Does sciatica occur suddenly or does it take time to develop?
Sciatica can do both, have a sudden onset or develop slowly over time. The difference is the cause of the sciatica, with a herniated disc usually causing a sudden pain, and an arthritic cause coming on slowly with age. The condition Sciatica is what happens when a sciatic nerve is irritated, which typically leads to pain in the lower back and down a leg. This condition also affects just one side of the body, and can travel through the hips and buttocks down the legs and can be acute or chronic. Chronic sciatica is a life long condition but is less severe than acute sciatica.
What triggers sciatica?
There are a number of causes that trigger sciatica flare ups. Aging comes with certain changes within the spine that can cause sciatica to start flaring up like bone spurs or herniated discs. Usually this is the most common cause of sciatica and up to 5% of all people in the United States will have a bulging disc at some point in their lives. Discs in your spine are like cushions that absorb the small shocks of bending and twisting the vertebrae of the spine together, and are found between vertebrae in your back. When they bulge they can press against the sciatic nerve, which is what causes the sciatica. The sciatic nerve is the longest nerve in your body and starts in your lower back and runs all the way down your leg. That’s why sitting for long periods of time can sometimes trigger sciatica, or doing workouts like squats improperly since it can cause a disc to bulge. Sciatica can also flare up during pregnancy as well, due to the hormones flooding the body that loosen ligaments holding spinal vertebrae together.
What are the risk factors for sciatica?
While sciatica can develop slowly over time due to aging, osteoarthritis or degenerative disc disease, there are certain factors that can put you at a greater risk. If you’ve had an injury previously to your lower back or spine you will have an increased risk of developing sciatica. Being overweight can also put you at greater risk since carrying extra weight puts more strain on your back, and may flare up sciatica. If you have a job that requires heavy lifting, repetitive motions of the back, or even sitting for excessive periods of time without a break, these can also be risk factors. Diabetes increases the chance of nerve damage in general, which includes sciatica. Smoking also weakens bones and increases the speed at which your spinal discs degenerate, so this can contribute to the development of sciatica as well.
Symptoms of Sciatica
Generally the symptoms of sciatica include:
- Mild to severe pain in the lower back, that radiates through the buttock and down the leg
- Discomfort anywhere along this nerve pathway
- Numbness, tingling or muscle weakness in the leg or foot
- Burning sensation through the lower back and leg
- Sharp or electrical like pain
Straight leg raise test
Doctors may use a physical test to see if you have nerve sensitivity or irritation in the lower back such as what happens with sciatica. There is one such physical examination technique called the straight leg raise test that can indicate if you likely have sciatica. The way this test is done is by having a patient lay flat on the back with the leg being raised while remaining straightened until some discomfort or tightness is noticed. Depending on where the pain occurs your doctor can figure out what kind of diagnosis may be appropriate, and if further testing is needed.
The physical exam is the first step of diagnosis. Your doctor will also go over your medical history, and ask questions about your day to day activities to help come up with an accurate diagnosis. If needed, imaging tests are available to pin point exactly where the problem is occurring. X-rays are used to see the bones of your spine and can be used to see if there is a bone spur causing nerve pressure. MRI scans are specially suited to view the back in 3 dimensions and create detailed images of bone, as well as tissue, so your doctor can view everything happening in your back. Using these imaging techniques your doctor can have images indicating the precise location of the pain causing disc or vertebrae and come up with a treatment plan accordingly.
How do I get my sciatic nerve to stop hurting?
Having a sciatica flare up is a pain, but luckily there are a few strategies to find sciatica pain relief. You might think laying down and resting would be the best way to find relief, but actually extended inactivity and bed rest may hurt more than it helps. Short rest periods might be necessary right after a back pain flare-up, but you’ll want to stay as active as you can to strengthen the muscles supporting your back. With too much rest the muscles will weaken and further dry out spinal disc which makes them more susceptible to damage. You can also apply heat and ice to the area which reduces inflammation and promotes blood flow which in turn propagates healing.
Medication can also help control the pain and inflammation at the injured area so you can do physical therapy. Some of the pain medications that are recommended are anti-inflammatory drugs like aspirin, ibuprofen, or, if the symptoms are more severe, a steroidal injection. Physical therapy and exercise are a cornerstone of recovering from sciatica, including stretching and things to improve posture. Working with a physical therapist is important so that you don’t over exercise or perform a regimen that is too heavy or out of form.