Sciatica: When should I see a back pain specialist?

Sciatica is a common and often painful condition that affects many individuals. In this article, renowned orthopaedic and spinal surgeon Mr James Langdon delves into the symptoms, causes, and potential relief measures, including spinal injections, for those experiencing sciatica.

Symptoms of sciatica

Sciatica typically manifests as pain that radiates along the path of the sciatic nerve. Patients often describe it as a ‘burning’ pain. Sciatica has the potential to restrict your ability to stand and walk, as well as hinder your ability to find comfort while lying in bed. It can be exacerbated by actions such as bending over, exerting physical effort, or experiencing coughing or sneezing. The sciatic nerve is the longest nerve in the human body, running from the lower back, down the back of each leg. Common symptoms of sciatica include:

1. Lower back pain: This pain often originates in the lower back and may be persistent or intermittent.
2. Leg pain: The pain can extend down one or both legs, often following a pattern like a shooting or burning sensation.
3. Numbness and tingling: Some individuals experience numbness or tingling in the affected leg, making it challenging to carry out daily activities.
4. Muscle weakness: Weakness in the leg or foot may occur, affecting mobility.

What causes sciatica?

Sciatica is primarily caused by compression or irritation of the sciatic nerve. Common causes include:

1. Herniated disc: A herniated or slipped disc in the spine can press on the nerve, leading to sciatic pain.
2. Spinal stenosis: Narrowing of the spinal canal can compress the nerve, resulting in symptoms.
3. Piriformis syndrome: The sciatic nerve can be irritated if it passes through the piriformis muscle in the buttocks.
4. Trauma or injury: Accidents or injuries may damage the nerve, causing pain.

Can sciatica be treated?

Sciatica is highly treatable. Sciatica is often a self-limiting condition for many individuals, with adjustments in lifestyle and physiotherapy playing a role in facilitating recuperation.

Numerous patients grappling with pain also find significant relief from their symptoms through spinal injections. If these measures fail to alleviate the pain, surgical intervention may become necessary.

While sciatica can improve spontaneously, it is advisable to seek an early evaluation to ascertain the source of your pain and receive expert guidance. This will allow you to make an informed choice about your treatment. Consulting a doctor with expertise in sciatica management, such as Mr James Langdon, is crucial.

Exercises for sciatica relief

Exercise can play a vital role in relieving sciatica. It can help alleviate pain, improve flexibility, and strengthen the muscles that support the spine. Some beneficial exercises include:

1. Stretching: Gentle stretching of the lower back, hamstrings, and buttock muscles can help relieve tension on the sciatic nerve.
2. Core strengthening: Exercises that target the core muscles provide stability and support to the spine.
3. Aerobic activity: Low-impact activities like walking or swimming can promote blood flow and reduce pain.
4. Yoga and Pilates: These practices can enhance flexibility and reduce muscle tightness.

Spinal injections

Spinal injections can be an effective method to manage the pain associated with sciatica. These injections typically contain a combination of corticosteroids, which have anti-inflammatory properties, and a local anaesthetic. The corticosteroid reduces inflammation around the compressed nerve, while the anaesthetic provides immediate pain relief. Spinal injections can be administered under the guidance of imaging techniques like fluoroscopy to ensure precise placement.

What should I avoid doing if I have sciatica?

While certain activities can help alleviate sciatica, it's essential to be mindful of actions that may exacerbate the condition. Avoid:

1. Heavy lifting: Straining the lower back with heavy objects can worsen symptoms.
2. Prolonged sitting: Sitting for extended periods can compress the nerve. If you have a desk job, take regular breaks to stand and stretch.
3. High-impact activities: Activities like running or jumping can jar the spine and should be avoided during flare-ups.

Treatments for sciatica

If you're struggling with sciatica, several treatment options are available:

1. Medication: Over-the-counter pain relievers and muscle relaxants can provide temporary relief.
2. Physical therapy: A physiotherapist can tailor exercises to your specific needs.
3. Epidural steroid injections: Injections can reduce inflammation and alleviate pain.
4. Surgery: In severe cases or if conservative treatments fail, surgical options may be considered.

In conclusion, understanding sciatica is crucial for patients dealing with this condition. While it can be painful and disruptive, a combination of exercises, lifestyle adjustments, and medical interventions can significantly improve the quality of life for those affected. If you're experiencing persistent sciatica, consult a doctor for a tailored treatment plan to address your unique needs.

If you would like to book a consultation with Mr Langdon you can do so today via his Top Doctors profile.