Sciatica: What Is It, And How Does It Relate To Low Back Pain?

Low back pain is something that will affect most of us at some point in our lives and it is the third most common cause of doctor visits. It can be intense. It can be scary. It comes as no wonder then that those who suffer from it want to know what is causing it.


Low back pain is a complicated condition. When you have a broken bone you head off for an x-ray and the doctor is able to see a break, tell you how they will fix it, and treat you accordingly. Low back pain is not like that. Firstly, imaging is often pointless with low back pain as few causes actually show up. What does show up, is often actually not even the cause of the pain.



Low back pain can be difficult to diagnose as it often does not show up on imaging.


Sometimes it is easy to pinpoint a particular injury or incident that led to the low back pain, but more often than not, people just wake up with a sore back, twist slightly wrong while doing some sort of activity that they always do, or simply find that they can’t stand up straight one day. This can make diagnosis challenging for doctors which is when you get the response, “Let’s wait and see”. Fortunately, most cases of low back pain will resolve on their own in a few weeks. Sciatica is one of those cases.



Sciatica is caused by inflammation, irritation, compression, or pinching of spinal nerve roots in the lower back.

What Is Sciatica?


Sciatica is pain that affects the back, the hip, and the outer leg. It is caused by inflammation, irritation, compression, or pinching of spinal nerve roots in the lower back. Most cases of sciatica are caused by herniated, degenerated, or slipped, discs.



Sciatica is often described as a sudden painful jolt, or like an electric shock in your leg or glute.


What Does Sciatica Feel Like?


Those suffering from sciatica complain about pain that radiates and shoots along the path of the sciatic nerve. This very long, and very thick nerve runs from your lower back, down through your hips and glutes, and down your legs. Sciatica is often described as a sudden painful jolt, or like an electric shock in your leg or glute. It can also be described as a sharp, shooting type of pain. Electric. Burning. It can come and go, or it can be more of a constant type of pain. Coughing, sneezing, and prolonged sitting can make it worse. Fortunately sciatica generally only affects one side of your body.



The term "sciatica” is used to describe any type of pain that starts in the lower back and then radiates down one of the legs.

Fortunately it is actually pretty rare to really injure your sciatic nerve, but we commonly use the term “sciatica” to describe any type of pain that starts in the lower back and then radiates down one of the legs. When you have “sciatica” you are basically talking about mild to intense pain anywhere along the sciatic nerve path described above. Pinching or compressing this nerve can also cause muscle weakness and numbness in your legs and feet. Some people report a sensation like “pins and needles” in their feet and toes.



Some cases of sciatica happen very suddenly, while others happen over a longer period of time.


How Long Does Sciatica Take To Occur?


There is no real definitive answer for this. Some cases of sciatica happen very suddenly, while others happen over a longer period of time. It really just depends on the underlying cause of the sciatica. Sciatica that is caused by arthritis of the spine would take a longer time to develop than one that is caused by a sudden disc herniation.


Is Sciatica Common?


Sciatica affects around 40% of the US population at some point during their lives, which is not surprising considering the very high numbers of people experiencing low back pain. Around 31 million people suffer from low back pain at any given time.



Herniated discs is one of the most common causes of sciatica.


Common Causes Of Sciatica


Sciatica can be caused by a range of different medical conditions including the following:


  • Herniated/slipped discs (this is the most common cause)

  • Degenerative disc disease

  • Osteoarthritis

  • Spondylolisthesis

  • Spinal stenosis

  • Spinal trauma

  • Sciatic nerve trauma

  • Spinal tumors

  • Cauda equina syndrome (rare, but serious)

  • Piriformis syndrome (not very common)

Age is a risk factor for sciatica.

Risk Factors For Sciatica

Since sciatic is such a common condition it can be helpful to know what your risk factors might be for getting it, and how to potentially avoid it. Some risk factors, like age, can’t really be helped, but, just like with lower back pain, there are other things we can do to lower our risk of having sciatica.

herniated discs and bone spurs are common culprits when it comes to sciatica.

