Sciatica/Lumbago

What is it: Sciatica refers to leg pain caused by a problem with the sciatic nerve. This is a large nerve that runs from the lower back down the back of each leg. When something injures or puts pressure on the sciatic nerve, it can cause pain in the hip, buttocks, and leg. Up to 90% of people recover without surgery.

 

Statistics: Up to 85% of Americans experience some type of back pain during their lives. But this doesn’t always involve the sciatic nerve. In many cases, back pain is the result of overextending or straining the muscles in the lower back. What most often sets sciatica apart is the way the pain radiates down the leg and into the foot. It may feel like a bad leg cramp that lasts for days.

Most people who get sciatica are between the ages of 30 and 50. Women may be more likely to develop the problem during pregnancy because of pressure on the sciatic nerve from the developing uterus. Other causes include a herniated disk and degenerative arthritis of the spine.

Important Facts: The Celts called sciatica “the elf’s arrow.” They didn’t understand what caused the terrible pain that shot down their leg. To them, it made sense to believe that an elf had shot them.

Shakespeare knew about the pain of sciatica, and he used it as a curse in his play Timon of Athens. “Thou cold sciatica, cripple our senators, that their limbs may halt as lamely as their manners” (Act 4, Scene 1).

The most common symptom of sciatica is lower back pain that extends through the hip and buttock and down one leg.

The most common cause of sciatica is a herniated disk.

Treatment Duration: When the cause of sciatica is due to a prolapsed or lumbar disc herniation, 90% of disc prolapses resolve with no intervention. Treatment of the underlying cause of the compression is needed in cases of epidural abscess, epidural tumors, and cauda equina syndrome.

Although medications are commonly prescribed for the treatment of sciatica, evidence from clinical trials to guide the use of analgesics to relieve pain and disability is lacking.[9] Research has shown no significant difference between placebosNSAIDs, analgesics, and muscle relaxants. Evidence is also lacking in use of opioids and compound drugs.[10][11]

Research has failed to show a significant difference in outcomes between advice to stay active and recommendations of bed rest.[12] Similarly, physical therapy (exercises) has not been found better than bed rest.[13]

Do’s/Don’ts: Sciatica Relief: Stretching — While your sciatica is healing, try to remain active. Motion can actually help reduce inflammation and pain. A physical therapist can show you how to gently stretch the hamstring and lower back. Depending on your medical condition, certain exercises may not be recommended.

Common Myths:  All patients with sciatica experience the same symptoms.

FACT: The experience of sciatica varies among patients. Typically, pain runs from the low back down the back of one leg, sometimes into the foot and toes. But some patients also feel tingling, burning, or prickly sensations, usually on one side of the body. The type of pain depends on the location of the nerve compression.