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Sciatica

At least every other day people come in with grimaces …“I’m getting a pain shooting up my leg…sometimes it’s so sharp I can barely stand or walk!” A very common complaint experienced by clients, many unaware of the actual name for the problem they are experiencing or how to treat it. If this description fits you, it’s sciatica, a nerve related problem.

Sciatica is not a medical diagnosis, but rather a symptom of an underlying problem in the lower back. However, the clinical diagnosis of sciatica is referred to as a “radiculopathy.” It is where a disc protrudes from its usual position in the vertebral column and is putting pressure on the radicular nerve (nerve root) in the lower part of the back.

Sciatica occurs most frequently in people between 30 and 50 years of age. Often a particular event or injury does not cause sciatica, but rather the sciatic pain over time tends to develop as a result of general wear and tear on the structures of the lower spine..

Generally, sciatica can get better with time, usually within weeks or a few months with the aid of non-surgical treatments. In some instances, however, the severity of the condition cannot be cured via alternative methods; living with the condition or surgery may then be the only options.

Symptoms

Sciatica symptoms occur when the large sciatic nerve is irritated. It’s the largest single nerve in the body and is composed of individual nerve roots that start by branching out from the spine in the lower back.

While sciatica can be very painful, it is rare that permanent sciatic nerve damage (tissue damage) will result. The symptoms sometimes make it almost impossible to carry out routine tasks like sitting, standing up or walking, and could include the following:

  • Pain from the lower back, straight down to the back of the calves

  • Tingling/burning/pins and needles in the feet and toes

  • Weakening of muscles/numbness of the legs.

Causes

Here are some conditions that may bring about sciatic nerve problems:

  • Lumbar spinal stenosis – a condition which usually affects the over 60 age group. It’s a narrowing of the spinal canal resulting from the aging process in the spine. It can cause a number of issues…bulging of the disc which in turn places pressure on the nerve roots that are exiting the spine, soft tissue overgrowth, and facet joint enlargement.

  • Sciatic nerve injury or spinal tumor – the sciatic nerve itself may be affected by an injury or tumor.

  • Piriformis syndrome – The piriformis muscle starts at your lower spine and connects to each thighbone (femur). Piriformis syndrome occurs when the muscle becomes tight or goes into spasms, putting pressure on the sciatic nerve. Prolonged sitting, car accidents and falls can contribute to piriformis syndrome.

  • Lumbar herniated disc – where leaking of the gel like substance in your spine seeps and presses onto a nerve causing pain. Most discs weaken over time due to repetitive stress with the final result being a herniation. A herniated disc is sometimes referred to as a slipped disc, ruptured disc, bulging disc, protruding disc, or a pinched nerve, and sciatica is the most common symptom of a lumbar herniated disc.

  • Spondylolisthesis – this condition, often the result of degenerative disc disease, occurs when one vertebra slips slightly forward over another vertebra. The displaced bone may pinch the sciatic nerve where it leaves your spine.

  • Trauma – A car accident, fall or blow to your spine can cause damage to the nerves.

Many conditions can contribute to your muscles, joints and bones being affected and as a result cause pains.

Risk Factors

Factors related to sciatica are:

  • Fluctuation in blood sugar which increases the chance of nerve damage in diabetics.

  • Deterioration of body parts/organs as one ages, and this is no different with the discs.

  • One’s profession (worse if you sit for extended periods), or extra curricula activities.

Treatment

A number of treatment options are available to aid in pain alleviation.

  • Ice/Heat

  • Aquatherapy

  • Electrical Therapy

  • Epidural Steroid Injections

  • Acupuncture

  • Massage Therapy

  • Manual Manipulation

  • Strengthening Exercises

  • Stretching Exercises

  • Low Impact Aerobic Exercise

  • Surgery.

The choice of therapy is almost always the patient’s decision. However, it’s useful to take note of your doctor’s recommendations regarding your options.

Your feet mirror your general health . . . cherish them!

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