Sciatic Nerve Pain

Sciatic nerve pain is pain that is felt near the section of the sciatic nerve as a result of compression or irritation, or radiates away from this area of injury. When pressure is put on the sciatic nerve, or when the tissues around the nerve become irritated, then its normal functioning may be disrupted. As a result, we may feel pain in our legs, the loss of strength, the loss of feeling, and other neurologic symptoms (e.g. burning, tingling, and electric shock) related to the entrapment of the nerve. These symptoms may be reversed when the pressure is taken off the nerve, though the chances of permanent nerve damage increases after several weeks or months of non-treatment. There are several possible reasons for sciatic nerve pain. We will examine most of them below.

Spinal Disc Herniation: The sciatic nerve is the largest nerve of the body, and travels the length of the leg to the foot. The sciatic nerve is a nerve that is combined from five separate spinal nerves L4-S3. Due to the spinal disc herniation of the last two lumbar discs, a person may experience pain in both the lower back and down the leg. These discs are found between vertebral bones L4 and L5, and between L5 and the first segment of the sacrum. The closer the vertebral bones and discs are to the bottom of the spine, the more weights and pressures they must support of the structures above them. Thus, they are prone to wear and tear, and eventually tear may occur that are wide enough for the material in its nucleus to spill out. Physicians estimate that a lumbar disc herniation is the cause of sciatic pain in 90% of all cases.

The discs in some cases do have the ability to heal themselves, and the tears in the disc may close. In these cases, patients with sciatica pain may begin to feel better when the discs heal and the inflammation subsides.

When discs do become herniated, they may cause intense pain and dysfunction if their ejected material presses in to one of the spinal nerves. If the material doesn't impact the spinal nerves or ligaments, patients may experience no pain at all.

Physicians will work with their patients to treat this condition non-surgically in order to get the symptoms under control. Non-surgical treatments include:
  • Icing in the first 24-48 hours after the initial injury or if the pain suddenly comes on in your lower back. The ice treatments may prevent muscle spasms and severe pain. For some people, the pain may come on suddenly when a person herniates their disc suddenly following some accident or trauma.
  • After the first 48 hours, heat may be applied to the tender or affected area to relax and warm the tissues. Heat treatments may last for about 20 minutes at a time and may be used several times a day. " Restriction of activities may be appropriate in the first several days when the symptoms are severe.
  • Light, non-weight bearing exercises may be good to prevent muscle spasms and keep the back physically fit. Some good light activities include Yoga, Tai Chi, swimming, and walking.
  • Anti-Inflammatory Medications: Anti-inflammatory medications available over the counter, such as aspirin, naproxen and ibuprofen may help to control inflammation in the acute stages of the injury.
  • More powerful prescription medications may be prescribed to treat severe pain
  • Physical therapy: Physical therapy is typically the treatment of choice for doctors, whenever possible, to treat lower back pain and sciatica, because of its low complication rate. Physical therapy only has the ability to help you, and it can rarely cause more harm to your body, as long as it is done safely.
Herniated Disc Surgery: If a these treatments fail to reduce pressure on the spinal nerves, then surgery may be considered after a time period of several months. Your surgeon will discuss what options are available to you, and he or she will outlines the risks for each. Some common surgery procedures include the Laminectomy, Corpectomy, and anterior cervical discectomy and fusion, and laminoplasty.

Hatha Yoga: Patients may try complementary therapies such as Yoga to give their spine a better chance to recovery from the prolapsed of their lumbar herniated discs. Hatha Yoga is gentle on the body and involves an array of body postures, slow movements, and proper breathing techniques.