Age

As we get older we start to experience changes in our spine. Our bone tissue and discs start to get worn down and herniated discs and bone spurs are common culprits when it comes to sciatica.


Osteoarthritis is a cause of sciatica.

Osteoarthritis

Osteoarthritis is a condition that affects the spine, hips, and knees. As we get older our chances of having osteoarthritis increases. The joint cartilage and underlying bone begin to degenerate, causing stiffness and pain and putting the nerves at risk of injury.


Obesity can trigger sciatica.

Obesity

Extra body weight can put additional stress on your spine which can trigger sciatica.

Heavy lifting can trigger sciatica.

Your Job

Certain occupations that require a lot of heavy lifting, repetitive movements, standing (or sitting) for long periods of time, or long hours of driving, can wreak havoc on your back. There is no conclusive link to causing sciatica but we do know that they play a role in low back pain so it might be something to consider. You can’t change your job but you can make sure you wear good shoes, use an ergonomic chair, or take frequent breaks to walk and stretch.


Lower back injuries can cause sciatica.

Previous injury

Lower back injuries can put you at a greater risk for sciatica.

Strong core muscles can help prevent sciatica.

Weak Core Muscles

Your core muscles are the support scaffolding for your spine. When you have strong core muscles your spine is more supported which leads to fewer low back injuries.


Diabetes can cause nerve damage and sciatica.

Diabetes

Diabetes is a condition that can cause nerve damage which increases your chances of sciatica.

Regular exercise is key for preventing sciatica.

Inactivity

Regular exercise is key for preventing low back issues. Not only does it improve circulation to your back muscles but it keeps them flexible and mobile. Research has shown that regular exercise can prevent low back pain as well as helping it to heal faster.

Loss of bowel or bladder function is a sign to seek immediate medical attention.

Complications

Thankfully most people recover fully from sciatica within a few weeks, and often without needing medical attention. There are some situations, however, where sciatica can potentially cause nerve damage which can sometimes end up being permanent. If you experience any of the following symptoms you should seek immediate medical attention:

  • Loss of feeling in the affected leg

  • Weakness in the affected leg

  • Loss of bowel or bladder function

Your doctor can do some tests to see if you have sciatica.

Diagnosing Sciatica

If you think that you have sciatica it is a good idea to make an appointment with your healthcare provider to go through your medical history and check for any red flags. Your doctor might have you do a straight leg raise test to help them pinpoint the affected nerves and to make sure there isn’t a problem with your discs. He or she may also ask you to walk on your toes and heels to see how strong your calf muscles are, and to do other stretches to see how strong and flexible your muscles are.

EMG is sometimes used to test for sciatica.

Common Tests For Diagnosing Sciatica

  • MRI/ CT scans

  • Spinal x-rays

  • EMG/ nerve conduction studies

  • Myelogram


How To Treat Sciatica

When dealing with sciatica the main goal is to reduce pain and help keep you active and mobile. Some simple treatments that you can do yourself, at home, include:

  • Heat pads

  • Ice packs

  • OTC medications (like naproxen and Aleve)

  • Gentle stretching


Regular exercise can help prevent sciatica.

How Can You Prevent Sciatica?


Sadly you can’t always prevent sciatica from happening, or from recurring once it has already happened, but there are some things you can do to lower your risk.


  1. Exercise regularly

  2. Strengthen your core muscles

  3. Check your posture

  4. Make sure you lift objects properly.

  5. Take regular stretching breaks if you stand or sit for long periods of time.


Gentle stretching can help with sciatica.

Conclusions


Sciatica is something that affects a large portion of the population but the good news is that it rarely lasts long, or is serious. If you stay active and follow some of the tips that we have shared above you can lower your chances of having it, or reduce your risk of it happening again. Keep moving and take care of your back and it will take care of you. As they say, “You are only as young as your spine”!