Sciatica is a symptom of pain that typically radiates from the lower back, down the leg and often ending in the foot. This may be accompanied by tingling/pins and needles, numbness and weakness of the foot and ankle. These symptoms can be aggravated by lifting, bending, sitting, standing, and walking. The medical term for sciatica is radicular pain.
In layman’s terms, sciatica occurs when one of the sciatic nerve roots (either L4, L5, or S1) becomes compressed or inflamed, typically from either a disc herniation, or a condition called stenosis.
Commonest causes of sciatica
Disc herniation is the commonest cause of sciatica. A disc herniation, which can also be called a slipped disc, or bulge, is a sometimes painful condition of the spine that occurs when the material from the centre of the disc escapes and irritates the adjacent lumbar nerve root.
Spinal Stenosis is another common cause of sciatica in older people. Stenosis occurs when one or more of the bony holes between vertebrae become narrowed (due to degenerative change/arthritis) and compress or irritate the adjacent lumbar nerve root.
Risk Factors For Sciatica
Your occupation may significantly increase the chances of developing sciatica. Research has indicated that performing heavy manual labour and, ironically, sedentary work are the two types of employment most frequently associated with sciatica. Research has also demonstrated that the type of occupation least associated with the development of sciatica involves a combination of sitting, standing, and moderate physical activity.
Treatment
The National Institute of Health and Care Excellence (NICE) guideline recommends manual therapy (spinal manipulation, mobilisation, or massage) as part of a treatment package including exercise.
NICE also recommends the prescribing an anti inflammatory drug, such as ibuprofen or naproxen and an opioid such as codeine with or without paracetamol. If pain remains uncontrolled drugs to treat neuropathic pain, such as amitriptyline, duloxetine, gabapentin, or pregabalin are advised.
Without question, the best treatment for sciatica is TIME. The good news is that, 60-80% of people suffering with sciatica will completely recover within 6 to 8 weeks.