Until the 1930s, doctors had many theories about what causes sciatica, a sharp, aching, and/or burning pain that affects the lower back, the buttocks, and/or the legs, but they were far from certain. At that time, though, they discovered that a great deal of sciatica pain came from the herniation, bulging, or rupturing of one or more of the cushioning discs that float between the vertebrae in the spinal column.
After about the age of twenty, these discs begin to be affected by everyday wear-and-tear, the exact amount depending on the amount of pressure and movement of the spine. It's most frequently seen in patients from thirty to fifty years of age, and the type of work a person does is a big factor. For example, repeated lifting can cause herniation followed by sciatica, and prolonged periods of sitting, such as at a computer or truck and automobile driving, can also play a role. In addition, some discs are more prone to herniate than others. The lumbar vertebrae (the lowest five) and the cervical vertebrae (those in your neck) are the most frequent culprits. Sciatica occurs when the herniated disc between the L-4 and L-5 discs presses against the sciatic nerve. This is more likely to cause a problem when the nerve is squashed between the offending disc and an adjacent bone.
When your body works right, the discs lose and then absorb a little bit of water and nutrients from the blood. Often after a person is thirty, this balanced function doesn't work as efficiently, and soon the discs are losing more water than they absorb. They dry out, and the thickness of the disc begins to shrink. This shrinking and drying out can cause the outer core to rupture, and some of the soft inner core can leak out. As we've seen before, this protrusion often presses against the sciatic nerve root, and pain can follow, although sometimes patients remain asymptomatic.
Muscle spasms from an injury or a fall can also irritate the sciatic nerve. The piranius muscle in your buttocks can become inflamed and press against the sciatic nerve and cause pain. Sciatic pain can also be caused by infections, injuries, tumors, arthritis, and ankylosing spondyltis. This is a severe inflammation of the spinal joints which then stiffen and cause agonizing pain.
How is Sciatica Treated?
If your healthcare provider is a traditional, Western medicine doctor, he will probably recommend one of a variety of conventional treatments. Medication is one of the primary treatments prescribed. The first choice is over-the-counter remedies, NSAIDS (non-steroidal anti-inflammatory drugs) such as aspirin, acetaminophen, ibuprofen, or naproxen, which can help reduce the pain and start to repair tissue at the same time. All of these are generally considered safe for temporary use in healthy adults.
Muscle relaxants, such as Valium®, Flexeril®, and similar medications, may also be an option. They don't actually work directly on the muscles, but they have a relaxing effect on the whole body and can be helpful for short-term use. Narcotics, such as Percodan® or Tylenol® 2, 3 or 4, are medications of last resort, when the pain cannot be controlled in any other way. The general rule is to use as little of a medication as works, and use it for the shortest time possible - generally no more than two weeks.
Bed rest is good, but only for one or two days at the most. Get up only for meals or to go to the bathroom. If after two days your pain has not improved, try something else, like physical therapy. Therapists use a number of different techniques to ease the pain. They may use hot or cold packs. Cold packs are used to help reduce swelling, while dry or moist heat rushes new blood to the injured area and helps in healing.
Only when the pain is severe and other treatments haven't worked, will doctors prescribe surgery, as it is highly invasive and carries a number of risks due to the delicate nature of the spine and its component parts.
There are also a number of alternative treatments available, such as yoga, biofeedback, massage therapy, and hypnosis. Each is non-invasive, and all are usually safe enough to try on your own if you want to go that route.
Once you have been diagnosed properly, curing sciatica, or at least reducing the pain and discomfort, can be accomplished by a number of alternative and/or traditional treatments. Make sure to ask your healthcare provider what the right treatment is for you.