Like some of my patient’s over 40, you may begin to experience pain on one side of your hips/buttocks, some numbness or tingling running down your leg, or even weakness in your legs. You may find it increasingly harder to sit comfortably or even have sharp pain when trying to stand or walk. If this sounds like you, you could have an increasingly common condition called sciatica – a cluster of symptoms that points to herniated or degenerating, spinal disks.
Sciatica affects people over age 30 and is almost always the result of a problem with the lower spinal disks causing radiculopathy, or compression/irritation, of the sciatic nerve that sends pain and/or tingling and numbness down into the legs. Let’s talk about what causes lower spinal disk problems.
Causes of Sciatica
As I tell my patients, sciatica is not really a diagnosis in itself, but rather a condition that includes several symptoms that can have different causes. Here are the most common of those causes:
1. Herniated lumbar disc – sudden twisting motions, or impact injuries, of lumbar, spinal disks causes the inner disc to bulge out between disks. This bulging puts pressure on surrounding nerves, the sciatic being the most prominent.
2. Lumbar spinal stenosis – a hardening, or “stenosing” of the spinal disks causes it to become inflexible and rub against the sciatic nerve. Most common in people over 60, but can occur earlier in athletes and people in occupations with a lot of impact shock to the spine.
3. Degenerative disk disease – degeneration of the disk can occur normally with the aging process. The edges can be rough and irritate the surrounding nerves.
4. Isthmic spondylolisthesis – a big medical name for when a disk is injured and falls out of place, sliding over another. The loss of space between the two disks can compress the nerve exiting the disks at this level and cause pain and irritation.
5. Piriformis syndrome – the piriformis muscle extends across the buttock. The nerve root, that includes the sciatic nerve, can get pinched or irritated as it runs beneath the piriformis down to the thighs.
6. Sacroiliac Joint Dysfunction – irritation of the sacroiliac joint can irritate the lumbar nerves and cause sciatic-like symptoms.
Other less common causes of sciatica can be pregnancy, muscle strain, spinal tumors, scar tissue from previous injuries, or infection.
Treatments for Sciatica
For my patients who have sciatica, almost always, treatment will include some sessions with a physical therapist who will design specific exercises to address the condition causing it. That is why correct diagnosis of what is causing the sciatica is crucial.
The good news about sciatica is that it almost always gets better in a few days to weeks after starting exercise treatment. Depending on the cause of your sciatica, it could take up to 12 weeks to fully resolve. You may still continue to experience flare-ups of it as well. Some particular causes, like nerve entrapment that doesn’t respond to exercise, or even chiropractic, may require surgery to return the nerve to its proper position.
Some Things You Can Do To Help Yourself
➢ Heat or Ice – Apply either heat or ice packs, or alternate between the two, depending on which feels best to you. Do this for about 20 minutes then repeat every 2 hours when sciatica flare first begins.
➢ Over the counter pain remedies – Such as ibuprofen, can be helpful.
➢ Homeopathic pain remedies – Arnica or Traumeel, sold at better health food stores, can help relieve symptoms without the side effects of nonsteroidal anti-inflammatory drugs.
➢ Magnesium – 500 mg of magnesium can help relieve pain causing inflammation.
➢ Quercetin – Another herbal anti-inflammatory helps relieve inflammation.
➢ Vitamin B1 and B6 – Helps relieve nerve irritation and numbness.
➢ Vitamin C – 1000 mg a day also helps to relieve inflammation.
➢ Calcium – Optimal calcium helps prevent deterioration of bone and spinal disks.
➢ Vitamin D – Insufficient Vitamin D can contribute to spinal disk, as well as overall bone and joint degeneration as your body will not be able to use calcium very well.
➢ Water – Optimal water intake is crucial to keeping discs buoyant, lubricated and moving correctly. Dried out disks can open the door for degenerative problems setting in.
➢ Acupuncture – Promising in relieving nerve pain of sciatica by restoring the normal flow of energy in the nerve and muscles involved.
➢ Massage therapy – Massage helps stimulate the muscles where the numbness, tingling is occurring to increase blood flow to them, decrease pain and numbness.
➢ Chiropractic manipulation – Chiropractic manipulations work on coaxing the spinal disks back into their correct place and releasing the pressure on the surrounding nerves.
Sciatica can truly be a genuine pain in the butt – but it’s not something you have to live with. Regular exercise, stretching, is the best preventative measure against sciatica. Try to avoid long periods of sitting. With proper nutrition, and treatment of underlying contributing conditions, sciatica doesn’t have to put you on the sidelines. You can be up and running and back in the game in no time.
Mark Bromson, M.D.