sciatica

What Is Sciatica?

Sciatica is the casual name for a medical condition called lumbar radiculopathy, which refers to an irritation of one or more of the nerves that exit the lower back. Nerves are like the electrical wiring system of your body. They are bundles of fibres that begin in the brain, travel down the spinal cord and branch out to different parts of your body. The nerves that branch out from the lower back travel to the leg, and carry message signals back and forth between the brain and different parts of your body/leg. Nerves have many different functions, but their main jobs are to help you feel things, and to help you move. 

When a nerve is irritated, this can interfere with the messages being sent back and forth, and can lead to issues such as pain, weakness, numbness and/or tingling. When the nerves from the lower back are affected, this often leads to these problems down the leg.

What Causes Sciatica?

In the majority of cases, sciatica is caused by a nerve being irritated from a disc injury. Discs are located between each segment or vertebrae in your spine, and they can act as shock absorbers and help provide movement to the spine. The disc is made up of a hard, tyre like outer ring, and a soft, fluid like centre. Sometimes, when excessive force is placed through the disc, the inner portion of the disc can push out through a tear in the outer ring. This is called a disc herniation. When this happens, the nerves that branch out from the lower back that sit besides the disc can become irritated or squashed, and this can lead to symptoms down the leg. A disc herniation can also cause inflammation in the back, which also contributes to pain.

What Does Sciatica Feel Like?

Sciatica can present in different ways for different people, and the intensity of symptoms can significantly vary. In general, however, symptoms of sciatica will include sharp, shooting pain down the leg, numbness, pins and needles and/or weakness in one leg.

How Do I Know If My Leg Pain Is Sciatica?

A true lumbar radiculopathy will only occur in about 5-10% of all people who experience lower back pain. However, leg pain associated with lower back pain can be more common than that. There are a few situations in which non nerve related leg pain can be confused for sciatica, with the most common type being referred pain. 

Referred pain occurs when pain is felt in a different part of the body to where the actual source of injury is. This often occurs because signals sent via the nerves from those different body parts to the brain can sometimes get mixed up. In general, the easiest way to tell if your leg pain is being caused by sciatica is by noticing the type of pain you are experiencing. Referred pain is generally dull, aching and diffuse. Nerve pain, in contrast, is normally sharp, shooting, and can often be traced down the leg in a line with one finger.

What Should I Do If I Think I Have Sciatica?

Majority of cases of sciatica will get better with time and appropriate conservative care and management. This can involve things such as taking anti inflammatory and pain medication, exercise based therapy, manual therapy and appropriate education and activity modifications.

In certain cases, medical interventions such as cortisone injections and surgery may be needed. However, it is important to note that the research has shown that in the majority of cases, although surgery can help alleviate symptoms sooner, there is no clinically significant difference between surgical management and non surgical management in the medium to long run (at 1-2 year follow-up).

If you suspect that you have sciatica, please seek help from a qualified physiotherapist or medical practitioner.