You know the pain can’t be ignored when simple movements or even coughing hurts your lower back…
Sciatica feels like a sharp pain running from your lower back into your buttock or leg, and it can be almost impossible to ignore. You might also notice tingling, numbness or weakness, and often sitting, bending or other simple movements make the pain worse.
These can all be symptoms of sciatica, a type of nerve pain associated with irritation or compression of the sciatic nerve or the nerve roots that form it.
Sciatica can range from a relatively mild irritation to pain that makes walking, sleeping, working and everyday activities difficult. The good news is that many people recover well. However, because several different conditions can produce similar symptoms, identifying what is actually causing your pain is a challenging but important first step.
So, what is sciatica?
The sciatic nerve is the largest nerve in the body. It starts from nerve roots in the lower spine and travels through the buttock and down the leg, with branches extending all the way into the foot.
‘Sciatica’ is the description given to the symptoms occurring when the sciatic nerve or its nerve roots have become irritated, inflamed or compressed. Rather than being a condition in itself, sciatica is better thought of as a collection of symptoms caused by an underlying problem affecting the nerve. So because of the size of the nerve and the various issues it can face, the types of pain can really vary.
One of its most recognisable features is radiating pain. Instead of pain remaining solely in the lower back, it may travel through the buttock and down the back or side of the leg. Sciatica often affects one side of the body, although symptoms can sometimes occur on both sides.
What are sciatica symptoms?
Sciatica does not feel exactly the same for everyone. The location and severity of symptoms can depend on which nerve roots are affected and the degree of irritation.
Common symptoms can include:
- Pain travelling from the lower back or buttock into the thigh, calf or foot
- Sharp, shooting or electric-shock-like pain
- Burning or aching sensations
- Pins and needles or tingling in the leg or foot
- Numbness
- Weakness in the leg or foot
- Lower back pain
- Pain that becomes worse with sudden movements like coughing, sneezing, or bending
For some people, the leg pain is considerably more noticeable than their back pain.
These symptoms do not necessarily mean you have sciatica. Other musculoskeletal and neurological conditions can cause these common leg pains, tingling or numbness, which is why an appropriate assessment is important to hone in on the cause of your pain before attempting treatment or exercises.
What are the most common causes of sciatica?
Sciatica occurs when the sciatic nerve or the nerve roots contributing to it become irritated or compressed. One of the most common causes is a herniated lumbar disc.
The discs between the vertebrae act as cushions within the spine. If a disc bulges or herniates, it can irritate or place pressure on a nearby nerve root.
Other common causes can include:
DJD or Degenerative Joint Disease: Also known as osteoarthritis. When the protective cartilage that cushions the ends of your bones gradually break down over time and can cause nerve compression.
Spinal stenosis: Narrowing within the spinal canal can reduce the space available for nerves.
Spondylolisthesis: This occurs when one vertebra moves forwards in relation to the vertebra below it, potentially affecting nearby nerves.
Age-related changes: Changes in the discs, joints and other structures of the spine can sometimes contribute to nerve irritation.
Injury or physical stress: An injury involving the lower back may occasionally irritate structures around the nerve.
Often sciatica is caused from a combination of these issues. If this doesn’t match your causes, note that there are various other less common reasons including complex situations requiring more detailed scans. Determining the likely cause is therefore more useful than simply treating every case of radiating leg pain in the same way.
What happens if I don’t get my sciatica treated?
Some cases of sciatica improve over time, and having sciatica does not necessarily mean you will develop long-term nerve damage.
However, symptoms can sometimes persist for months or become chronic. Ongoing pain can interfere with sleep, work, exercise and everyday movement, as well as affecting overall quality of life.
Given the complexity of where the nerve can be impacted, it can also difficult to know what activities to change or reduce to improve your situation. This is why many can fall into the trap of exercising less, which ultimately impacts quality of life and can introduce other issues.
People can also adapt to sciatica subconsciously, such as changing posture or positioning to avoid discomfort. While helpful in the short term, they can become habitual and have larger implications for your function in the long run.
Most importantly, worsening neurological symptoms should not be ignored.
Seek urgent medical attention if your back or leg pain is accompanied by new problems such as changing in bladder or bowel control, numbness in the pelvic region, or significant or worsening weakness or numbness in the legs. These symptoms can indicate a serious neurological problem requiring immediate assessment.
If your symptoms are persistent, worsening or interfering significantly with normal activities, it is sensible to have them professionally assessed rather than simply waiting for them to disappear.
Can I treat sciatica on my own?
Mild sciatica can often improve, and staying gently active with correct movements can assist recovery. Low-impact movement and gradually returning to normal activities may be more appropriate than prolonged bed rest.
The difficulty with self-treatment is not knowing why your symptoms are occurring in the first place.
Pain travelling down your leg does not always have the same cause. Without an assessment, you may choose exercises or stretches that are poorly suited to your particular presentation. You may also overlook weakness, altered sensation or another sign that requires further investigation.
This does not mean you need treatment every time you experience a minor ache. But attempting to diagnose and manage persistent sciatica entirely on your own introduces unnecessary uncertainty and may delay appropriate care, or make your pain worse.
An assessment can help you find out what movements are appropriate, what you should temporarily modify in your activities and whether referral or further investigation is required.
Can you completely recover from sciatica?
Absolutely. Many people with sciatica recover, often within weeks to a few months, although recovery times vary considerably from person to person.
Your recovery can depend on the underlying cause, how severe the nerve irritation is, how long symptoms have been present and your general health and activity levels.
Some people experience recurring episodes of sciatica, while others may have symptoms that continue for longer than expected. This is another reason why understanding the underlying factors contributing to your sciatica can be helpful. And the sooner the better.
Once symptoms settle, maintaining regular movement, exercising appropriately, lifting safely and managing the physical demands placed on your lower back may help reduce the likelihood of future problems.
How can chiropractors help with sciatica?
Given the relationship of the sciatic nerve pain originating from the spinal column, chiropractors are uniquely placed to diagnose and treat all kinds of sciatica. This is why chiropractic care for sciatica should begin with an assessment rather than assuming that every case requires the same treatment.
At Northside Chiropractic in Preston, your initial consultation includes consideration of your health history and symptoms along with physical, functional, postural and neurological assessment. The aim is to develop a working diagnosis and determine whether chiropractic care is appropriate for you.
Depending on your situation, a treatment plan may include techniques such as chiropractic adjustments, joint mobilisation, soft tissue work, massage and rehabilitation exercises. Care can be modified as your condition and symptoms change, and of course your movement goals.
Sciatica can be painful and frustrating, but you do not have to guess what is causing your symptoms or which movements you should avoid. A proper assessment can help you understand what may be contributing to your pain and help put together an appropriate plan for moving forwards.
If you are experiencing pain travelling from your lower back into your buttock or leg, book an appointment with Northside Chiropractic in Preston for an individual assessment and personalised care plan.