08/22/2016

Sciatica: what it is and possible treatments

Sciatica is not a single condition but rather a group of symptoms, typically caused by an underlying condition. The symptoms include a constant pain in the buttocks or hamstrings, along with shooting pains that move down and along the leg, and are typically described as burning or searing rather than a dull ache.

The condition can range in intensity from mildly debilitating to chronically incapacitating. Some find it a niggling interference that merely prevents them from walking occasionally. For others, it is so severe that daily errands are dictated by the rhythms of nerve pain. Since the pain is worse when sitting, there is often no respite for these individuals.

The sciatic nerve is the largest single nerve in the body, and it is comprised of separate nerve roots that fan out from the spine near the lumbar region. It is due to the nerves fanning out like tree roots that we are susceptible to sciatic pain, especially as we age, and our discs weaken and collapse.

Sciatic pain is seldom found in individuals younger than 20, and even then the prevalence is much larger in those in their 40s and 50s. This is because, while you can increase your risk of sciatica by heavy lifting or the operation of vibrating machinery, it is most commonly caused by herniated or degenerating discs.

As we age, our bones begin to narrow, weaken, and break down. In our 40s and 50s, we are at greater risk of a herniated disc. This is where the soft contents of the disc leak out and irritate the nerve roots.

In more severe cases, the disc begins to degenerate, and again, as with herniated discs, this process is most typical in old age. The causes are twofold: a breakdown in the cartilage that separates the discs, and the collapse of the disc space in the vertebral segments. Because the cartilage nourishes the discs, where this material erodes it can cause both inflammation and micro-motion instability.

Micro-motion instability can be visualised by imagining a bicycle. If the socket for a pedal widens, then when you ride it the nut will continue coming loose, since as you pedal the motion will keep jiggering loose the bolt, time and time again.

Lumbar spinal stenosis is another age-related condition that underlies sciatica, and it is frequently encountered in adults over 60. In this case, the sciatica is due to a narrowing of the spinal column and either bulging or herniated discs putting pressure on nerve roots.

This brings us to the question of treatments. For the short-term, heat and ice packs can be used for 20 minutes at a time, and some find that alternating hot and cold can work for them. Alternatively, non-steroidal anti-inflammatories such as Ibuprofen or Naproxen may be used, or oral steroids which reduce the area inflammation near the compressed nerve root.

For pain relief, doctors may prescribe narcotic pain killers or muscle relaxants. An extreme option is that of the epidural – an injection directly into the base of the spinal column that can alleviate pain for either as little as a week or as long as a month, depending on the patient.

However, the best therapy for sciatica is that of chiropractic manipulation, as administered by either a professional Chiropractor or an osteopathic physician. As a regular treatment/therapy, chiropractors can help you over the long term by creating both a healing environment, and by aligning the spinal column so as to reduce the effects of the underlying conditions which influence the pain. Chiropractic manipulation is not painful, and chiropractors themselves can be a profitable source of advice as you move through the treatment process.