Sciatica is characterised by pain experienced down the leg, specifically along the route of the sciatic nerve, which is the back and side of the leg. Using the term to describe pain in the front or inside of the leg would be inaccurate since these areas are supplied by different nerves but it often gets used as a ‘general’ name.
Sciatica or not sciatica? That is the question.
However, just because you are experiencing pain in the back or side of the leg doesn’t mean that you necessarily have sciatica. There are many different conditions that can present with similar pain. Genuine nerve pain is usually shooting and sharp, often associated with numbness or weakness of the area/function it supplies. Obtaining an accurate diagnosis is vital to ensure that you get the right treatment and management for the pain.
While the nerve can be compressed in several places, by far the most common cause of sciatica, accounting for around 90% of problems, is an intervertebral disc prolapse in the bottom two segments of the spine, known in layman’s terms as a ‘slipped disc’. One analogy is to visualise a jam doughnut. The nucleus (jam) squeezes out through the annulus (dough) and moves into the space where the nerve exits the spine.
Is a slipped disc common? Yes. Does it need surgery? Not usually. Around 85-90% tend to recover without any surgical intervention.
Most sufferers fall into the 20-50 age bracket so are, perhaps, younger than might be expected. The nucleus of the disc is made up of a jelly-like hydrated substance which dries up and becomes desiccated/dehydrated over time. Because of this, once you pass the age of 50, the nucleus is no longer mobile, which prevents the disc from bulging out. That doesn’t mean you don’t get sciatica once you’re over 50, just that it is caused by degeneration and bony compression more usually rather than the disc. However, the pain is much the same.
Prevention and treatment
Some elements of disc prolapse may be hereditary, so choose your parents wisely! On a serious note, keeping strong and stable around the pelvis/lower back and good posture all reduce pressure on the disc. Lift carefully and preferably not repetitively. Importantly, don’t lift and twist at the same time – move your feet.
For first-timers, experiencing sciatica can be terrifying, but we urge sufferers to try not to panic. Relax as much as possible and take enough pain relief to stop the leg pain as this will also allow the rest of your body to relax and not tense up. Speak to your GP if you need stronger medication than what’s available over the counter and try to keep moving; you need a good blood supply and to allow the body’s own pump mechanisms to keep working to keep those discs nice and plump. Try not to sit down much, since this puts more than double the pressure on the disc than standing. So sit to eat, but other than that, do your best to potter around and lie down with a pillow under your head and knees. Hot packs might help too and keep hydrated – the main content of a disc is water so hydrate like you usually would if you can.
Good advice – great idea
Treatment can help in the early stage and later if you have waited to see if things improve. Ring up and get advice; even if you can’t move, we can give you some reassurance and make sure you are doing the right thing. Very few patients go on to have surgery, with those who do usually requiring it because the nerve is becoming more compressed and at increasing risk of permanent change. Usually the nerve will bounce back to normal function with the right management.
The osteopathy, Physiotherapy and acupuncture offered at Walnut Grove Clinic can all help with sciatica.
