Diagnosing and Treating Sciatica.
- When you stand, does pain shoot from your lower back, down your thigh and maybe to your knee?
- Do you have tingling, numbness, weakness or difficulty moving your leg or foot?
- Does one side of your buttocks constantly ache?
- Do you have hip pain?
- Does your discomfort worsen when you bend at the waist, cough, sneeze or sit?
If you answered yes to any of those questions, there’s a good chance you’re suffering from sciatica.
This common condition, which often shows up in middle age, involves irritation to or inflammation of the largest nerve in the body. The sciatic nerve starts from nerve roots in the spinal cord in the low back and extends through the buttocks to send nerve endings down the lower limb.
Sciatica – not to be confused with other back pain – is often caused by a herniated disc in the lower back pressing on or pinching the sciatic nerve. Other causes include spinal stenosis, which is a narrowing of the spinal canal; nerve irritation from adjacent bone; tumors; infections; arthritis; injury; pregnancy; or prolonged sitting on an object such as a wallet in a back pocket.
Sometimes, no direct cause of sciatica can be found.
Doctors diagnose sciatica by conducting a physical exam and taking the patient’s symptoms and medical history into consideration. Sometimes, x-rays and other tests such as a CT scan, an MRI and an electromyogram are used as well.
Pain management specialists, chiropractors, orthopedists, rheumatologists, internists, general practitioners, physical therapists and massage therapists are among the health care professionals who evaluate and treat sciatica. It can last for days or weeks, or it can become a chronic ailment.
Traditionally, bed rest was the recommended treatment for sciatica. But how realistic is that approach? Many people, especially those who have jobs, children or other responsibilities, don’t have the luxury of lying around and doing nothing for weeks.
And there’s no guarantee that lying low will ease a bout of sciatica. One study by a research team in the Netherlands showed that patients who rested for three months showed a level of improvement equal to those who practiced “watchful waiting” during that period. The two groups also had similar rates of absenteeism from work and of surgical intervention.
So, what can you do to ease the agony of sciatica? Don’t expect to find a lasting solution from over-the-counter pain medications, heating pads, cold packs or dietary supplements. They either don’t help or provide only temporary relief.
Chiropractic adjustments performed over multiple sessions can be effective. TENS units, which send stimulating pulses across the surface of the skin and along the nerve strands, are sometimes useful, too.
Physical therapy, as well as low back conditioning and stretching exercises, are other options, as are muscle relaxers, cortisone injections, prescription medications, acupuncture and activity restrictions. For those whose sciatica results from nerve compression at the lower spine, surgery sometimes is required.
Once patients recover from sciatica, they need to use common sense and a healthy lifestyle to prevent it from coming back. That means exercising regularly, maintaining proper posture and bending at the knees while lifting heavy objects.