Lower back pain with Sciatica – How serious is it?

Back pain can present in a variety of ways. You can either feel the back pain immediately after an inflicting injury or it may arise slowly with time. The back pain might be sudden (acute) or it can be long lasting ( chronic). With the passage of time, research has proposed multiple different treatment modalities for back pain from physical therapy regimens, interventional image-guided injections, orthotics, and braces, and finally various innovative minimally invasive surgical procedures to resolve the root cause.

Sometimes it may be difficult to identify the reason behind your back pain but mostly, with a good exam and imaging guidance, the reason is apparent.  Sciatica is one of the commonest symptom-associations with back pain and it is pretty easy to recognize.

What is Sciatica?

Sciatica is typically described as a ‘shooting, electrical impulse-like pain’ radiating down the leg. The sciatic nerve is a long nerve the goes all the way down from your lower back to both of your legs. It is the longest and thickest nerve of your body. It is basically composed of five nerve roots. These five roots are combined together to form the left and right sciatic nerve. As you know, there are two sides of your body so, one nerve runs all the way down from your buttocks and ends just below your knee on both the left leg as well as the right leg. The sciatic nerve then forms branches to other nerves that continue to innervate motor ( movement ) function and sensory function to the entire leg and foot.

An actual injury to your sciatic nerve is very rare. A common word Sciatica is often used to elaborate any kind of pain that originates from your lower back and goes down towards your legs. If you have this pain, then it means that there has been an injury to your nerve, and you might feel irritation, inflammation, compression, and pinching in the nerve of your lower back.

Sciatica is usually accompanied by mild pain anywhere along the path of your sciatic nerve. It may weaken different parts of your legs. The condition could be very uncomfortable for some people as they suffer from a tingling and pinching experience usually in their thighs and calves.

What Are the Symptoms of Sciatica?

Some common symptoms of Sciatica are given below:

• Pain in your leg or butt that gets worse with activity
• Pain in your hip.
• Irritation and tingling down your leg.
• Weakness and difficulty in moving your leg or foot.
• Continuous pain on one side of your butt.
• Pain goes down your foot that makes it difficult for you to stand and the foot feels numb

Typically, just one side of your body is affected by Sciatica. The pain usually extends from your lower back through your thigh all the way down to one of your legs. It depends on how and where your sciatic nerve or nerve roots are being compressed. In some cases, the pain might also go down to your toe and foot.

In some people, the pain of Sciatica is so severe that they may not be able to do things that they usually perform easily in their daily routine. For some people, the pain may resolve after some time whilst in others, it is a progressive pattern of worsening pain.

What Are The Causes of Sciatica?

Some common causes of Sciatica are as follows:

• Narrowing of the spinal canal in your lower back. This is also known as Lumbar Spinal stenosis.
• Prolapse or ‘bulging’ of the disc material that provides cushioning in your vertebrae. This is also known as degenerative disk disease.
• Spondylolisthesis ( slippage of the vertebrae, one against another )
• Pregnancy
• Core muscle weakness in your back or buttocks exacerbated by heavy lifting and strenuous physical activity

Other things that can increase the preponderance of back pain are obesity, lack of exercise, sleeping on a very soft mattress, and wearing high heels.

How is Sciatica Diagnosed?

It is best to visit an orthopedic specialist to get a proper diagnosis of Sciatica. The doctor will first ask you some questions about your back pain like: do you feel weakness or numbness in your legs? Do you feel discomfort in certain positions? Has the pain-affected any of your activities? After this history-taking session, you will undergo a physical exam to determine which nerve is actually causing the problem. The doctor may also make you do some ‘provocative’ exercises to check when the pain gets worsens.

Further, they may use medical imaging like a CT Scan, X-ray, or MRI to determine where the problem actually exists. If it is nerve root compression, it will be clearly visible in the images. An EMG test can also be performed to check which nerve in your back is compressed.

What Treatment Options Are Available For Sciatica?

Non-Surgical Treatment

In most cases, sciatica can be treated symptomatically with pain control and good ergonomic education. If the condition is more severe, then the doctor may suggest one of the following solutions for the treatment of Sciatica :

Physical Therapy

You can take help from a physical therapist and he or she can create a stretching and exercise routine for you that you can follow to improve your condition. It will also help you in improving your posture and releasing pressure on your sciatic nerve.

Hot And Cold Packs

You can apply hot and cold packs on your lower back several times a day; It will help to relieve pain and make things better for you.

Alternative therapies

Alternative therapies like yoga, pilates, massage, biofeedback, or TENS therapy as well as acupuncture can be used to improve the symptoms of Sciatica.

Medicines

You can use Non-steroidal and anti-inflammatory drugs, i.e., aspirin, ibuprofen, and naproxen, to improve the symptoms like pain and inflammation. Nerve vitamins and nerve-modulating medications like Lyrica can also sometimes be useful.

If your condition is severe, then the above non-surgical methods may not work for you. As such, you might need to undergo surgery to make things better. Your doctor will analyze the seriousness of your injury and then make a recommendation on which type of surgery will be best for you and which method should be adopted. Patients with sciatica who undergo surgery typically have an almost instant improvement in their sciatic symptoms. Core strengthening exercises and physical therapy are a crucial component of post-operative rehabilitation.

If you are suffering from Sciatica and need more information about available treatments, then please contact Dr. Gowreeson Thevendran or visit www.orthofootmd.com.