Sciatica - Causes
Sciatica is the resulting pain and discomfort that follows a pinched sciatic nerve root. This pinching transfers pain all the way from the buttocks down to the toes. The following is a list of potential causes of sciatic pain:
1. A Herniated Disc - A herniated disc of the lumbar vertebra L4-5 through the sacral vertebra S1-3, is the most common cause of sciatic nerve pain. Intervertebral discs basically serve as cushions between the vertebrae of your spine and act as shock absorbers during physical activity. The disc is primarily composed of water. While the "annulus fibrous" (outer disc) is tough, it has a jelly-like center known as the "nucleus pulposus". When a disc bulges or ruptures (herniation), it can place pressure on the sciatic nerve- this causes pain in the lower back and legs. Once the sciatic nerve has been irritated, most people complain of pain in the buttocks and back of the legs. However, in more serious cases, a herniated disc can even irritate the nerve to the point of bladder and bowel problems.
2. Spinal Stenosis - Your spinal cord, which extends from the base of your brain to the upper lumbar (lower back), is contained in the vertebral canal. Spinal Stenosis, a nerve compression disorder, occurs when an area of the spinal canal narrows, placing pressure on the surrounding nerves. When spinal stenosis occurs in the lower back, it may be the lumbar nerves that are pinched- this creates sciatic-like pain.
3. Spondylolithesis - Most commonly affecting the lumbar region of the spine, this disorder occurs when a vertebra slips forward over the sub-adjacent vertebra. Consequently, the sciatic nerve may be pinched, causing lower back pain and leg pain. Spondylolithesis is usually caused by a combination of spinal degeneration and physical stress.
4. Degenerative Disc Disease - Firstly, Degenerative Disc Disease is more of a degenerative process that occurs naturally with age, rather than a disease. Over time, the discs that support our vertebrae begin to deteriorate, becoming more rigid and losing their ability to move fluidly and freely.
5. Piriformis Syndrome - Piriformis Syndrome occurs when the piriformis muscle has a spasm. This irritates the sciatic nerve, which runs beneath the muscle deep in the buttocks. Deep pain is felt in the buttocks and is often transferred to the hips, lower back and the legs. Often, the injury is caused by over-training, running too hard and too frequently for example, but is not limited to athletics. Furthermore, most people complain of increasing pain in a seated position. Technically speaking, piriformis syndrome is not sciatica even though it produces similar pain.
6. Sacroiliac Joint Pain - The sacroiliac joint is located where the pelvis connects to the spine. It is not a joint with a lot of movement such as the hip, knee, or shoulder, but the SI joint is critical in the transfer of the upper body weight load to the lower body. Sacroiliac joint pain can be difficult to diagnose for several reasons. For one, the SI (sacroiliac) joint often shows up as normal on diagnostic imaging tests such as CAT scans, MRIs, X-Rays, and bone scans. It is nearly impossible to isolate the SI joint on tests. In addition, it is difficult to manipulate or palpate the sacroiliac joint due to its location. To further complicate the diagnosing of sacroiliac joint pain, other problems such as sciatica, back pain, hip arthritis, and others can cause the same or similar symptoms.
Age, occupation, lifestyle and genetics are factors to be aware of when considering back pain, sciatica and your susceptibility to each. Firstly, spinal disc deterioration begins around age 30, and people most commonly suffer herniated discs in their 30's and 40's. To make matters worse, men and women in their prime are more likely to work a job that requires twisting, lifting and carrying heavy loads. Conversely, those who lead a less active lifestyle are more likely to develop sciatica than active people.
Sciatica - Treatments
The journey to sciatica pain relief begins with obtaining a proper diagnosis from a doctor specializing in back pain/disorders. In many cases, sciatica is associated with over-exertion or a back injury. In these cases, it's important to determine if conservative measures including ice/heat therapy, anti-inflammatory medications, moderate stretching, and Ultrasound Therapy (such as our Personal Therapeutic Ultrasound System) are adequate. Conservative treatments are usually very effective. However, if you experience more serious symptoms like considerable loss of feeling and numbness, a loss of bladder and bowel control, muscle weakness or if the pain lasts and gets progressively worse, then get medical attention immediately. Bed rest has long been accepted as necessary for relieving back pain and sciatica. In more recent years, however, the long term benefits of bed rest have been challenged. While rest may temporarily relieve pain within the first day or two of an injury, prolonged bed rest may be detrimental to healing. Inactivity causes muscle atrophy (loss of muscle mass), muscle tightness and reduced blood flow in the back, all of which are disadvantageous for healing. Rather, treatments should be geared at maximizing mobility and maintaining back strength while taking care not to re-injure it.
Sciatica Treatment Options
Ultrasound - For more detailed information on how Ultrasound helps heal lower back pain and sciatica, see our About Ultrasound page. Essentially, Ultrasound Therapy provides stimulation to deep muscle tissue, which increases nutrient rich blood flow to the area. It has been found to aid distended connective tissue, which is important for stretching- this helps increase your range of motion for safer and more effective stretching and rehabilitation.
An Inferno Wrap Energy Device for the back is one of the most helpful tools for a wide variety of painful back-related problems. Through the use of the patented Energy Web, soft tissues are safely and gently heated- increasing oxygen and nutrient rich blood flow within the treated area. Your body's natural response to this increased temperature is to try to maintain a condition of homeostasis in a balanced environment (basically, your body increases blood flow to the heated area in an attempt to drop the temperature). With the rapid increase in blood flow to the area (a term known as vasodilation), there is an increase in the supply of oxygen and nutrients to injured cells, and toxins are flushed out (including lactic acid, commonly found in trigger points)- both of which promote healing. Our Inferno Wrap for the Back provides effective, non-invasive, non-addictive pain relief with no side effects.
Cold Wraps - Our "Freezie" Cold Compression Wraps allow you to actively treat yourself as part of the R.I.C.E. formula (Rest, Ice, Compression, Elevation) within the first couple days of injuring your back. The coldness of the wrap effectively numbs the nerves in the treated area, which reduces pain!
Physical Therapy - Extension exercises may be part of the daily regimen recommended by your chiropractor or therapist. One exercise involves lying on your stomach in a prone position, and propping your upper body up on your elbows. Keep your hips on the floor and gently stretch by holding the position for up to 30 seconds if possible. This change in position from bending forward can temporarily relieve the pressure on the sciatic nerve. Advanced forms of extension exercises will be given as the inflammation causing sciatic nerve pain begins to resolve. The use of Ultrasound Therapy or our Inferno Wraps before stretching and exercising the lower back will help compensate for impaired movement, enabling a thorough stretch and/or workout.
Medication - Over-the-counter anti-inflammatory medications are another possible sciatica treatment. Since sciatica is caused by pressure on the sciatic nerve complex, reducing the swelling around the nerve endings is necessary for lowering the pain intensity. Anti-inflammatory medications are generally not as effective when used alone as when used in combination with other sciatica home treatments, such as exercise or Ultrasound Therapy. And besides, physical therapy like stretching and massage often provide the same pain relieving benefits as medication, but without any side effects.
Do you have more questions?
We encourage you to contact our office directly with any questions you may have or advice on treating your back injuries, whiplash injuries or sciatica. You can be assured all your questions will be answered in a thorough and courteous manner by our trained staff.
Feel free to email us at contact@AidMyBack.com.
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