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. The sciatic nerve is the longest nerve in the human body, running from the lower back, down the back of the leg. Common symptoms of sciatica include:

1. Leg pain: The pain can extend down one or both legs. The pain is often described as shooting or burning in nature.
2. Numbness and tingling: Some individuals experience numbness or tingling in the affected leg.
3. Muscle weakness: Weakness in the leg or foot may occur.
4. Sciatica can, but not always, be associated with back pain.

What causes sciatica?

Sciatica is typically caused by compression or irritation of the nerves in the lower back. These nerves then come together to form the sciatic nerve. The commonest causes of sciatica are:

1. Herniated disc: A herniated, prolapsed or slipped disc can compress a nerve in the lower back causing sciatic pain.
2. Spinal stenosis: Narrowing of the spinal canal caused by degenerative tissue can compress the nerves causing sciatic symptoms.

Sciatica can also be caused by other conditions including:

1. Piriformis syndrome: The sciatic nerve can be irritated as it passes beneath the piriformis muscle in the buttock.
2. Trauma or injury: Accidents or injuries may damage the nerve causing pain.

Exercises for sciatica

Exercise can play a vital role in managing sciatica. It can help alleviate pain, improve flexibility, and strengthen the muscles that support the spine.

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, reduce muscle tightness, and improve core muscle function.

Can spinal injections help?

Spinal injections can be an effective option to manage the pain of sciatica. These injections typically contain a combination of corticosteroids, which have anti-inflammatory properties, and local anaesthetic. The aim of the injection is to reduce inflammation and give pain relief. Spinal injections are administered under the guidance of imaging and are usually carried out in the operating theatre under sedation.

What to avoid doing if you have sciatica

While certain activities can help alleviate sciatica, it is essential to be mindful of actions that may exacerbate your symptoms. If struggling with sciatica, then it is sensible to try to 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. Many patients find sit /stand desks helpful.
3. High-impact activities: Activities like running or jumping can jar the spine and should be avoided whilst symptomatic.

Treatments for sciatica:

In many cases, sciatica is a self-limiting condition. However, if you are struggling with sciatica, several treatment options are available to you:

1. Medication: Over-the-counter painkillers (ibuprofen, paracetamol/co-codamol) can be helpful in managing symptoms. Some patients benefit from stronger medication prescribed by a doctor.
2. Physical therapy: Assistance from a physical therapist (physiotherapist / osteopath/chiropractor) can help with symptom relief.
3. Spinal injections: Injections can reduce inflammation and can give very effective pain relief.
4. Surgery: In severe cases or if conservative treatments fail, surgery to decompress the nerve may need to be considered.

In conclusion, understanding sciatica is crucial for patients dealing with this condition. While it can be painful and disruptive it is generally treatable; a combination of exercises, lifestyle adjustments, and medical interventions can significantly improve the quality of life for those affected. If you are struggling with sciatica consult a doctor for advice and a treatment plan to address your symptoms.

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