Sciatica

Sciatica is a weakness and/or changes in sensation (tingling, jolts, hot and cold, numbness) along the path the sciatic nerve travels. Irritation or damage to lumbar nerve roots is often also referred to as lumbar radiculopathy.

Lumbar radiculopathy (Sciatica) is the most common form of this problem. Radiculopathy can occur in any of the nerves coming out of the spinal cord. The problems caused depend on which nerves are involved. The sciatic nerve is the large nerve supplying the branches of nerves going from the hip to the toes. It often causes a numbness or weakness in the skin and/or muscles that the sciatic nerve serves. It also may cause symptoms (problems) of pain, burning, tingling, or electric shock-like feelings in the path of this nerve. This usually comes from injury to the fibers that make up the sciatic nerve. Some of these symptoms are low back pain and/or unpleasant feelings in the following areas:

  • From the mid-buttock down the back of the leg to the back of the knee.

  • And/or the outside of the calf and top of the foot.

  • And/or behind the inner ankle to the sole of the foot.

CAUSES

  • Herniated or slipped disc. Discs are the little cushions between the bones in the back.

  • Pressure by the piriformis muscle in the buttock on the sciatic nerve (Piriformis Syndrome).

  • Misalignment of the bones in the lower back and buttocks (Sacroiliac Joint Derangement).

  • Narrowing of the spinal canal that puts pressure on or pinches the fibers that make up the sciatic nerve.

  • A slipped vertebra that is out of line with those above or beneath it.

  • Abnormality of the nervous system itself so that nerve fibers do not transmit signals properly, especially to feet and calves (neuropathy).

  • Tumor (this is rare).

Your caregiver can usually determine the cause of your sciatica and begin the treatment most likely to help you.

TREATMENT

Taking over-the-counter painkillers, physical therapy, rest, exercise, spinal manipulation, and injections of anesthetics and/or steroids may be used. Surgery, acupuncture, and Yoga can also be effective. Mind over matter techniques, mental imagery, and changing factors such as your bed, chair, desk height, posture, and activities are other treatments that may be helpful. You and your caregiver can help determine what is best for you. With proper diagnosis, the cause of most sciatica can be identified and removed. Communication and cooperation between your caregiver and you is essential. If you are not successful immediately, do not be discouraged. With time, a proper treatment can be found that will make you comfortable.

HOME CARE INSTRUCTIONS

  • If the pain is coming from a problem in the back, applying ice to that area for 15 to 20 minutes, 3 to 4 times per day while awake, may be helpful. Put the ice in a plastic bag. Place a towel between the bag of ice and your skin.

  • You may exercise or perform your usual activities if these do not aggravate your pain, or as suggested by your caregiver.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • If your caregiver has given you a follow-up appointment, it is very important to keep that appointment. Not keeping the appointment could result in a chronic or permanent injury, pain, and disability. If there is any problem keeping the appointment, you must call back to this facility for assistance.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You experience loss of control of bowel or bladder.

  • You have increasing weakness in the trunk, buttocks, or legs.

  • There is numbness in any areas from the hip down to the toes.

  • You have difficulty walking or keeping your balance.

  • You have any of the above, with fever or forceful vomiting.