Sciatica is caused by pressure or compression of the sciatic nerve or one of the root nerves in the spine. It becomes chronic when pain continues for a long time – such as more than three months. Sciatica can be difficult to diagnose and treat.
The most common causes of sciatica are:
- degenerative disc disease
- herniated disc
- bone spurs
- spinal stenosis
- poor posture
- excessive smoking or alcohol
- work that requires bending and twisting
Only a doctor can determine whether the pain is due to chronic sciatica.
The guideline below is a partial list of sciatic symptoms and includes:
- pain, tingling or numbness radiating from the lower back through the buttocks, hip, and backs of leg
- pain that worsens while sitting or standing
- muscle weakness in legs
Sciatica is painful but rarely life-threatening; however, is there is extreme muscle weakness or trouble controlling bowels or bladder seek medical attention immediately. This can indicate cauda equina syndrome, which can cause paralysis and is potentially fatal.
Diagnosis to identify underlying causes involves:
- discussing symptoms and medical history with the physician
- physical exam to check range of motion and locate painful areas
- neurological examination
- x-ray, MRI, CT scans
Chronic pain, in general, is demoralizing and depressing. Coping with chronic pain requires finding ways to manage the pain and may require alternative measures that help in maintaining a positive attitude. Some of these measures include:
- mental health professional if feeling hopeless, loss of interest in friends or activities, or life in general
- stay physically active can help the body fight causes of pain and may provide temporary relief
- physical therapy
- chiropractic treatments (if recommended)
- anti-inflammatory medicines ( ibuprofen)
- ultrasound or steroid injections
Alternative therapies may include:
- herbal supplements
- biofeedback therapy
If conservative treatment does not help, minimally invasive procedures, like laser therapy, may bring relief.
In the event open back surgery is needed there are several risks like failed back surgery syndrome and bone graft rejection. Additional risks (as with any surgery) include:
- thrombosis, pulmonary embolism
- nerve damage
- fusion failure
Staying in shape may help with coping and possibly avoiding symptoms that can become debilitating. Muscle strength is important to stabilize the lower back and for cardiac health. An exercise program that can help create optimal health may include:
**Always consult with a physician before starting an exercise program.
Reducing risk factors may help to prevent sciatica symptoms. Changes in lifestyle are a part of the process as well.