Myth : If You Have Sciatica You Should Stay In Bed And Rest
Fact: Most patients do better if they remain active and avoid excessive rest, says Atul Patel, MD, a physiatrist at the Kansas City Bone and Joint Clinic, with locations in Kansas and Missouri.
Numerous studies have found that there is little to no benefit to staying in bed compared with staying active for people with sciatica.
Who Should I Go To For My Sciatica
Sciatica is not a disease or a diagnosis. It is a symptom of an underlying medical condition. The term is used to describe nerve pain, tingling, numbness and weakness that travels from the lower back, across the buttocks, down the back of the thighs to the calves and feet.
It occurs when the sciatic nerve the longest in the body gets compacted or aggravated. Common conditions that cause sciatica include herniated lumbar discs, spinal stenosis, degenerative disc disease, and spondylolisthesis.
Sciatica pain can vary from periodic and mildly inconvenient to constant and incapacitating. Symptoms depend on the location of the nerve impingement or irritation and may include:
- Symptoms intensify during sudden movements or changing positions
- Constant pain in one side of the buttock or leg
- Sharp pain in one leg making it difficult to stand up or walk
- Pain originates in the lower back or buttock and continues along the path of the sciatic nerve
- Pain lessens when lying down or walking but increases when standing or sitting
- Pain is burning, tingling, or searing
- Pain radiates down the leg and possibly into the foot and toes
- Lower back pain is not as severe as leg pain
- A pins-and-needles or prickling sensation, numbness or weakness down the leg
Sciatica is rare among young people. It tends to start appearing in middle age, between the ages of 40 to 50.
That Hip Pain Could Actually Be A Sciatica Problem
Your hips are incredibly active joints and no strangers to the occasional ache and pain, especially as you get older. But searing pain in one of your hips may have nothing to do with your hip at all, but a pinched nerve root in your lower back.
At Healthy Life Family Medicinein Goodyear, Arizona, Dr. John Monroe understands the many conditions that can lead to radiating pain. One of the biggest culprits in this regard is sciatica, which develops when certain nerve roots in your lower back are irritated or compressed, causing symptoms to travel down your sciatic nerve.
Heres a look at how sciatica pain develops and why your hip pain may be a result of a problem in your lower back.
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Does Sciatica Ever Go Away How Long Does Sciatica Pain Last
Sciatica is a pain that spreads out to the lower back, buttocks, down the leg to the foot. The pain is caused due to the pinching or inflammation of the sciatica nerve. This sciatica pain usually subsides in a few weeks time and in rare cases it may ail the person for a few months. The nervous system constitutes the sciatic nerve, which is the largest nerve in the body. It starts from the spinal cord and runs down to the lower back, thigh region and the knees. At the knee joint, it divides into two nerves, one of which runs down the back portion of the leg to the foot and the other on the front portion of the leg into the foot. The sciatica nerve is not only responsible for the feeling and sensation within the leg but also it controls the muscles in the leg and the foot.
Sciatica as the name suggests, is a condition ailing the sciatica nerve due to irritation in it which may arise due to nerve dysfunction or nerve compression. The pain due to sciatica can be both acute as well as chronic. The Acute sciatica pain is a short term condition which does not require much of professional treatment but can be treated with over the counter medications, exercises and hot and cold application. On the other hand, the chronic sciatica pain lasts for more than a month and requires chiropractic help along with heat application, exercising and surgery.
- Accidents/Injury in the Piriformis muscle
- Strenous Physical Posture and Activities
- Prior health condition.
Herniated Discs: The Basics
Your spine contains a series of bones called vertebrae that link together to form a protective tunnel for your nerves. The nerves travel from your brain through the spine, exiting at intervals to go to all the other parts of your body, including your arms and lgs.
Between each pair of vertebrae is a spongy disc that acts like a shock absorber for your spine. Each disc has a tough exterior shell and a gel-like interior that helps protect your vertebrae and nerves, as well as making your spine flexible.
Normally, each disc is contained within the boundary of the vertebrae like a sandwich. But sometimes, a disc can slip out of place extending beyond the edge of the bones, or the outside of a disc can rupture allowing the gel to leak out. As you move your back, the bone edges or the protruding gel can irritate or compress the spinal nerves, causing back pain.
Depending on where the nerve is heading, you might also have pain, numbness, or weakness in your arms, legs, hands, or feet. Some people may have problems with controlling their bowels or bladder.
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Which Treatments Have You Already Tried
There are several ways to manage sciatica without surgery, depending on the cause. They may include pain relief medications, steroid injections, physical therapy, aquatic therapy, meditation and nerve blocks, among others. What works for one person may not be as effective for someone else.
There are several types of doctors who treat sciatica pain. If you feel like you have exhausted your options with your primary care physician, consider making an appointment with a rehabilitation physician or a pain medicine specialist before calling a surgeon. Because every person experiences pain differently, it often takes working with the right specialist to find the combination of treatments that works for you.
