Sciatic Nerve Pain: How to Identify It

“My sciatica hurts.” This very common complaint is often heard from those who suffer from lower back pain, but what exactly are they referring to? Sciatica can be one of the most uncomfortable pains there is, and one of the most common.

It is estimated that between 5% and 10% of patients with low back pain have sciatica pain, while those who will suffer low back pain at some point in their life range from 49% to 70%.

What is commonly called “sciatica” refers to back pain (in the lower back) that radiates down the legs, passing through the hips and buttocks and reaching the heel or foot. Generally, this pain is caused by compression of the lower vertebrae on the sciatic nerve (the longest and widest in the body, which runs from the lower spine to the toes). It should be noted that between every two vertebrae, the nerve roots come out, responsible for sensitivity in the lower limb and for giving mobility to the leg muscles. When these roots are damaged, then sciatica will arise.

WHAT CAUSES SCIATICA?

The concrete thing is that, regardless of the cause, sciatica occurs when compression of the sciatic nerve occurs. Here are the most common reasons why you may be suffering from this pain:

• Disc herniation. It is the most common cause and occurs in most cases. A disk, which is like a shock absorber located between the vertebrae, has a soft, gelatinous nucleus encapsulated by a harder, rubberier ring. The discs serve to smooth the movements of the vertebrae of the spine. The hernia appears when a part of the nucleus protrudes through a tear in the annulus, causing inflammation of the surrounding tissues and irritation of the nerve.
• It is less frequent. It occurs when tumors appear within the spine that affect the spinal cord or nerve roots.
• Spinal stenosis. The spinal canal (space through which the spinal cord passes) is narrowed and compresses the nerve roots of the sciatic nerve. This narrowing can be caused by bone spurs, spondylolisthesis, inflammation, or herniated discs.
• Pyramid syndrome. In 15% of the population, the sciatic nerve passes through the “pyramidal or piriformis” muscle and not below. When the muscle shortens or spasms due to trauma or overuse, compression or strangulation of the sciatic nerve below the muscle can occur.
• It is a deviation of one vertebra over another that can be caused by a degenerative process or fracture and generates compression on the sciatic nerve.

WHAT IS SCIATICA PAIN?

Sciatica is characterized by a particular symptom which is radiating pain down the legs. It can be disabling and usually begins with an acute phase of very intense pain, but it rarely lasts for a long time. In most cases, depending on the cause, the symptoms improve in a few days. To identify if what you suffer from is sciatica, you can check if the following signs appear:

• Constant pain in one buttock or one leg (rarely it can occur in both legs).
• Pain exacerbation when sitting.
• Tingling down the leg.
• Numbness or weakness to move the leg or foot.
• Stabbing pain when standing up or walking.

WHAT SHOULD I DO IF I HAVE SCIATICA?

In principle, a rheumatologist doctor should confirm if you have it through a physical examination, in which he will control your muscle strength and your reflexes. Then you can corroborate it with diagnostic tests such as x-rays, resonances or tomographies, if necessary, depending on the intensity of the pain.

Once sciatica is confirmed, there are various treatments that can be addressed:

• Medications: If the pain is not very intense, then your doctor may recommend useful drugs to reduce inflammation.
• Heat and ice: they serve to relieve acute pain, especially that of the leg in its initial stage. Ice or heat is generally applied for approximately 20 minutes and repeated every two hours. Most people use ice first, but some find more relief with heat. They can be alternated.
• Exercises: focus on three areas:
• Strengthening: to strengthen the spine, as well as the muscles, ligaments and tendons that support it.
• Stretching: to relieve pain as the muscles that cause pain are exercised.
• Aerobics: walking or swimming are used to recover muscles and keep the locomotor system active.
• Physical therapy: When the acute pain subsides, you can do physical therapy to help prevent future injuries. They are generally exercises to correct posture, strengthen the muscles that support the back, and improve flexibility.

When the pain does not stop, then you have to resort to more invasive treatments such as:

• Infiltrations: an anti-inflammatory medication is applied to the area around the affected nerve root to reduce pain by eliminating inflammation around the irritated nerve. Its effect lasts a few months and cannot be supplied unlimitedly.
• Surgery: This is the last option and is used when the pinched nerve causes significant weakness and loss of bowel or bladder control. In these cases, the bone spur or the part of the herniated disc that exerts pressure on the pinched nerve is usually removed.

CAN IT BE PREVENTED?

Sciatica pain cannot be prevented, but you can take actions that help to maintain a healthy state and, if it occurs, the pain is not so intense and you are better prepared to combat it.

It is recommended that you are not obese or overweight, has a healthy life away from tobacco, do frequent aerobic exercise (not impact) and try to have firm and upright postures when working, sitting and standing.