Sciatica (or sciatic neuritis) is a symptom or set of symptoms, rather than a disease condition per se. That is, it's a description of the effects of a certain condition, rather than a description of the cause of it. Sciatica, as it turns out, can be caused by a number of different things. This is why it is important, if you believe you suffer from these symptoms, to see a competent doctor or chiropractor and get a full diagnosis, to pinpoint what the actual cause of these symptoms may be in your case.
What are the symptoms of sciatica?
Sciatic pain results from irritation of or compression of the sciatic nerves, located at the base of the spine. Its symptoms commonly present themselves as "shooting" pains in the lower back and buttocks that make standing or sitting difficult. This pain can be felt to "travel" down the legs, and is often felt on only one side of the body. Many people who have sciatica also experience numbness, muscle weakness, a tingling sensation, and restricted leg and lower back movement.
Sciatica can develop suddenly or over a period of time. The pain may seem to increase when you sit or stand for long periods of time, or when you cough or sneeze. More rarely, people with sciatica report an inability to bend their knees or move their feet and toes.
What causes sciatica?
Often, sciatic pain is the result of a compressed or "pinched" nerve in the lower spinal area. It can also be caused by herniated vertebral discs, which are now applying pressure on nearby nerves. Another cause of sciatica occurs when the piriformus muscle in the buttocks becomes too tight and experiences spasms, thus applying pressure to the sciatic nerves. At least two of the potential causes of sciatica are structural – spinal stenosis (a narrowing of the spinal canal), and spondylolisthesis (a "slipped disc" that moves out of alignment with others, and thus places pressure on adjacent nerves).
How is sciatica treated?
There is no sure-fire "cure" for sciatica, although it usually goes away, given sufficient time, rest, and rehabilitative exercise. The goal of most medical treatment of is to first decrease the pain, and second to increase mobility. Analgesics such as aspirin or ibuprofen often enable sciatica sufferers to deal with the pain, and if that doesn't work more powerful painkillers can be prescribed. Anti-inflammatory drugs can reduce the stiffness and lack of mobility, and muscle relaxants such as cyclobenzaprine (Flexeril) are sometimes prescribed to reduce muscle spasms.
Rest is often recommended – and is a valuable first step – but can be actually be counterproductive if overdone, because the condition is often caused by overly tight muscles, which require stretching to relieve that tightness. That is why many doctors and chiropractors recommend a series of gentle exercises to "stretch out" the tight muscles that are placing pressure on the sciatic nerves. This often feels counter-intuitive to the sciatica sufferer, because all they want to do during an attack is go to bed and rest until it subsides. But in practice the best form of self-treatment is gentle stretching exercise, which strengthens the muscle groups in your lower spine and back, stimulates blood flow to promote healing, and triggers the production of endorphins, our body's own natural painkillers. Most sciatic exercises focus on strengthening the abdominal muscles, to more efficiently support the spine and keep it aligned, and many of them focus on stretching the hamstring muscles.
Serious cases of sciatica that do not respond to any of the above methods may be treated with injections of cortisone-based anti-inflammatory drugs into the lower back, and in rare cases with surgeries such as microdisectomy or laminectomy. But remember, most cases of sciatica go away on their own, and most sciatica sufferers recover from episodes within six weeks.