deficiencies or arthritic inflammation in the lower spine. Prolonged constipation can build pressure on the nerve and cause sciatic pain. Occasionally, a tumor may develop near the nerve and press on it. Sometimes a herniated, or slipped, disk at the level where the nerve roots emerge in the low back may protrude and press on the nerve, thereby causing sciatica.
Treatment and Therapy
If the sciatic nerve is being compromised, surgery may be indicated. However, more than 50 percent of patients with sciatica recover on their own within six weeks. In the acute stage, reducing one's activity level is important, but bed rest is not recommended; the patient should gradually return to his or her daily activities and stay active. Applying ice for the first two to three days, and then heat after, may give temporary relief from pain. The type of medication used depends on the cause of the sciatica. Ultimately, a therapeutic exercise program to develop stabilizing strength and endurance in the trunk muscles is essential for functional recovery.
Bibliography
Brown, Mark D., and Björn L. Rydevik, eds. Causes and Cure of Low Back Pain and Sciatica. Spec. issue of Orthopedic Clinics of North America 22.2 (1991): 181–362. Print.
Fairag, Maryam, et al. "Risk Factors, Prevention and Primary and Secondary Management of Sciatica: An Overview." Cureus, vol. 14, no. 11, 10.7759/cureus.31405. Accessed 8 Apr. 2024.
Fishman, Loren, and Carol Ardman. Back Pain: How to Relieve Low Back Pain and Sciatica. 1997. New York: Norton, 1999. Print.
Gillette, Robert D. “A Practical Approach to the Patient with Back Pain.” American Family Physician 53.2 (1996): 670–76. MEDLINE Complete. Web. 6 May 2016.
Hildreth, Carolyn J. "Sciatica." Illus. Cassio Lynm. Ed. Richard M. Glass. Journal of the American Medical Association 302.2 (2009): 216. Academic Search Complete. Web. 6 May 2016.
Hooper, Paul D. Preventing Low Back Pain. Baltimore: Williams, 1992. Print.
Liu, Chang, et al. "Surgical versus Non-Surgical Treatment for Sciatica: Systematic Review and Meta-Analysis of Randomised Controlled Trials." BMJ, vol. 381, 19 Apr. 2023, doi.org/10.1136/bmj-2022-070730. Accessed 8 Apr. 2024.
"Sciatica." Upd. C. Benjamin Ma. Rev. David Zieve et al. MedlinePlus Medical Encyclopedia. Natl. Lib. of Medicine, 8 Sept. 2014. Web. 6 May 2016.
"Sciatica." OrthoInfo. Amer. Acad. of Orthopaedic Surgeons, Dec. 2013. Web. 6 May 2016.
Smoots, Elizabeth. "Sciatica." Health Library. EBSCO, 20 Dec. 2014. Web. 6 May 2016.