Sciatic pain involves the body’s longest nerve. Two treatments alleviate the pain and both of them make taking good care of your back a lifetime mission.
By Dona Suri
It can come on in an instant. One minute you’re moving normally, and the next you are paralyzed by a pain straight out of hell. No pain-killer seems strong enough to give you relief. If you have had it before, then there is no mistaking the problem: “My sciatica is acting up again.” Sciatic pain is excruciating in itself, and it’s also a pain in the sense that you can’t guess how long it will last. The pain may pass after a couple days of rest, or you may be in for months of medication and physiotherapy.
It is common to call any pain in the back, hip or leg “sciatica” … common, but not necessarily accurate.
Sciatica is caused by injury or pressure on the SCIATIC NERVE.
The sciatic nerve is the longest nerve in the body. Five nerve roots in the lower spine come together to form the sciatic nerve which passes deep in the buttock and down the back of the thigh all the way to the heel and sole of the foot.
It is a MOTOR nerve, which means when you want to move your legs, the “move” message from the brain passes down the sciatic nerve to the large muscles in the back of the thigh, down to the calf muscles, anterior leg muscles and on to muscles in the feet.
It is also a SENSORY nerve: if you step on a thorn, the “pain” message from your foot travels up the sciatica nerve to the brain.
Not every back pain is a sciatic pain. Several quick, simple tests of flexibility tell a doctor whether or not a pain in the back or leg is related to the sciatic nerve or is caused by something else. For most people, sciatic pain is a shooting or shock-like pain that blitzes from the lower back down the leg to the foot, along the sciatic nerve. A dull, persistent ache in the back is caused by something else.
If the sciatic nerve is indeed the cause of your misery, then you are a member of a very large club: four out of ten Americans will suffer from this type of pain at least once in their life. People most likely to be affected are between 30 and 50 years old and male. Sciatic nerve pain strikes people in strenuous jobs who do a lot of lifting … but it is also likely to affect people whose occupation requires sitting for long hours with little opportunity for exercise. The actual name of this condition is lumbar radiculopathy.
A look at the spine in the lower back reveals why that big nerve is giving big trouble. The spine is a stack of bones called vertebrae. Placed between the vertebrae, like shock absorbers, are rubbery cushions called discs. Each has a soft, jellylike center (nucleus) encased in a tough, rubbery exterior (annulus). When a part of the nucleus pushes out through a tear in the annulus, it is a herniated, or ruptured, disc. Also called a slipped disk. When the injured disc presses on the sciatic nerve, it hurts – seriously ! Nine out of ten cases of sciatic nerve pain are caused by herniated disk.
There’s another cause. Foramina are little openings inside the body that allows one part of the body to connect with another. The small nerves in the lower back that merge into the big sciatic nerve come out from between the vertebrae by way of such foramina. If these opening become narrow (in Greek, the word is stenos) then the nerves are pinched. Doctors call this foraminal stenosis and the result is pain all up and down the sciatic nerve.
More rarely, the problem is that the spine is unstable: one or more vertebrae become deformed or dislocated and pinch the roots of the sciatic nerve. Very, very rarely, the sciatic nerve is compressed by tumors, cysts, infections, or abscesses in the lower spine or pelvic region.
Over-the-counter painkillers for people with lumbar radiculopathy are useful and so are hot or cold compresses to soothe the lower back. A back brace can also help. These braces are designed specifically to protect the sciatic nerve. They provide enough compression and support to prevent further injury and encourage healing. A brace works like a crutch to assist your core muscles in absorbing the force exerted by activities of daily living, e.g., getting up/down, walking, bending, turning. However, just as crutches should be temporary, a back brace shouldn’t be used as a long-term pain management strategy.
Symptomatic relief is not cure.
Regaining a life free of sciatic pain will most likely involve two long-term treatments:
Treatment Number One consists of four to six weeks of sessions with a physical therapist to improve muscles, correct posture and learn movement habits that minimize damage to the vertebrae or discs.
Treatment Number Two focuses on substituting healthy habits for bad habits. Chiefly, this mean achieving and maintaining correct weight.
Giving the back a rest might seem like the logical way to overcome sciatic nerve pain but, in truth, rest is not what helps. The better option is a structured exercise routine – not just any exercise but those movements that avoid putting pressure on the spine but instead restore the spinal discs, improve muscle and bone strength, and tone up the sciatic nerve. A quick search on the internet – specifically YouTube– will turn up many sites that demonstrate exercises that lead to reduction in lower back and leg pain. The common sense rule for any exercise routine is
Start Easy,
Persist Day-by-Day,
Build the Body’s Capability Step by Step.
This is particularly valid for back pain sufferers who are determined to launch into Do-It-Yourself treatment.
If sciatica pain does not go away, but increases, or if there are any red-flag signs such as weakness or loss of control of bowel or bladder, it calls for immediate medical intervention.
Many products can give relief from sciatic nerve pain:
- Analgesic tablets
- Pain relief ointments
- Bags, warm and cold
- Lumbar-sacroiliac belts
- Posture correctors
- Deep tissue massagers
- Lumbar support cushions
If you suffer from sciatica, then Taking Good Care Of Your Back Is Important.
If you have never suffered from sciatica but know that it’s a pain you never want to feel, then Taking Good Care Of Your Back Is Important.
What is “good care”?
- When it comes to any type of intense movement involving the spine, learn and practice the postures that keep the vertebrae straight and aligned. This applies whether you are lifting something, showing off your dance moves or bungee-jumping.
- The spine endures some wear-and-tear every day. Get adequate sleep so that the body in general and the spine in particular get a chance to repair and recuperate. Sleep on your side so that the spine does not suffer much pressure.
- The spine is supposed to move. Exercise that stretches and strengthens the body’s core muscles decreases the risk of back pain. Walk. Climb the stairs. Move.
- Watch your weight. Less weight means less pressure on the spine.
- The spine is not only about support and movement, it also protects the nervous system. Damage to the spine can affect vital organs and impact the entire body.
All this adds up to a LIFE-TIME MISSION. And it’s worth it. A healthy spine – which means a happy sciatic nerve – is essential if you want to lead a long, active life.