What is Sciatica?
Sciatica is an inflammation of the sciatic nerve, the longest nerve in the body. The sciatic nerve stretches from the spinal cord to the end of each leg and may become inflamed for a number of reasons, including age-related changes in the spine, obesity, or a sedentary lifestyle. Sciatica usually develops gradually as the nerve is compressed over time. This results in pain along the nerve pathway, as well as numbness, tingling and muscle weakness in the affected area.
The compression of the sciatic nerve is usually the result of a herniated disc or spinal stenosis, a narrowing of the spinal canal often caused by a bone spur. Other causes of sciatica may include:
- Piriformis syndrome, a muscle disorder
- Nerve damage from diabetes
- Pelvic injury
Since a sedentary lifestyle contributes to sciatic problems, individuals whose occupations require prolonged sitting, extensive driving or frequent air travel are at greater risk of developing the disorder.
The most common symptom of sciatica is pain that radiates from the lumbar (lower) region of the spine into the buttock and down the back of the leg. At times, the sole of the foot may be affected. Patients with this condition may experience a variety of sensations in the region, including tingling, burning, numbness or jolts of acute pain. Discomfort may increase with sudden movement, such as occurs during sneezing or coughing, or upon standing after an extended period of sitting.
When the symptoms of sciatica set in suddenly, as may happen after an accident, or when the patient has difficulty controlling the bladder or bowels, immediate medical attention should be sought.
The good news about sciatica treatment is that most people with the condition get better within 6 to 12 weeks. Once Dr. Girardi has diagnosed your condition through physical examination and imaging tests, he’ll start you on a treatment plan that will involve rest, ice packs, physical therapy, and over-the-counter pain medications. Anti-inflammatory corticosteroid injections may be used. Regular exercise is the key to preventing future flare-ups of sciatica. Here’s some more information on individual treatment options.
- Heat/Ice: This is especially important in the initial phase of treatment. Ice or heat is applied for approximately 20 minutes, and repeated every two hours. Ice and heat may be alternated, or one may prove more effective than the other.
- Pain medications: Nonsteroidal anti-inflammatory pain relievers such as ibuprofen and naproxen are the first line of pain relief. Dr. Girardi prefers to avoid using prescription options unless absolutely necessary for short-term pain.
- Epidural steroid injections: When a patient has severe acute pain, Dr. Girardi may use steroid injections. These can be effective because they can be delivered into the painful area surrounding the sciatic nerve. For some patients, these corticosteroid injections can be very effective in relieving pain for up to a year. But in other patients they aren’t effective. These injections will usually allow the patient to begin or return to a conditioning and exercise program.
- Exercise: Exercise is important to calm sciatica. Exercises focus on stretching (especially the hamstrings), strengthening your core muscles to support your spine, and low-impact aerobics.
Will Sciatica Go Away On Its Own?
Whether your sciatica will resolve on its own is dependent on how bad the disc herniation or spinal compression is. It also depends on lifestyle issues. For instance, if you have a job that involves a good deal of heavy lifting, or prolonged sitting without breaks, both of those activities can damage discs. The key is to not take it easy. Movement is important to start the healing, coupled with ice/heat and anti-inflammatory medications. If you start exercising, particularly stretching your hamstrings and strengthening your core, there’s a good chance your sciatica will get better in a few weeks.
How Long Does Sciatica Last?
The majority of people who experience some degree of sciatica get better in a few weeks or months — there’s no set duration. The duration of your pain will depend on the changes you make to address it. Those are changes that Dr. Girardi will help you plan and implement.
What Are the Exercises That Help Sciatica?
Sciatica exercise involves three keys: strengthening, stretching, and aerobic conditioning. • Strengthening exercises focus on the spinal column and supporting muscles, ligaments, and tendons. Beyond the back, these exercise focus on the abdominal, gluteal, and hip muscles. • Stretching is important for sciatica, especially the hamstrings. The target of these stretching exercises are the muscles that are causing pain due to being overly tight and inflexible. • Low-impact aerobic exercise is a component of treatment; it encourages the exchange of fluids and nutrients. Plus, aerobic exercise releases endorphins, the body’s natural painkillers.
At a Glance
Dr. Federico Girardi MD
- Triple fellowship-trained spinal surgeon
- Performs over 400 spinal surgeries per year
- Professor of orthopedic surgery at Cornell University
- Learn more