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Sciatica – a pain in the backside!

July 2011 

sciaticaIt is rare that someone will reach their 50s or 60s without having encountered a friend of colleague who has complained of pain from their sciatic nerve.

This nerve is the largest single nerve in our body and many people experience problems from it; often temporary or minor, but in some cases extremely painful and debilitating.

The sciatic nerve runs from each side of the lower part of our spine, down through our bottom to the back of the thigh and then all the way down to our feet; it connects the spinal cord with the muscles in the leg and feet.

When you hear someone say they are suffering from sciatica, they are usually experiencing leg pain or possibly a tingling or weakness in the lower back and down the back of the leg. Sometimes sciatica can result in constant severe pain on one side, or in a sudden sharp pain that makes it difficult to stand up or walk. Pain from problems with the sciatic nerve can radiate causing pain elsewhere such as in the feet or even in your toes. Interestingly sciatica usually only affects one side of the body.

Because it is such a long nerve, pain can radiate down the nerve which doesn’t always indicate the exact site of the problem. Generally sciatic pain is caused by compression or interference with the nerve’s root where it moves away from the spine although sometimes problems can be caused by actual damage to the nerve anywhere along its position.

For older people sciatica is often caused by changes in the spine possibly due to osteoarthritis, causing localised pressure on the nerve or because of a narrowing of the spinal canal. This last condition is known as spinal stenosis. Bone diseases and injury can cause problems with the sciatic nerve – and sometimes bad posture such as a poor sitting position can result in sciatica.

Sciatica, while common, is not a condition to be ignored. Even when minor, it can affect the quality of life and in really serious cases is can lead to loss of sensation around the genital areas, difficulty in passing water and a progressive weakness.

However, the good news is that sciatica often gets better on its own after a few days or weeks. Generally the majority of sciatic flare ups heal themselves and recover within three months.

However, sometimes the condition continues or worsens and medical help and treatment is required.

Initially pain management techniques and exercise may be recommended. Painkillers, anti-inflammatory medication and sometimes even epidural injections may be suggested. Many instances of sciatic pain can be controlled by specific exercise programmes that are tailored around the underlying cause of the problem. These exercises can not only reduce the pain but also help to condition the areas to prevent future problems. Strengthening back exercises can also help to relieve other back problems that can come with age.

Your doctor will advise and there are a number of specialists including physiotherapists, osteopaths and chiropractitioners who specialise in helping people suffering from sciatica.

In some cases though, when general treatment and pain relief methods are not working, spinal surgery needs to be considered. The actual surgery will depend on the cause of the problem and surgical procedures can include a microdiscectomy (when the sciatic pain is due to a disc herniation in the spine) and lumbar laminectomy, an open decompression. Results from surgery are generally good.

By far the best thing though is to minimise the likelihood of suffering from sciatica in the first place. This means taking care not to sit in awkward positions for long periods of time, learning to lift properly and taking regular exercise to keep the back flexible and strong.

For more information about Sciatica visit NHS Direct



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