Sciatica is a condition caused by the irritation or compression of the sciatic nerve. This nerve is the longest in the body and runs from the base of the spine, through the buttocks and down both legs, into the feet.
There are two types of sciatica:
- Acute – lasting up to 6 weeks. This will usually pass without the need for treatment
- Chronic (or persistent), which can last a lot longer than 6 weeks. This often requires the help of a physiotherapist and, in rare cases, surgery.
What causes it?
Sciatic pain is usually caused by the compression of the nerve at its root (i.e. the spine). In young and early middle-aged adults, the most common cause of sciatica is a prolapsed intervertebral disc in the lumbosacral area of the lower back, according to BBC Health.
The spine is made up of vertebrae, discs and nerves. Vertebrae are the blocks of bone that make up the structure of the spine and protect the nerves and are supported and cushioned by discs. A slipped disc occurs when the outer part of the disc splits, allowing the gel inside to bulge between the vertebrae. When this presses against the sciatic nerve, it can cause severe pain (sciatica).
The older a person gets, the harder and more brittle his or her discs become. Repeated strain on the back means there is a greater chance of a hardened disc splitting and rupturing.
Another possible cause of sciatica is spinal stenosis, according to the NHS. This is defined by the narrowing of nerve passages in the spine. It occurs when the bones, ligaments or discs squash the nerves of the spine (usually the sciatic nerve), causing pain in the lower back and legs. It usually affects people in late middle age and older.
What are the symptoms?
Sciatica is unlike ordinary back pain, as it is concentrated in the lower back and runs down one or both legs.
Sufferers may also experience numbness, tingling and muscle weakness in the affected leg. It can get worse when coughing or moving, and is sometimes accompanied by lower back pain. Loss of tendon reflexes is also common, the NHS states.
More serious symptoms such as loss of sensation around the genital area and buttocks, difficulty passing urine or opening your bowels all require urgent medical attention.
How is it treated?
Sciatica can usually be treated through the following:
- Hot or cold compression packs to reduce the pain
- Exercise – it is important to remain as physically active as possible. In severe cases it is often advisable to enlist the help of a physiotherapist
- Cognitive Behavioural Therapy has been shown in studies to help sufferers to live and come to terms with chronic sciatica
In certain rare and severe cases the sufferer may require surgery to ease symptoms. This, according to the NHS, may be necessary if:
- There is an identifiable cause, such as a slipped or herniated disc
- The symptoms have not responded to other forms of treatment
- The symptoms are getting progressively worse