Does Sciatica Ever Go Away
The sciatica pain ususally subsides by itself. In most of the cases the pain lessens within four to eight weeks by following simple measures likes stretching exercises, heat and cold application, usage of over the counter medications like NSAIDS, etc. The other ways in which one can get relief from sciatica pain are as follows:
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Depression And Negative Emotions
Stress can be a trigger for any kind of pain, including sciatica. According to Dr. John Sarno, a Physician at the New York University Medical Center and Clinical Rehabilitation Medicine Professor at New York University School of Medicine, bodily pain can be a result of repressed emotions and stress.
Sciatica and Dr. Sarnos study on mind-body pain became topics of interest for people who suffer pain in their the lumbar area, buttocks, legs, and feet. For years, he has been advocating a different approach to determining the cause and managing back pain that is associated with emotions rather than those that are picked up through MRI scans or verified using a diagnostic injection.
Needless to say, not all medical professionals have been supportive of his straightforward yet patient-centric way on diagnosing and treating back pains.
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How Often Should I Get Treatments
The number of treatments depends on your condition, its severity and how your body responds. Most patients have an appointment once a week. Others get treatment more or less often, depending on how long the effects last. Your acupuncturist will recommend a schedule that is right for you.
You may not get the full benefits of acupuncture on the first or second treatment. If you decide to try acupuncture, you should give it at least five treatments.
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Why Does My Herniated Disk Pain Come And Go
Herniated discs are a common cause of chronic back pain, especially among people between the ages of 30-50 years. While many people with herniated discs suffer from chronic, unrelenting pain, others may find their symptoms come and go, or at least vary in their severity.
At Woodbury Spine, our orthopaedic surgeon, Evan OBrien, MD, helps patients find the best solutions for their herniated disc pain, offering both conservative and surgical options, depending on each patients unique needs. If you have a herniated disc, heres why your symptoms can change over time.
What To Do If Its Getting Worse
Sciatica often responds to home treatment, but you should see a medical professional first to make sure youre dealing with sciatica. If you havent already tried treating your symptoms at home, you may find the following methods helpful:
- Cold. Try applying an ice pack or cold compress to the painful area for about 20 minutes several times a day.
- Hot. You can apply hot packs or heating pads to the sore area for 15 to 20 minutes several times per day after the first couple of days to stimulate blood flow to the injured area.
- Nonsteroidal anti-inflammatory drugs .NSAIDs like aspirin or ibuprofen can help you manage pain, swelling, and inflammation.
- Physical therapy, stretching, and exercise: A physical therapist can help you strengthen weak muscles and stretch tight muscles that may be contributing to your pain. The United Kingdoms National Health Service recommends resuming normal activities and gentle exercise as soon as possible. Always perform these activities under the guidance of a professional.
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Sciatica May Come Back
Sciatica usually resolves on its own without treatment within a month or two. However, that doesnt mean its gone for good. If you dont resolve the underlying condition that caused sciatica, it may recur and even develop into a chronic pain condition.
Strengthening and stretching exercises create strong core muscles to support your spine, which takes pressure off the nerves. If youre overweight or obese, losing weight may help, too.
If youre having a flare of sciatica pain, you may be able to control it by alternating cold packs and heating pads. You could also take painkillers and muscle relaxants for relief.
However, if the cause of your recurring sciatica is a slipped or ruptured disc, we may recommend laminotomy with discectomy. During this simple, minimally invasive surgical procedure, we remove the part of the ruptured or herniated disc thats pressing against your sciatic nerve.
Dont let sciatica become a normal part of your life. If you suffer from persistent or chronic sciatica, give us a call today at 833-774-6327 for diagnosis and treatment options. Or, book your appointment online with our convenient form.
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Why Is My Sciatica Not Going Away
Sciatica is a type of nerve pain that radiates down the back into the hip and leg. It often goes away in a few weeks, but for some people, the condition is chronic.
The pain can feel like an intense cramp or burning electrical sensations.
Sciatica that lasts more than 3 months or that goes away and comes back may be chronic sciatica.
Chronic sciatica is a long-term condition that can cause ongoing pain. It is more difficult to treat than acute sciatica, but several remedies can offer relief.
This article reviews what sciatica is, what causes it, and how to treat it.
Sciatica happens when something presses on or traps the sciatic nerve.
The is a herniated disk in the lower spine.
Another risk factor is spinal stenosis, a condition that causes the spinal column to narrow.
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How Is Sciatica Pain Treated In Atlanta Ga
In a number of cases, sciatica pain can be relieved simply through rest and/or altering certain behaviors. However, severe or prolonged sciatica symptoms often require medical treatment. Dr. Williams offers a wide variety of advanced sciatica treatments in Atlanta and will begin with more conservative methods to help alleviate pain in the most natural ways possible. If a patients sciatica is resistant to conservative treatments and persists or becomes worse, additional intervention may be needed. Common sciatica treatments include:
- Resting the back
- Chiropractic Care
- Pulsed Electromagnetic Frequency Therapy
- Over-the-counter medications
- Orthobiologic Treatments
For patients with severe sciatica that begins to affect other functions, such as bowel and bladder function, surgery is often necessary.
