Sciatica

Sciatica is a term that describes pain in the buttocks or legs that is caused by the sciatic nerve becoming compressed or irritated. This nerve runs from the feet, through the legs, buttocks and to the back of the pelvis. Sciatica symptoms may last for just a few weeks or many years. Everyone will experience sciatica symptoms differently according to what causes sciatica for them.

Sciatica occurs due to damaged discs in the spine, found in the lumbar region of the body.

The human spine consists of 33 bones or ‘vertebrae’ that are stacked one on top of the other to form the spinal column. Nerve fibres run through the whole of the spine, connecting the brain to each part of the body so that it can send and receive messages.

Vertebrae are held together with discs, which allow the spine to be flexible. Discs are made up of a hard outer casing with a substance inside that has a gel-like texture. Sometimes, a person can experience damage to these discs, where the soft, internal section of the disc bulges out of the external casing. This is known as a herniated disc, or a slipped disc.

A slipped disc may then press on or touch a nerve, which can result in pain around the area of the damaged disc. Sciatica causes pain in the lower back, buttocks and legs, due to a slipped disc and pressure to the nerves in that area of the body.

So, what triggers sciatica and damage to the spine? Here are the most common factors:

For more information on what causes sciatica, see the NHS Choices website.

You may also find the Spine Health website useful, which features an overview of sciatica, explained with an animated video.

Read on to find out more about sciatica symptoms and sciatica treatments available to you that can help manage the pain, including sciatica exercises and physiotherapy.

Symptoms may be exacerbated if you make sudden movements, such as sneezing or coughing, or when sitting or lying in certain positions for long periods of time.

For further information on symptoms of sciatica, see the NHS website.

Some physicians and professionals distinguish between two types of sciatica and the type you are diagnosed with determines the root causes of sciatica and your treatment plan. The first sciatica type is neurogenic, and is caused by disc damage and nerve agitation, as described in the section ‘what causes sciatica?’.

It is important to visit your GP to determine if you have sciatica. They will be able to rule out other conditions. Your GP will likely be able to diagnose sciatica by asking you to explain the symptoms you’re experiencing, so it’s important to inform them accurately of how you are feeling. You GP may physically examine you, or you may be asked to lie on your back and lift your legs individually, to ascertain if this causes pain. Your GP will then be able to suggest an appropriate treatment.

It is important to see your GP if you think you are experiencing sciatica as there are other, more serious but rare conditions that can lead to similar symptoms. If you feel numb around your legs and bottom or have unexplained, sudden incontinence, or shooting pains in both legs, you should call 999. These could be symptoms of a condition called cauda equina syndrome.

You will be able to monitor how your sciatica symptoms are progressing. If you are still experiencing pain and discomfort after an agreed timescale, your GP may offer you further medications such as:

Very rarely, some people require surgery to mend the damage to their spine, which may include procedures such as an open discectomy or microdiscectomy. These are only considered if your sciatica symptoms are prolonged, non-responsive to other treatments, or very severe.

Sciatica causes difficulty undertaking daily tasks for some people, and can cause discomfort when sitting, walking, or lying down. Sciatica symptoms can last for varying amounts of time, and each person experiences it differently, so the extent to how daily life is affected is hard to say. For some people, sciatica treatments will be very effective, and they will find ways to manage their pain. For others, it may take longer to recover.

At Healthcare Pro, we are experts in ‘daily living aids’. These are products designed to help people who are finding everyday activities difficult due to mobility problems or healthcare conditions. We have a range of products that may provide help for sciatica symptoms, encourage a better sitting or lying posture and ensure you can carry out tasks in greater comfort. Here are a selection of sciatica aids you may find useful:

If you would like to speak to one of our Occupational Therapists to find if there are any daily living aids that may help you or someone you care for, please email them productadvice@healthcarepro.co.uk or telephone 0345 121 8111.

Regular exercise is essential to maintain our health and wellbeing. Exercise increases blood flow to all parts of the body, strengthens muscles to take the pressure off bones and keeps tendons and ligaments flexible to reduce stiffness. A regular exercise routine can help to prevent aches and pains.

If you have sciatica and visit a physiotherapist, they will be able to show you exercises that strengthen specific muscles which have become inflamed and are causing nerve pain.

The NHS website provides a useful video demonstrating gentle exercises for sciatica.

Maintaining a healthy diet is important to keep the body functioning at its best. Being overweight is one of several sciatica triggers, due to increased pressure on the spine and muscles.

There is no specific diet for sciatica but some nutritional experts recommend eating foods that help combat inflammation, such as cheese and lamb that contain vitamin B12, and magnesium-rich foods such as seafood, brown rice and fish. Some people try taking these in tablet form as sciatica supplements. Other suggested sciatica supplements are bromelain, curcumin or St. John’s Wort, which are suggested as being anti-inflammatory remedies. We recommend consulting your GP before embarking on any new dietary regime or taking supplements for sciatica.

Most people with sciatica are able to work, but some people may find it difficult whilst they are experiencing pain. They may need to discuss this with their employers and take time off to recover. Some people may find that their job is having an adverse effect or even causing their sciatica, for example, if it involves manual handling or sitting down for long periods.

Facebook Back Pain & Sciatica Sufferer Support Group

PainSupport Forum

Pain Concern Forum

Backcare – provides advice if you have back or neck pain

Focus on Disability – provides information about various conditions affecting older people and people with disabilities, and their carers.

NHS – helps to explain health conditions in more detail

NICE – advice about the care you should expect to receive from a healthcare professional about sciatica

Amitriptyline

– medication that is part of a group of tricyclic antidepressants, which is also used to treat chronic pain

Cauda equina syndrome

– a serious medical condition where the ‘cauda equina’ area of the body, found at the bottom of the spinal cord, suffers pressure or swelling, causing sciatica symptoms. This condition requires immediate medical care, unlike sciatica caused by a slipped disc

Corticosteroids

– a medication which reduces swelling, inflammation, redness, and overactive immune system

Diazepam

– a type of benzodiazepine medication used for anxiety treatment as well as muscle spasms

Duloxetine

– an anti-depressant medication that is also used to treat pain

Epidural injection

– a method for administering drugs into the lower back to block pain signals

Gabapentin

– a drug that is used to treat nerve pain

Lumbar region

– the lowest section of the spine, consisting of 5 bones

Microdiscectomy

– similar to an open discectomy, but carried out with a smaller incision

Neurogenic

– related to the nervous system, which carries messages between the brain and spinal cord and out to all parts of the body

Open discectomy

– a surgical procedure to remove part of a disc that is prolapsed or slipped, to reduce nerve pressure

Pelvis

– the bones that form the bottom of the spine

Pregabalin

– a drug used to block nerve pain

Sciatic nerve

– the largest nerve in the body which runs down each leg from the lower back

Spinal stenosis

– a condition where the bones of the spinal column become narrowed

Spondylolisthesis

– a condition where one of the vertebrae (bones) in the back slips out of its usual position

Vertebrae

– the 33 bones in the spine