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Understanding Sciatica
From "ACE Certified News",
Volume 10, Number 1
December 2003/January 2004
Sciatica is a nerve-related condition that can have a major
impact on your fitness program and your ability to perform simple, daily
tasks with ease. A relatively common form of back pain, sciatica refers to
irritation of the sciatic nerve, which is made up of five
branches of nerves that come out of your lumbar and sacral spine.
In many cases, sciatica is caused by a
herniated disc that is putting pressure on the sciatic nerve. A herniated
disc, which is often brought on by a sudden twisting motion or injury, is
sometimes referred to as a slipped, ruptured, bulging or protruding disc, or
a pinched nerve. For others, sciatica may be caused by a narrowing of the
spinal canal, or stenosis, which can be congenital or may develop over time.
In this case, lesions can form and protrude into the canal and press on the
nerves. Sciatic irritation may also be caused by slippage of a vertebral
body in front of another, a condition known as spondylolisthesis. Poor
biomechanics, curvature of the back, weak abdominal muscles or pregnancy can
contribute to this slippage, which can press on the nerve.
Symptoms of Sciatica
As the longest nerve in your body, the sciatic
nerve runs down from your lower back through the back of your thighs, where
it divides into two branches just above your knees. It further branches out
into the muscles below your knees, all the way down to your feet. Classic
symptoms of sciatica often start out with back pain, which may improve over
time. However, you may begin to feel pain in one of your hamstrings or
calves, and some numbness or tingling in your toes.
For some people, the pain from sciatica can be
severe and debilitating. For others, the pain might be infrequent and
irritating, but has the potential to get worse. While sciatica can be very
painful, permanent nerve damage is rare. Fortunately, because the
spinal cord does not extend through the lumbar (lower) spine, there is no
danger of paralysis from a herniated disc in this area. (Note: If your
symptoms include progressive weakness in the legs or bladder/bowel
incontinence, this may indicate a serious condition called cauda equina
syndrome, which requires immediate medical attention.)
Treating Sciatica
How sciatica is treated depends on the severity
of the problem. You should, of course, see your doctor for an evaluation And
diagnosis if the pain is keeping you from everyday activities. Nerve pain is
caused by both pressure and inflammation on the nerve, and treatment is
concentrated on relieving both of these conditions.
For acute pain along the sciatic nerve, heat
and/or ice packs can help relieve pain. Begin by applying heat or ice for
about 20 minutes at a time, and repeating every two hours as needed. You can
also alternate the two to see if this provides more relief. For some people,
taking oral steroids or an anti-inflammatory such as ibuprofen will help. If
the pain is severe, your doctor may inject an epidural directly into the
affected area to reduce the inflammation that is causing you pain. Manual
treatments, osteopathic or chiropractic, may help relieve the pressure. Your
doctor may also suggest a physical-therapy program that includes
back-strengthening or lumbar-stabilization exercises. Fortunately, most
people with sciatica can expect their symptoms to improve within a matter of
days. For others, relief may come within two to three months. In a small
percentage of cases, where pain is severe and the combination of manual and
medical treatments have not provided relief, surgery may be necessary to
help relieve both pressure and inflammation.
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