The sciatic nerve is the largest nerve in the body. It begins at the spinal nerve roots in the lumbar (low back) region of the back and extends around the hip through the buttocks, then down the lower limbs. There are actually two sciatic nerves, one going down each leg.
The pain resulting from irritation of the sciatic nerve is called sciatica. The pain is usually from the low back, extends around behind the thigh, and radiates down one of the legs. Typically it is only down one leg. In some instances, the pain will go down both legs. Depending on the severity, the pain can be go all the way down to the bottom of the foot.
Any irritation or inflammation of the sciatic nerve can produce sciatica symptoms. Frequently the irritation is the result of a disc from the spinal column pressing on the nerve.
Other sources of irritation are
- muscle spasm
- internal bleeding creating pressure to the area
- Infections creating inflammation and swelling
The most common complaint of patients with sciatica is severe pain. There may also be a burning sensation, numbness and tingling or the feeling the affected leg has fallen asleep. Pain radiating down the buttock and leg can extend from the thigh to the toes. Severe sciatica symptoms can make walking difficult or impossible. Bending and twisting become extremely challenging and are not recommended upon initial diagnosis.
When a patient presents with sciatica symptoms; the doctor will take a detailed medical history to help determine how severe the sciatic nerve may be being compressed. Physical exam may or may not confirm sciatica. Diagnostic x-ray, CAT scan and MRI scan can show the location where the nerve is compressed and aid in determining what course of treatment should be taken.
Treatment for sciatica usually begins with medication such as pain relievers and anti-inflammatory agents. Steroids are sometimes utilized to systemically reduce the inflammation. Muscle relaxers may also be prescribed. Most patients are advised that activity as tolerated instead of complete bed rest is preferred. Many cases of sciatica resolve, without surgical intervention. Physical therapy can be very beneficial in improving an acute attack of sciatica symptoms and also to aid the patient with long term treatment. Exercises to strengthen the inner core muscles that support the spine may reduce the number and severity of reoccurrences.
Chiropractic treatment is used by a great many sufferers of sciatica. A great many chiropractors specialize in the treatment of sciatica. Many patients see a chiropractor regularly as part of a treatment routine for sciatica. When other treatments have failed to bring relief of sciatica symptoms, surgery may have to be performed in order to correct the underlying cause of the sciatica. This type of surgery is usually done by a surgeon who has received special training in spinal procedures.
Some patients have episodes of sciatica for many years, yet never require surgery. In the most severe cases permanent nerve damage and paralysis can occur.