What is Sciatica and How Does It Cause Lower Back Pain?
Sciatica is an inflammation of the sciatic nerve, which is the longest nerve in the body running from the spinal cord across the buttock and hip area and down the back of each leg. It is actually a secondary symptom of another problem placing pressure upon the nerve, most often a herniated disk. Most prominent among the symptoms of sciatica is pain along the area of the nerve, which may cause considerable discomfort in acute cases. While this pain generally goes away on its own in four to eight weeks or so, it can reoccur if the underlying problem isn't addressed. In most cases, treatment involves self-help measures to ease sciatica related lower back pain. However in severe cases, doctors may suggest more aggressive treatments.
Common Symptoms and Complications of Sciatica Related Lower Back Pain
Sciatica is most commonly associated with pain radiating from the lower (lumbar) spine to the buttock and down the back of the leg. Discomfort can be localized to a certain area along the nerve pathway (i.e. the lower back, right buttock, left calf, etc.), but it usually follows a path along the lower back to the buttocks and back of the thigh and calf.
The pain can vary greatly, from mild aches; sharp, burning sensations; or excruciating discomfort; and often feels like a jolt or electric shock. This discomfort can be aggravated by lack of exercise, prolonged sitting, bad posture, and improper lifting techniques; and may be exacerbated by coughing or sneezing. Usually, only one lower extremity is affected.
Although it is rare, sciatica can potentially lead to permanent nerve damage including loss of feeling and/or movement in the affected leg. Additionally, extremely rare instances result in a loss of bladder or bowel control; a sign of cauda equina syndrome, a serious condition that requires immediate medical care. Untreated, it can lead to paralysis of the legs.
Leading Causes of Sciatica Related Lower Back Pain
Sciatica related lower back pain most frequently occurs as a result of a compressed nerve due to aherniated disk in the lower (lumbar) spine. These disks, which are pads of cartilage that separate the spinal bones (vertebrae), keep the spine flexible; acting as shock absorbers to cushion the vertebrae during movement. They consist of a tough, fibrous outer covering with a jelly-like substance in the center.
However, the disks can deteriorate as we age, becoming drier, flatter and more brittle. Eventually, the outer portion of the disk may develop tiny tears, causing the inner material to seep out (herniate or rupture). The herniated disk may then press on a sciatic nerve, causing pain in your back, legs or both. If the damaged disk is in the middle or lower part of your back, you may also experience numbness, tingling or weakness in your buttock, legs or feet.
Herniated Disks - The Leading Cause of Sciatica Related Lower Back Pain
Herniated Disks and Other Spinal Conditions That Can Lead to Sciatica
Related Lower Back Pain
In addition to herniated disks, there are several other conditions which can lead to sciatica related lower back pain including:
- Lumbar spinal stenosis, in which one or more areas in the spinal canal narrow, putting pressure on the spinal cord or on the roots of the branching nerves.
- Spondylolisthesis, often the result of degenerative disk disease, occurs when one vertebra slips slightly forward over another vertebra. The displaced bone may pinch the sciatic nerve where it leaves your spine.
- Piriformis syndrome, which causes the piriformis muscle, that runs directly above the sciatic nerve, to tighten or go into spasms.
- Tumors inside the membranes (meninges) that cover the spinal cord or in the space between the spinal cord and the vertebrae, Which can compress the cord itself or the nerve roots as it grows.
- Trauma from a car accident, fall, or blow to the spine.
Traditional Treatments for Sciatica Related Lower Back Pain
In most cases, sciatica can be treated with self-help measures. Continuing usual activities, while avoiding what may have triggered the pain may ease symptoms. Resting may also prove beneficial although, excessive inactivity could worsen symptoms. Some self-help measures that may help:
- Cold packs may help reduce inflammation and relieve discomfort, when applied to the painful areas for at least 15 to 20 minutes.
- Hot packs should be applied to painful areas or alternated with cold packs.
- Stretching the low back at least 30 seconds can help alleviate pain and relieve nerve root compression.
- Over-the-counter medications, such as aspirin and ibuprofen, and acetaminophen (Tylenol, others) can be helpful for sciatica related lower back pain. However, there's a limit to how much pain they can control and they can cause side effects; including nausea, stomach bleeding or ulcers.
- Regular exercise, low-impact exercises such as a stationary bicycle or water exercise can help patients stay active without aggravating the symptoms. Also, once the pain lessens, aerobicactivity with strength training and core exercises to strengthen the back muscles and limit spinal disk degeneration.
In severe cases, doctors may recommend more aggressive treatment beyond the self-help measures including:
- Physical therapy typically involving exercises to correct bad posture, strengthen the back muscles and improve flexibility, can play a vital role in recovery for a herniated disk and help prevent recurrent injuries.
- Prescription drugs such as anti-inflammatory medication or muscle relaxers may be used for short-term pain relief. Tricyclic antidepressants and anticonvulsant drugs may also ease chronic pain, by blocking pain messages to the brain or enhancing endorphin production, which act as natural painkillers.
- Epidural steroid injections, which suppress inflammation around the irritated nerve, and help to relieve pain. However, the number of injections you can receive is limited (usually to three per year) by the potential side effects and therefore are only usefull as a short-term solution.