Sciatica is another name for pain that radiates down the back of the leg. In some cases, the pain may be caused by a herniated or ruptured disc. Discs are cushions of cartilage between the bones (vertebrae) of the back. They can herniate, or rupture, and protrude into the spinal canal, putting pressure on the spinal cord. Sometimes surgery is required but in other cases, surgery is not indicated, and chronic pain results from the ongoing nerve irritation.
Sciatica is not a disease or medical diagnosis, but a collection of symptoms that indicate an underlying medical condition. It may cause low back pain but the cardinal sign of sciatica is pain that travels down the back of the leg. The sciatic nerve originates in the low back and travels through the buttock to the lower leg; pain may occur anywhere along its length. Pain may be intermittent or constant and may be worse when sitting. In addition, tingling, numbness and weakness of the leg may also occur.
In some cases, sciatica can be treated by dealing with the underlying condition. For example, a ruptured disc may need to be surgically removed. Non-surgical treatments include over-the-counter medication, physical therapy, pain medications, medications to relieve muscle spasms, and medications that specifically target nerve pain. X-ray guided epidural steroid injections can target the exact anatomic source of pain resulting in relief which may last for a number of months. Some patients benefit from massage therapy, chiropractic treatment, and/or acupuncture.
Self-management is an important part of living with sciatica. Proper body mechanics (how the patient moves) and avoiding heavy lifting can reduce stress on the back and prevent further injury. Although exercise is important, the right kind of exercise is even more so, as some exercises can exacerbate sciatic pain. In an acute flare, alternating heat and ice on the low back can help alleviate leg pain. Getting adequate sleep reduces stress, helps relieve depression and anxiety, and promotes overall health. Weight loss can relieve stress on the back.
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