Demystifying sciatica: Insights and solutions

Sciatica is a prevalent yet often misunderstood condition that affects millions of individuals worldwide. Characterised by pain radiating along the sciatic nerve, it can significantly impact one's quality of life. Understanding the underlying causes, recognising the symptoms, and implementing effective management strategies are essential in navigating this condition. In his latest online article, esteemed physiotherapist Ian Repton delves into the intricacies of sciatica, shedding light on its causes, symptoms, and viable management options.

Understanding sciatica

Sciatica refers to the pain that travels along the route of the sciatic nerve, extending from the lower back, coursing through the hips and buttocks, and down each leg. It typically affects one side of the body and can vary in intensity, from a mild ache to excruciating discomfort. While sciatica itself is not a medical condition, it serves as a symptom of an underlying problem, such as a herniated disc, spinal stenosis, or degenerative disc disease.

Causes of Sciatica

Herniated disc: One of the most common causes of sciatica is a herniated disc, where the soft inner material of a spinal disc leaks out and irritates or compresses the adjacent nerve roots. 

Spinal stenosis: Spinal stenosis involves the constriction of the spinal canal, resulting in the compression of nerves, including the sciatic nerve.

Degenerative disc disease: As we age, the discs in our spine can degenerate, leading to changes that can irritate or compress the nerve roots.

Spondylolisthesis: This occurs when one vertebra slips forward over the vertebra below it, putting pressure on the nerves and causing sciatic pain.

Piriformis syndrome: The piriformis muscle, located in the buttocks, can sometimes irritate or compress the sciatic nerve, leading to similar symptoms.

Symptoms of sciatica

The primary symptom of sciatica is pain that radiates from the lower back down the leg, typically following the path of the sciatic nerve. Other common symptoms include:

Burning or tingling sensation: Some individuals may experience a sensation of pins and needles or numbness along the affected leg. 

Weakness: Sciatica can make the leg affected feel weaker, making it hard to move or bear weight.

Worsened pain: Certain activities such as sitting for prolonged periods or coughing can exacerbate sciatic pain.

Difficulty standing: Individuals with severe sciatica may find it challenging to stand up or walk due to the pain.

Effective management strategies

Pain medications: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help reduce mild to moderate sciatic pain. In more severe cases, prescription medications like muscle relaxants or narcotics may be necessary.

Physical therapy: Specific exercises and stretches can help improve flexibility, strengthen muscles, and alleviate pressure on the sciatic nerve.

Hot and cold therapy: Applying heat or cold packs to the affected area can provide temporary relief from sciatic pain.

Epidural steroid injections: In cases of severe pain that does not respond to other treatments, corticosteroid injections directly into the spine can help reduce inflammation and alleviate symptoms.

Surgery: In rare cases where sciatica is caused by a severe underlying condition such as a herniated disc or spinal stenosis, surgery may be recommended to alleviate pressure on the affected nerve roots.

Ian Repton is a respected physiotherapist. You can schedule an appointment with Ian Repton on his Top Doctors profile.