It is believed throughout the medical and caregivers community that sciatica afflicts every adult at some time in their life, costing billions of dollars in health care and more lost days of work than anything aside from the common cold.
Low back pain and sciatica can baffle physicians and other medical professionals, as it oftentimes occurs without warning in healthy, fit individuals and is capable of continuing for long periods of time.
Have you had your sciatica yet?
Simply put, sciatica is an inflammation or irritation of the sciatic nerve.
This nerve path affects the lower back, buttocks, upper legs, behind the knees and into the calf area.
Individuals who have sciatica are often crippled by it and driven to seek relief from conventional medical treatment, alternative therapies and "miracle" cures.
Sciatica symptoms are pain, burning, tingling or electric shock-like feelings in the path of the sciatic nerve.
These painful feelings might rundown the back of the leg and the back of the knee, from the mid- buttock down the leg or at various locations at the calf. An aching lower back might also develop in part from muscle tension to compensate for the buttocks/leg pain. If you feel these symptoms accompanied by weakness and/or changes in sensation (tingling, jolts, hot and cold, numbness) along the path that the sciatic nerve travels, or numbness or weakness in the skin and/or muscles that the nerve's fibers serve, then you quite likely are suffering from sciatica. A confirmation from a medical professional is highly recommended.
If it is true that most adults will suffer from sciatica at some time, what causes this almost-universal torment? In the literature of 15th-century Florence, the term sciatica was used and cited as a suspected cause for tuberculosis and arthritis.
The literature gives proof to this malady's mark in history and medical researchers' long-lasting quest for understanding and treatments _ hundreds of years' worth.
Sciatica arises from injury to the fibers of the sciatic nerve. The fiber injury could be from a herniated or slipped disc; this is by far the most common cause of sciatica. Pressure emanating from the piriformis muscle in the buttock can cause pressure on, or pinching, of the fibers that make up the sciatic nerve. Slippage of one vertebra so that it is out of line with those above or beneath it (spondylolisthesis) is another possible cause that may have taken years or even a life time to develop.
In general terms, there are four common causes of sciatica:
1) Especially for men who first complain of sciatica symptoms, a care provider might ask where he carries his wallet. Even a thin wallet that is habitually carried in the back pocket can cause a sciatic irritation, prevalent in those who spend a lot of time in a vehicle or seated with the ever-present wallet causing an imbalance. Overuse of muscles by constant sitting, prolonged standing on a hard surface, twisting while bending and lifting and over-exercise of the gluteus muscles can all bring on the pain of sciatica.
2) Trauma from a fall, a fracture, a jarring twist or pull of muscles, especially in the lower back and hip area, can create long-lasting sciatic nerve irritation
3) Uncommon situations that may cause sciatica or aggravate the condition are infections such as tuberculosis and autoimmune diseases such as lupus.
4) The link between stress and sciatica is common, but sometimes it becomes a question of which came first. Chronic tension, tightened muscles, inability to relax, rest and sleep certainly might lead to an inflammation of the sciatic nerve. Conversely, the sensitive and continuous pain associated with sciatica can create a high level of stress from the painful situation.
With proper diagnosis, the cause of most sciatica can be identified and the condition can be cured or greatly alleviated. Communication and cooperation between the care professional and patient are crucial. A diagnosis usually does not take multiple visits or a tremendous amount of testing if it is sciatica causing the pain. Often a physician may order a MRI, CAT scan and electromyography immediately to rule out any complicating factors but conservative therapy is typically used as the first line of treatment after diagnosis.
Typically, when someone begins to suffer from sciatica, he or she will self-medicate with over-the-counter pain relievers such as ibuprofen. In mild cases this, along with rest, will be enough, but if the sciatic condition persists, the person will typically seek help from a medical professional. Because sciatica can cause irritability and loss of sleep, in addition to persistent pain, patients become desperate for relief.
Massage, physical therapy, acupuncture, chiropractic care, rest, exercise and addressing outside influences can ease or eliminate the condition. Acupressure, meditation and yoga can also be effective, in addition to making changes in environmental factors such as the bed mattress, chair style, desk height and floor padding. Under the care and direction of a physician, injections of anesthetics, steroids treatment or surgery are the next level of treatment usually not considered unless tests show this necessary and the person is not responding to any other treatment.
Medical doctors, physician assistants and nurse practitioner all are placed on the front lines of identifying sciatica. Previous to many major medical insurers integrating alternative care options in their coverage packages, the traditional medical field was the only option for many. Family health nurse practitioner Joanne McLaughlin of Roxbury said she sees many patients with sciatica. Once the condition is diagnosed, physical therapy and, if necessary, pain management classes are prescribed.
McLaughlin recommends preventative measures of muscle strengthening and exercise as well as becoming familiar with your body mechanics. Anyone who has additional or complicating factors in his health is strongly encouraged to seek out help with sciatica by first meeting with his regular health-care provider. McLaughlin stressed that surgery is the last-resort decision for addressing sciatica.
Many who have never had chiropractic treatment before might not have considered this avenue to treat pain and sensitivity down their legs. But chiropractors are a valuable resource for sciatica relief. Treatments often involve stimulating the inflamed nerve and relaxing it with heat and vibration. Manipulation of the lower spine might also be involved.
Licensed physical therapist Mary Dolan said she sees most of her clients through a physician's office, and usually they have already had MRIs and scans to determine if there are any other complications causing the sciatica. Physical manipulation, massage, acupressure, stretching and exercise are all incorporated into the treatment program. Once a person is out of the immediate pain and discomfort, she is better able to integrate stretching and gentle exercise into the healing process.
Acupuncturist and Chinese herbalist Colleen Blacklock stated that sciatica and low back pain are the most prevalent conditions that she treats. By inserting tiny needles into acupuncture points in the arms and legs, she can help a client experience instant relief, she said. Blacklock explained that typically acute conditions respond to treatment much more rapidly than chronic sciatica and most patients will need a series of treatments. She usually recommends complex and highly specific Chinese herbal formulas that help to speed healing and increase blood circulation instead of masking the pain with painkiller medications, she said. Though painkillers can sometimes work to relax the muscles enough to resolve the sciatica, they can also give a false sense of relief and create more problems, she said.
Licensed massage therapists such as Joan Marzeski typically have a great deal of experience relieving their clients' sciatica pain. Massage can release tense muscles and this relieves the sciatic nerve irritation. Marzeski said that many new clients will not realize just how tense they are until they get a massage. There are many people who are apprehensive about getting a massage, they are uncomfortable about being touched or are unsure about what a massage entails. Marzeski said she likes to reassure those new to massage that they can keep all their clothes on if that would make them more at ease. Many people getting a massage keep underclothes on and will let a massage therapist know if there are areas that are overly sensitive to touch. There are many different forms of massage and most massage therapists tend to specialize in a certain style. Generally the Swedish style massage is a more gentle approach, while deep-tissue massage can be physically intense. Acupressure and connective tissue massage are other styles.
An excellent website to visit for an easy-to-understand description, causes and treatments of sciatica is www.sciatica.org. Asking family, neighbors and co-workers about their experience with sciatica before deciding on a certain method of treatment can be encouraging, especially when you discover the number of people who suffer or have suffered in the past from sciatica.
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