Glenn Ellis

*You know what it feels like: shooting pain down your leg. You might also have tingling or numbness. Your doctor says it’s sciatica, but surprisingly, sciatica isn’t actually a medical condition. It’s a medical term used to describe symptoms (the shooting pain, tingling, and numbness) caused by a low back condition.

Here’s how it happens. Nerves extend from the brain into the arms and legs to send messages to the muscles or skin. A nerve that leaves the spine to go into the arms or legs is called a peripheral nerve.

Peripheral nerves are bundles of millions of nerve fibers that leave the spinal cord and branch outward to other parts of the body such as muscles and skin. For example, these nerves make muscles move and enable skin sensation (feeling).

A pinched nerve in the low back usually is perceived as radiating down the leg.That means that your sciatica could be caused by a bulging disc or a herniated disc, pregnancy, spinal stenosis, a spinal tumor or spinal infection, or trauma.

Any one of those conditions can put pressure on the sciatic nerve or related nerve roots in your low back. And that pressure is what causes your pain and other symptoms.

The term sciatica describes the symptoms of leg pain and possibly tingling, numbness or weakness that originates in the low back and travels through the buttock and down the large sciatic nerve in the back of the leg.

Good news! The vast majority of people who experience sciatica get better with time (usually a few weeks or months) and find pain relief with non-surgical sciatica treatment. For others, the pain might be infrequent and irritating, but has the potential to get worse.

While sciatica can be very painful, it is rare that permanent sciatic nerve damage (tissue damage) will result.

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.

As stated earlier, in many cases, sciatica will improve and go away with time. Initial treatment usually focuses on medicines and exercises to relieve pain. You can help relieve pain by:

•          Avoiding sitting (unless it is more comfortable than standing).

•          Alternating lying down with short walks. Increase your walking distance as you are able to without pain.

•          Taking acetaminophen (Tylenol) or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve).

•          Using a heating pad on a low or medium setting, or a warm shower, for 15 to 20 minutes every 2 to 3 hours. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours. There is not strong evidence that either heat or ice will help, but you can try them to see if they help you.

Exercise like swimming strengthen the muscles that support the back without putting any strain on it or subjecting it to a sudden jolt, and can prevent and reduce the symptoms of sciatica. Yoga or Pilates can help improve the flexibility and the strength of the back muscles. Bad posture can aggravate sciatica. Taking measures to improve it can alleviate pain and swelling:

Standing

Stand upright with a straight back and front-facing head. Weight should be balanced evenly on both feet and legs kept straight.

Sitting

Sit upright with a support, such as a cushion or rolled-up towel in the small of the back. Knees and hips should be level and feet should be flat on the floor, with the aid of a footstool if necessary.

Driving

As with sitting, the back should be properly supported. Correctly position wing mirrors to prevent having to twist the back. Foot controls should be squarely in front of the feet. If driving long distances, regular breaks should be taken to stretch legs.

Sleeping

Sleep on a medium-firm mattress (not too firm). The mattress should be firm enough to support the body while supporting the weight of the shoulders and buttocks, keeping the spine straight. Support the head with a pillow, but make sure the neck is not forced up at a steep angle.

Lifting and handling

To prevent injury-caused sciatica, the correct method for lifting and handling objects should be followed.

Additional treatment for sciatica depends on what is causing the nerve irritation.

If the sciatica pain is severe and has not gotten better within six to twelve weeks, it is generally reasonable to expect spine surgery to be recommended by your doctor.

Surgery speeds the resolution of pain. Two years after surgery, however, surgical and non-surgical management have about the same results; so whatever you are most comfortable with can be a valid reason to choose one or the other.

If sciatica is new to you, perhaps the most important thing to do after a days rest is to start doing gentle stretching and exercise. This may be the last thing you want to think about, particularly when it is even painful just to move. Sometimes the best way to get started is to do some gentle stretches before you get out of bed. Always ask your heath care provider what stretches or exercises are most suitable for you.

Remember, I’m not a doctor. I just sound like one.

Take good care of yourself, and live the best life possible.

Glenn Ellis, author of Which Doctor? is a health advocate/columnist and media commentator who lectures on health and medical topics. For more health information email me: [email protected] or visit: www.glennellis.com