When properly diagnosed and treated, most men and women are able to achieve dramatic relief from sciatica pain within 14 days. To help prevent future episodes of sciatica, patients are encouraged to practice proper posture and exercise regularly.
When To See A Doctor
A mild case of sciatica will generally resolve over time. However, if the pain is severe, gradually increases, or lasts longer than a week, you should see a doctor.
Seek immediate medical attention if:
- Symptoms began after traumatic injury.
- Sciatic pain is accompanied by fever, nausea, or weight loss.
- Extreme weakness or numbness can be felt in the leg.
- Controlling bladder or bowels movements becomes difficult.
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What Is Sciatic Nerve Pain
In the last section we described how the sciatic nerve originates from roots in the lower spine. These nerve roots can become pinched, which will result in intense pain that runs down the entire length of one or both legs. So while the pain you feel is in your leg, the cause of the pain may be in your spine. Most people find this pain to be intolerable, sometimes excruciating. And since they may not understand the cause of their pain, they become frustrated when theyre unable to manage it.
So how do you know if you have sciatica? Most often the symptoms are
- Shooting pain the back of the leg and/or lower back
- Numbness or tingling in your legs
- Trouble moving or staying active
- Stiffness in your feet
- Pain during the night
- Nagging pain after sitting or standing for a long time
The cause of the pain, numbness, tingling, and weakness depends on where the nerve is pinched. For example, symptoms in your foot and ankle indicate nerve impingement near lumbar segment 5 .
What Can I Expect If I Have Been Diagnosed With Sciatica
The good news about sciatic pain is that it usually goes away on its own with time and some self-care treatments. Most people with sciatica get better without surgery, and about half of these recover from an episode fully within six weeks.
Be sure to contact your healthcare provider if your sciatica pain is not improving and you have concerns that you arent recovering as quickly as hoped.
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Types Of Sciatic Nerve Pain
Sciatica pain is usually described with a wide variety of characteristics. This pain has the potential to worsen over time and may become debilitating. The pain may come and go or stay for longer periods and may get relieved with certain postures, exercises, and/or medications.
When Sciatic Pain Is A Medical Emergency
While quite rare, there are times when sciatica symptoms may indicate a potentially serious injury to the sciatic nerve. A medical emergency is indicated when:
- The sciatica pain is severe or there is a sudden increase in pain
- There is loss of bowel and/or bladder control
- The sciatica pain is accompanied by fever, nausea and/or weight loss
See When Sciatica Pain Is a Medical Emergency
These symptoms can indicate serious underlying conditions such as cauda equina syndrome, infection, or spinal tumors.
Typically, it is best to consult a medical professional for an accurate diagnosis, as a wide range of issues can affect the sciatic nerve, causing symptoms. Treatments that target the underlying cause of sciatica symptoms, rather than palliative approaches that only relieve symptoms, will be most effective for long term pain resolution.
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When Should You Call The Doctor About Foot Drop
If you are having trouble moving your feet, or you notice that you are adjusting the way you walk in order to avoid dragging your toes, contact your doctor. He or she will examine you to determine whether you have foot drop.
Last reviewed by a Cleveland Clinic medical professional on 11/09/2018.
References
What Can You See From A Myelogram
A myelogram is able to show your spinal cord, spinal nerves, nerve roots, and bones in the spine by injecting contrast into your spinal fluid. As a result, it will also reveal whether anything is pressing against your spinal cord or nerves. There are a few different things that could be responsible for causing this pain and creating this unwanted pressure, including:
- Herniated or bulging discs.
- Arthritis in your spinal joints.
- Tumors within, or adjacent to, your spine.
- An infection, or other inflammatory processes.
Compared to an MRI, a myelogram, and the post myelogram CT scan, is able to show the bony details in a better way, but is less capable of showing the soft tissue details in your spine.
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How Is Sciatica Affecting Your Quality Of Life
Sciatica pain may extend all the way from the lower back, through the back of your thigh, to your foot. The pain can come and go, sometimes lingering for days and even weeks. This may cause anything from mild discomfort to making the simplest tasks intolerable. Sitting could be painful with sciatica and driving even more so. Not to mention playing sports and being active.
As you contemplate surgery for sciatica, consider how much the pain affects your quality of life. If your work, hobbies, social life or relationships suffer from your being in constant pain, it may be time to think about surgery.
Although sciatica starts as nerve inflammation, it may eventually progress to nerve damage. If the sciatic nerve is damaged, it could result in numbness, tingling and, in more severe cases, weakness in the knees or legs. The longer it is left untreated, the longer it will take for numbness and weakness to go away, and they may become permanent.
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