Sciatica



Sciatica is an extremely common, painful, and at times a debilitating condition affecting the lower back, and either one, or both legs. It is caused by the compression of the sciatic nerve. The sciatic nerve is a very important and major nerve, in fact is it the longest nerve in the body. There are two nerves, each one running down the length of the leg, with many other smaller nerves running off it. It supplies both legs with the ability of movement. The sciatic nerve runs directly off the spinal cord.

What causes sciatica?

Sciatica usually results from a herniated disc in the lower back, however it can also be caused through the muscles of the buttocks compressing the nerve (as the sciatic nerve runs through these muscles).
Mild sciatica can also arise in some women during their premenstrual or menstrual phase of their cycle, due to muscle spasm, which can be very painful, but should only last a for short time.

Symptoms of sciatica

These can vary from annoying and worrying, to becoming completely bed ridden.
Pins and needles down your leg/s (including your foot)
Pain down your leg/s
Inability to lift leg/s
Inability to walk
Loss of bowel/bladder function. This will only occur in very severe cases - if this happens, see your doctor immediately or go to your nearest hospital.

Treatment

Treatment for sciatica is very similar to any other kind of back pain. When the pain first arises, if walking around is too painful then rest. Do not lift anything, or do any kind of activity, which worsens the pain. During this time the use of aspirin may help (this is more effective than paracetamol, due to it's anti-inflammatory effects). You may also try the use of over the counter anti-inflammatory drugs such as ibuprofin. If you chose to do this, it is extremely important you don't mix these with aspirin, as they work in similar ways, and may damage the lining of your stomach, along with other side effects.

Once the pain subsides, try and walk. Walking is in fact is good for back problems.
If you can get to a swimming pool, do so, as swimming places very little stress on your back, as your spine is not carrying your weight, the water is. Just don't try a difficult stroke, such as butterfly (the Australian crawl); this will probably be harmful. A nice, easy freestyle stroke is probably your best choice.

Staying in bed has been found to make recovery slower when it comes to healing the back, so once the pain is bearable, the best thing you can do is to resume regular activities. Just don't go crazy and start lifting heavy things (or go skiing or try backflips!)

If you know the types of activity that either caused your sciatica, or made it worse, avoid it during this healing time, try and let nature take it's course. If it doesn't get better after a few days, see your doctor for further suggestions.

If it only gets worse...

If you have had sciatica for a long time and it's only getting worse, you may have to consider a more aggressive treatment, such as surgery. You will already know from X-rays if you have a herniated disc. You will need to discuss this option with your doctor. If your doctor feels this is a valid option, then you will be referred to an orthopaedic surgeon. What happens next will be up to the specialist. Surgery is a last resort, and is used in only the most non-responsive cases.

Make sure specialised back strengthening exercises have been tried, along with incorporating correct lifting techniques into your lifestyle. You can discuss this with your doctor or physiotherapist, as they are the experts in reducing the pain.

Most importantly, if your sciatica is an ongoing problem, don't continue to use analgesia to control your pain, as using medications for long periods of time can also cause problems unrelated to your back. And if you have sciatica, the last thing you need is more problems.

- Louise Ganey


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