Many people consider sciatica to be an all encompassing term for low back pain. Actually, sciatica refers to a very specific set of symptoms.
Sciatica symptoms occur when the sciatic nerve (the largest nerve in the body) is irritated. The sciatic nerve is formed in the buttock from several individual nerves (nerve roots) originating in the lower part of the spine. These individual nerves combine in the buttock to form the sciatic nerve, which then travels down the back of the leg. Therefore, sciatica is not low back pain, but pain in the buttock and the leg. However, sciatica is often caused by low back problems which irritate one of the contributing nerve roots.
For some people, sciatica pain can be severe and debilitating. In other cases the sciatica symptoms might be infrequent and irritating, but have the potential to get worse. Usually, sciatica only affects one side of the body, and the pain radiates from the buttock, to the back of the thigh and down the leg. Depending on where the sciatic nerve is affected, the pain and other sciatica symptoms may also radiate to the foot or toes.
With sciatica, low back pain may be present along with the leg pain, but usually the low back pain is less severe than the leg pain.
The sciatica symptoms are different depending on which nerve roots are affected. For example, impingement of the L5 nerve root (L5 is the bottom lumbar vertebra) can cause weakness in the big toe and potentially in the ankle.
The good news is that sciatica usually will get better on its own, and the healing process usually only takes a few days or weeks. Overall, the vast majority of episodes of sciatica pain heal within a six to twelve week time span. However, occasional flare-ups of sciatic nerve pain may be an indication of a condition that should be managed so that it does not get worse over time.
During an episode of sciatica, there are a number of non-surgical treatment options available to help alleviate the sciatic pain and discomfort.
For acute sciatica pain, heat and/or ice packs are can help alleviate the leg pain, especially in the initial phase. Usually ice or heat is applied for approximately 20 minutes, and repeated every two hours. Most people use ice first, but some people find more relief with heat. The two may be alternated to help with sciatica pain relief.
Acupuncture and chiropractic have also been shown to provide effective sciatica pain relief for many patients.
Acupuncture involves hair-thin needles (that are usually not felt) that are inserted into the skin near the area of pain. In the United States, the FDA and the National Institutes of Health recognize acupuncture as effective in relieving back pain and sciatica.
Spinal adjustments and manual manipulation performed by chiropractors are focused on providing better spinal column alignment, which in turn should help to address a number of underlying conditions that can cause sciatic pain. Chiropractic adjustments of the spine are focused on the problem area, and can create a better healing environment to help the underlying cause of sciatica heal.
While it seems counter-intuitive, activity and exercise typically provides more sciatica pain relief than rest.
When the sciatica pain is at its worst, many suffers may need to rest for a day or two. However, resting for longer periods of time is usually not advisable. In fact, inactivity will usually make the sciatic pain worse. This is because regular movement and exercise is necessary to nourish the various structures in the low back and encourage the strength needed to support the low back.
Stretching exercises for sciatica target the muscles that cause pain when they are tight and inflexible. A regular program of gentle strengthening and stretching exercises can help one to recover from a flare up of sciatica and can help to prevent future episodes of pain.
Low impact aerobic exercise, such as walking and swimming (or pool therapy) is also usually a component of recovery. Aerobic activity encourages the exchange of fluids and nutrients to help create a better healing environment. Aerobic conditioning also has the added benefit of releasing endorphins, the body’s natural pain killers, which is a natural way to alleviate sciatic pain.