You’ll Know It When You Feel It

Sciatica is often described as a shooting pain that bolts down your leg from your lower back. It is said to be unlike any other pain. “You’ll know it when you feel it” might not be enough to reassure you that you can diagnose this condition for yourself. So what are the signs that you have sciatica?

You might associate sciatica with your 80-year-old Aunt Millie, and think that you don’t need to worry about it yet. However, according to the American Academy of Orthopaedic Surgeons, it is most common in people between the ages of 30 and 50 years old. It is true that the wear and tear of aging can lead to sciatica, but there are many causes that are not related to age.

Touching a Nerve

The sciatic nerve is the longest nerve in the body. It originates in the lower spinal column, branches out and then continues down each leg to the foot. Sciatica results when this nerve is irritated. The four main causes behind the pain are:

  1. Herniated Disk. Disks serve as cushions between the vertebrae that make up the spine. The Mayo Clinic compares this disk to a “jelly donut.” A herniated disk, also referred to as a slipped disk or ruptured disk, occurs when some of the softer ‘jelly’ pushes out through a tear in the tougher exterior. The nearby nerves are irritated by the pressure and can result in pain, numbness, or weakness. This is the most common cause behind sciatica. One in 50 people will suffer a herniated disk in their lifetime.
  2. Spinal Stenosis. This refers to the narrowing of the open space in the spinal column where the spinal cord and nerves are located. This can also put pressure on the sciatic nerve, causing tingling, numbness, and/or weakness.
  3. Spondylolisthesis. Your spine is made up of bones called vertebrae, which are stacked on top of each other. Your spine is flexible, allowing you to bend. However, when a vertebra slips out of position, it can squeeze your spinal cord or the sciatic nerve, resulting in pain, numbness, or weakness.
  4. Piriformis Syndrome. The piriformis muscle is a small muscle under your gluteal muscles that is close to the sciatic nerve. A muscle spasm can affect the sciatic nerve, causing the pain, tingling, or numbness of sciatica. This cause is more common among athletes.

On Pins and Needles: Three Signs to Watch For

There are multiple signs that point to sciatica, but these three warning signs are the most common. If you experience any one of these three, you likely have sciatica. If you have all three signs, it’s more than likely:

  1. One leg. A pinch in the sciatic nerve generally affects only one leg, rarely both. The sciatic nerve is usually affected below the point where the nerve splits, one nerve branching down each leg. Although sciatica is often associated with lower back pain, the telltale sign is actually pain in one leg.
  2. Shooting pain. Sciatica pain can range from a mild, unpleasant sensation to excruciating pain. Sciatica is a result of a pinched nerve rather than pain originating in a muscle. Nerves send electric pulses, so pinched nerves will send out electric pain, ranging from a tingling sensation to a burning pain to what feels like a bolt of lightning shooting down your leg.
  3. Weakness. If you feel weak in the knees, it could be a sign that you have sciatica. Numbness is another sign. Although pain is the symptom that often sends you to the doctor, your doctor might be more concerned with your weakness.

If you suspect that your pain is sciatica, you should see a doctor to confirm your self-diagnosis. It is absolutely urgent to see a doctor if you experience these signs:

  • Loss of bladder or bowel function. This could be a sign of Cauda Equina Syndrome, a rare condition resulting from a herniated disk. If left untreated, it can result in paralysis. Don’t assume that this condition will go away by itself. You are a prime candidate for emergency surgery.
  • Result of severe injury or an accident. It’s always wise to consult a doctor in these cases and not make assumptions about your condition.
  • Sudden excruciating pain along with muscle weakness. The emphasis here is on the suddenness of the onset combined with the intensity.

Treating Sciatica

Except in extreme cases when surgery might be required, sciatica is highly treatable. Many at-home remedies will take care of your symptoms.

  • Cold/Heat. Ice packs for the first few days to reduce swelling followed by heat will treat your pain in many cases. If the pain persists, try alternating cold and heat.
  • Over-the-counter or prescription pain relievers. Follow directions and avoid long-term usage to control pain.
  • Stretching and exercise. One of the benefits of exercise is the production of endorphins, the body’s natural pain reliever. It’s advisable to consult a physical therapist for the best exercises and stretching techniques for treating sciatica.

Doctors generally recommend that you keep up your daily routine as best you can because sciatica can worsen with inactivity. Your doctor might also suggest physical therapy to help alleviate the pain.

Treating sciatica pain through physical therapy is similar to treating other types of pain. At Midland Physical Therapy, we will provide a thorough evaluation to determine the source of your sciatic symptoms.   A treatment plan will developed based on the findings and may include:

  • Manual traction
  • Joint mobilization
  • Soft tissue mobilization
  • Core strengthening
  • Posture and body mechanic instruction
  • Strengthening
  • Stretching
  • Aerobic Conditioning

When you exercise regularly, your body is better able to recover from the pain. You might even lessen or prevent recurrences of sciatica.

Keeping Sciatica Under Control

The same way your doctor will advise you to keep taking your blood pressure medication even when you feel alright, we recommend that you continue your physical therapy regimen for sciatica even after the pain has subsided. Keeping your lower back and spine in good physical condition is key to keeping your sciatica under control.

At Midland Physical Therapy, we also recommend focusing on improving or maintaining good posture. Mom was right when she said, “Sit up straight!” Good posture is another defense against sciatica.

If you sit at a desk at work most of the day, it’s essential to pay attention to the ergonomics. Make sure the chair properly supports your back. Your feet should be comfortably flat on the floor when you sit. Additionally, if your chair has arms, use them!  Consider having a standing desk to be able to avoid sitting all day.

Also, pay attention to how you move throughout the day. Don’t slouch when you walk. Make sure you lift heavy objects properly. Bend your knees rather than your back. And never twist your back when you’re holding a heavy object. Remember, the sciatic nerve originates in the spine. Treat your spine with respect.

Sigh of Relief

When you notice signs that you have sciatica, see your doctor and then call us. Our physical therapists here at Midland Physical Therapy are ready to put together a custom regimen of stretching, strengthening exercises, and aerobic conditioning that will provide you with a sigh of relief.

We hope you never experience the shooting pain of sciatica. If you do, you now know how to alleviate the pain, and you know you can call us for help.