Nearly 40% of adults will have sciatica. Here's what you can do to make it less painful.
If you’ve been seeking information on sciatica over the past few weeks, you’re not alone. This painful nerve condition has been searched more this fall than any other time in Google Trend’s history.
“Sciatica occurs when the sciatic nerve — the largest nerve in the body that begins in the lower back — is irritated,” Dr. Jennifer Caudle, an associate professor at Rowan University, tells Yahoo Life.
In most cases, it is not a problem of the sciatic nerve, but of the structures that contribute to the formation of that nerve, Dr. Brian Cole, an orthopedic surgeon at Englewood Spine Associates, tells Yahoo Life. “The sciatic nerve is a large peripheral nerve that runs down the back of the legs,” he says. “Historically, because the symptoms traverse the pathway of the sciatic nerve, it was called sciatica.”
According to the American Academy of Orthopaedic Surgeons (AAOS), sciatica is most likely to develop between the ages of 30 and 50. Nearly 40% of all adults will experience sciatica, according to Cleveland Clinic, though the condition rarely occurs in those under the age of 20 unless it’s related to an injury.
Here, our experts explain the symptoms, risk factors and treatment options for this condition.
What are the signs of sciatica?
Pain that spreads from the lower back and down one leg is the telltale sign that indicates you’re dealing with sciatica as opposed to a different type of back pain, according to the Hospital for Special Surgery in New York City.
“The symptom of sciatica is typically pain down the back of the legs [usually one leg], which may be associated with numbness and tingling,” says Cole. The HSS reports that this radiating pain can also begin in the buttocks and be described as dull, aching, shooting or burning.
The symptoms may worsen when bending, lifting, coughing, sneezing, laughing or sitting down, according to Penn Medicine. And in the most severe cases, symptoms can include muscle weakness, as well as urinary or fecal incontinence.
What causes sciatica?
“The sciatic nerve can be irritated for several reasons, including a herniated disk,” explains Caudle. Also referred to as a ruptured, slipped or bulging disk, it can be brought on by age-related wear-and-tear of the lower spine, as well as osteoarthritis. Other common causes include bone spurs or spinal stenosis, she says, which is when the area inside the backbone is too narrow and puts pressure on the spinal cord and the nerves that connect to the spine.
Sciatica can occur episodically throughout life, notes Cole. “As we age, the probability of sciatica shifts from herniated discs in the younger ages to the spinal stenosis in the older ages,” he says.
Extra body weight (whether caused by pregnancy or obesity), Type 2 diabetes, tobacco use and lack of physical activity, as well as experiencing a previous muscle or bone injury, are also contributing risk factors.
How can sciatica be treated?
For starters, consult with your doctor as soon as possible if you’re suffering from extreme numbness or tingling, pain that travels below the knee or problems urinating or moving your bowels.
If the pain is mild to moderate, there's some good news. "For some people, sciatica will resolve on its own,” Caudle says. In fact, the AAOS states that an ample amount of time and some rest usually encourages the condition to heal.
To ease the pain in the meantime, Cole explains that early treatment focuses on alleviating the problems of inflammation and compression. “We do this through initiating physical therapy, along with prescribing anti-inflammatory medications,” he says. “These can be highly effective in eradicating the symptoms.”
Applying ice packs, followed by heat, such as a heating pad or warm compress, to the affected area can offer relief as well, notes Caudle. Cleveland Clinic recommends using cold packs for about 20 minutes at a time throughout the day during the first 48 to 72 hours, then switching to heat around day three.
While your typical workout routine will likely need to be put on hold for a few weeks — along with twisting your back and lifting heavy items — and it's important to rest, that doesn't mean completely forgoing regular movement. Since motion aids in reducing inflammation, staying in bed during the day can cause pain in other parts of the body, according to the AAOS. If your doctor hasn’t prescribed physical therapy, Caudle suggests doing gentle stretching exercises.
Alternative therapies, such as massage therapy, acupuncture and chiropractic care, can provide relief as well. Caudle also suggests osteopathic manipulative medicine (OMM), a type of manual therapy that can be performed by an osteopathic physician.
If the pain is not subsiding and mobility is not improving after six weeks, Cole says your health care provider may need to further investigate through imaging tests of the spine, such X-rays or an MRI. “Some people may elect for spinal injections, which is another route of administration of anti-inflammatory medication in a higher proportion to a specific area,” he says.
Up to 90% of people with sciatica feel better over time without having an operation, according to the AAOS. Surgery — such as a laminotomy or laminectomy, in which part or all of the vertebral bone is surgically removed to relieve pressure on the nerve, respectively — would be a last resort. “Surgery may be required when conservative care has failed or there is a neurologic deficit such as weakness, atrophy of muscles or bowel or bladder compromise,” says Cole.
