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Sciatic Nerve Pain

Sciatica (or sciatic nerve pain) is a common affliction that describes pain in the lower back that often travels down the leg and can result in a numbing of the area, ranging potentially from the below the knee to the buttock and lower back. As the term sciatic nerve pain suggests; sciatica is caused by an irritation of the sciatic nerve. The sciatic nerve is actually the longest in the body, starting in the lumbar spinal cord (in the lower back) and travelling all the way down to the bottom of the legs. The fact that it is so long is both partly responsible for its prevalence and for its seriousness.

Among things that can potentially irritate the sciatic nerve so leading to sciatic nerve pain is a disc herniation – which can cause a spinal disk to press onto the nerve so trapping and squeezing it. Alternatively, adjacent bones, tumors and muscles can also push against the nerve causing it to be trapped to damaged. Internal bleeding and infections can both also cause damage to the area. This will then be noticed by the patient as a burning sensation, or tingling and numbness in the areas described. If sciatic nerve pain is severe it can make it difficult for patients to walk, bend or sit down and can be completely debilitating in some instances. In these cases patients should lie down in an attempt to relieve symptoms.

Sciatica is then diagnosed with a physical exam combined with the patients medical history. Certain manoeuvres can help a physician to ascertain whether the pain is in fact caused by the sciatic nerve or whether there is a separate cause. If it remains unclear as to the cause of the problems then the patient will be subjected to an x-ray, CAT scan, MRI scan or electromyogram which can help the doctors to see precisely what’s going on inside the afflicted’s back.

Bed rest is generally recommended for patients though its usefulness has been debated. In some studies it has been shown that ‘watchful waiting’ (acting as normal) has almost the same success rate as bed rest. However bed rest is usually the best way to avoid the immediate symptoms while waiting for the condition to die down. There are also many exercises however which one can perform to lessen the symptoms of sciatica.

The first exercise involves kneeling on the floor in ‘all-fours’ position then arching your back as high as possible like a cat in order to stretch it. Hold this position for a couple of seconds then release allowing the mid section and back to dip and hang naturally. Rest, then repeat until the pain has been mildly relieved.

A second exercise you can perform yourself is to lie flat on the ground with your legs up on a chair or sofa at right angles. The flats of your feet should be touching the back rest of the chair and your own back should be completely flat against the ground. This way your lower back is pressed more firmly against the ground and kept more in line than if you were lying normally. This should immediately alleviate the pain and after half an hour should have some kind of lasting affect.

In some cases sciatic nerve pain consists and the doctor or physio therapist is forced to take more decisive action. Other treatments for sciatic nerve pain include addressing the underlying cause by operating to remove slipped disks or misaligned muscles and bones, medications to relieve pain, remove inflammation and relax the muscles, or physical therapy. There are also surgical procedures that can be performed if persisting sciatica is caused by nerve compression at the lower spine.

The best known procedure for sciatic nerve pain is probably the epidural. An epidural is actually a form of regional anaesthesia that blocks localised pain in the lower spine. In these procedures, steroids are injected directly into the area causing pain to provide at least short term sciatic nerve pain relief that can enable patients to begin rehabilitation.

The spinal chord is contained by a channel within the vertebrae and surrounded by the protective membranes known as ‘meninges’. Through here the spinal chord carries signals (AKA action potentials which are small electrical impulses). At various points throughout the spin, the spinal chord is connected to the main nerves of the body. These nerves serve the purpose of carrying information both to and from the limbs – both instructions to move the limbs and information back telling the brain the limb is in pain. Down the bottom is the ‘epidural space’ surrounding the outermost membrane of the spinal chord. By injecting into this area then, it is possible to block off one stream of information returning to the brain from the lower body and so numb the pain signals from the sciatic nerve so temporarily putting an end to sciatic nerve pain.

While this procedure is generally highly affective it is also unfortunately high unpleasant in itself and carries with it certain risks. Patients are awake during the procedure though may have a form of sedative in order to relax. From here they lie on their side in the foetal position in order to open up the space between the vertebrae in the back. The needle is fairly large and can look fairly daunting at first, though the initial pain from the injection should only last several hours.

Unfortunately however there are also several potential side effects including nausea, backache, vomiting, inability to pass urine and itchy skin. There is also a risk of permanent damage such as partial paralysis, though this is extremely rare.

When deciding on an epidural, weigh up the pros and cons and consider the severity of the condition. If you still wish to go ahead it can be a very effective form of relieving sciatic nerve pain.





Mack LeMouse

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  • Comment #1 (Posted by John Hop Ping)
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    Very good article but wanted some info related to spinal stenosis and if it can cause peripheral neuropathology.
     


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