Sciatica

What is sciatica?

Sciatica is the name given to any sort of pain caused by of the sciatic nerve.

The sciatic nerve is the longest nerve in your body. It runs from the back of your pelvis, through your buttocks, and all the way down both legs, ending at your feet.

The pain of sciatica is usually felt in the buttocks and legs.

Most people find it goes away naturally within a few weeks, although some cases can last for a year or more.

When the sciatic nerve is irritated, it can cause:

• pain
• numbness
• a tingling sensation that radiates from your lower back and travels down one of your legs to your foot and toes
• weakness in the calf muscles or the muscles that move the foot and ankle

The pain can range from being mild to very painful, and may be made worse by sneezing, coughing or sitting for a long period of time.

While people with sciatica can also have general back pain, the pain associated with sciatica usually affects the buttocks and legs much more than the back.

Causes of sciatica

In the vast majority of cases sciatica is caused by a slipped disc. A slipped disc occurs when one of the discs that sit between the bones of the spine (the vertebrae) “slips” and starts pressing on the nerves.

It’s not always clear what causes this to happen, although as you get older your discs become less flexible and more likely to be damaged. The good news is that most slipped discs resolve on their own but this can take some weeks or months.

Less common causes include:

• spinal stenosis – narrowing of the nerve passages in the spine
• spondylolisthesis – when a vertebra slips out of position
• a spinal injury or infection
• a growth within the spine – such as a tumour
• cauda equina syndrome – a rare but serious condition caused by compressed and damaged nerves in the spinal cord

Treating sciatica

Most cases of sciatica pass in around six weeks without the need for treatment.

A combination of things you can do at home – such as taking anti-inflammatory painkillers for any back pain, staying active and exercising, and using hot or cold packs – may help reduce the symptoms until the condition improves.

Further treatment may be needed in some cases, such as:

• an exercise programme under the supervision of a physiotherapist
• injections of anti-inflammatory and painkilling medication into your spine
• stronger painkiller tablets
• manual therapy (treatments such as manipulating the spine and massage, usually carried out by physiotherapists, chiropractors or osteopaths)
• psychological therapy and support

In rare cases surgery may be needed to correct the problem in your spine.

Preventing sciatica

You can minimise your risk of a further episode of sciatica by:

• adopting a better posture and lifting techniques at work
• stretching before and after exercise
• exercising regularly