Sciatica (Lumbar Radiculopathy)
Sciatica, or lumbar radiculopathy, is a common type of pain, tingling, or numbness that originates in the lower back before traveling down the leg and into the lower extremities. Nearly 40% of people will experience sciatica at some point in their life; many will be treated for lower back pain, but it is important to point out that sciatica (and its treatment) is very different than other conditions affecting the lower back and legs.
Radiating from the sciatic nerve, sciatica refers to pain that extends along the path of the sciatic nerve, which originates in the lower back and branches through your hips and buttocks and down each leg.
Common Causes of Sciatica
Sciatica typically occurs when the sciatic nerve becomes pinched or compressed, resulting in inflammation, pain, and numbness in the affected areas. Sciatica is often caused by a number of issues or conditions, including:
- A herniated disk in your spine;
- Degenerative disc disease, or a breakdown of the discs which cushion vertebrae;
- An overgrowth of bone (bone spur) on your vertebrae;
- Spondylolisthesis, a condition where one vertebra slips over another;
- Spinal stenosis, or a narrowing of the spine.
While rare, sciatica can also result from a tumor compressing the sciatic nerve or by damage caused by certain diseases, including diabetes.
Risk Factors For Sciatica
Risk factors associated with an increased likelihood of sciatica include age (most common in people between 30 and 50 years old), obesity, being pregnant, lack of regular exercise, heavy lifting, prolonged sitting, wearing high heels, and sleeping on a mattress that is either to hard or too soft.
Symptoms
The most common symptom of sciatica is pain that radiates from the lumbar (lower) spine to the buttocks and travels down the back of the leg and to your lower extremities, including the thigh and calf. Because it is a nerve-related condition, it is normal to experience varying degrees of pain or discomfort nearly anywhere along the pathway of the nerve.
The discomfort associated with sciatica varies in intensity, ranging from a mild ache to a distinct tingling or burning sensations to debilitating and excruciating pain. Other symptoms of sciatica include:
Numbness
Muscle weakness in the affected area
Pain in one part of the leg and numbness in another part,
Burning and tingling sensations in the lower back and leg
Diagnosis
Considering your symptoms, and while conducting a physical exam, a physician will typically assess your muscle strength and reflexes through a series of movements in an effort to replicate the movements causing the pain associated with sciatica.
Other diagnostic tools, used to assess herniated discs, bone spurs, compressed nerves, and soft tissue damage, include x-rays, an MRI, CT scan, and/or an electromyography (EMG) may also be used to assist with diagnosing the condition .
Possible Treatments
The good news is that most people suffering from sciatica often feel better in a couple weeks and without medical treatment or surgery. While recovering from sciatica, your physician will most likely recommend OTC pain relievers to relieve pain and reduce inflammation in the affected area. Many also find effective pain relief by alternating between cold packs and hot packs on the lower back while also engaging in a series of lower-back stretches designed to relieve pain associated with sciatica.
Should sciatica-related discomfort not improve with the above self-care measures, your doctor might recommend additional treatment, including:
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