Sciatica: Causes, Symptoms, Diagnosis and Treatment

Sciatica is the most commonly known name of the pain that results from the severe irritation of the sciatic nerve, the largest nerve in the human body. Located in the lower part of the body, which not surprisingly is where the pain originates, the nerve starts from the spinal cord and extends continually through the buttocks.

Commonly caused by a herniated disc that presses against the nerve, any subsequent inflammations or irritations of the nerve produce the symptoms. The possible causes of the condition are actually quite endless, ranging from infections, irritation of the bone, internal bleeding, muscle cramps, tumors, and several other uncommon types of injuries.

Specifically, conditions such as lumbar spinal stenosis, in which certain areas in the spinal canal narrow, putting extreme pressure on the spinal cord, spondylolisthesis, in which one vertebrae painfully slips over another, displacing the bone, and piriformis syndrome, in which the piriformis muscle becomes significantly tight and likely goes into spasms, putting an intense amount of pressure on the sciatic nerve, serve as additional causes aside from the more conventional herniated disc.

The presence of sciatica is often discernable due to the searing pain that an ailing sufferer can and will likely feel in his or her lower leg, posterior thigh, or feet. This pain, while not to discount the lower back pain that often also serves to cause incredible discomfort, is usually worse and will cause the patient to quite possibly experience anything from simply moderate discomfort to extremely severe pain in the lower part of the body, beginning in the buttocks and running all the way down to the feet. True sciatica produces a sharp, unnerving pain that more often than not radiates well beyond the area of the knee, until the leg pain in the patient becomes far worse than the back pain, which, for all intents and purposes, becomes almost a non-issue.

The pain from true sciatica has also been known to gradually localize itself to the back of the leg, as well as the buttocks, in a situation where the sufferer may then feel a prickly, aching pain that courses all the way to the feet. Even so, often times there will not be a specific event or traumatic occurrence that would indicate the onset of sciatica. However, on occasion other ailments such as weak and diminished bowel and bladder functions will accompany the condition as rare but possible symptoms.

While the pain can vary from being merely a mild ache to turning into a sharp and intense pain, there is often a burning sensation or even a feeling of an electric sensation or jolt that accompanies it. The pain from sciatica will often start gradually and intensify over a short period of time, becoming significantly worse through frequent sneezing or coughing, as well as prolonged walking or sitting. Numbness and muscle weakness, especially in the leg or foot, as well as a tingling feeling in the toes, are quite common for sufferers to experience in addition to the searing pain.

The most critically important step in the accurate and appropriate diagnosis of sciatica includes a thorough and accurate physical examination and overview of the sufferer's medical history. Tests for nerve root tension, which recreates the discomfort with emulative body positions and motions, is also an efficient way to confirm the presence of the condition.

A qualified medical doctor is an ideal and necessary choice for performing these relatively complicated tests, as they involve the significant moving of the legs into certain positions that may very well stretch the sciatic nerve in seriously dangerous ways. When a sufferer begins to feel pain during any of these tests, it is an indication of the source of the pain as being an irritated sciatic nerve.

When the pain lasts longer than five or six weeks, it is classified as being "severe," which calls for one or more imaging tests that can be used to help identify the cause of the compression of the sciatic nerve. Spinal X-rays, which can detect herniated discs unlike normal x-rays, as well as magnetic resonance imaging, which uses a powerful magnet wave to produce images of the back, and computerized tomography scans, which use narrow beams of radiation to create detailed, cross-sectioned images of the body, are the most common types of tests that are performed on a sufferer with severe symptoms.

Although most sufferers of sciatica will eventually recover from the disorder on their own willpower, those that do seek medical assistance are usually instructed by their doctors to employ a course of extremely conservative treatment, including periods of brief yet frequent rest and to limit their overall participation in strenuous physical activities. Anti-inflammatory medications, which are less effective when compared to the aforementioned treatments, are usually also prescribed.

A range of stretching and strengthening exercises are often also suggested, as well as physical therapy which allows the sufferer to return to normal activity. Surgical options, in the case of extreme or intolerable pain caused by the condition, are also available, but are usually left for the more severe cases as determined by objected evidence such as MRI scans. The most aggressive forms of treatment are taken only when more conservative measures do nothing to alleviate the pain.

Treatments such as epidural steroid injections, which is a corticosteroid medication injected into the area affected, mimic the body's natural hormone effects to suppress inflammation and, hopefully, relieve the pain and pressure. Surgery, the most extreme measure, reserved for cases in which the compressed nerve irrefutably causes significant weakness in the muscles, is performed in order to remove a portion of the herniated disc, with the intention of keeping intact as much as the normal anatomy as the surgery will allow. Although sufferers may experience incredible and immediate results from the surgery, it usually does nothing to prevent degenerative changes and the pain caused by the sciatica may very well return over time.