The term sciatica is used to describe a symptom of leg pain, possibly accompanied by tingling, weakness, or numbness, that begins in the lower back and travels through the buttocks and down the back of the leg. Usually, only one leg is affected. Sciatica is not a medical diagnosis but rather a symptom of an underlying medical condition. Some common reasons for sciatica are:
- A lumbar herniated disc
- Spinal stenosis
- Degenerative disc disease
- Bone spurs
- Piriformis syndrome
- Improper posture
- Injury to the neck or head
- Spinal tumors
- Tumors on the nerve roots of the spinal cord
The Pain of Sciatica
Sciatica is often known for one or more of the following:
- Leg pain that is described as burning, searing, or tingling
- A sharp pain that makes it difficult to stand up or walk
- Constant pain usually on only one side of the buttocks or legs
- Pain that radiates down the leg and possibly into the foot and toes
- Pain that worsens when sitting for a long time but may feel better when lying down or walking
- Difficulty, weakness, or numbness when trying to move the leg, foot, or toes
- Pain may be infrequent and irritating or constant and incapacitating
- Symptoms depend on the location of the irritated or pinched nerve
Sciatica rarely causes permanent sciatic nerve damage or tissue damage. Spinal cord involvement is possible but is also quite rare. Symptoms may often become worse when you sneeze, cough, or change positions. Certain symptoms depend on the underlying cause of sciatica and may be present only in those with these conditions. For example, bending the body backward or walking a long distance may trigger symptoms in those with spinal stenosis. If you have a lumbar herniated disc, bending forward may be a trigger for your sciatica.
The Nerve Roots
The sciatic nerve is the largest single nerve in the human body, and it runs from each side of the lower spine through the buttocks and into the back of the thigh all the way to the foot. It is important because it connects the spinal cord with the leg and foot. There are two nerve roots that exit the lumbar spine and three that exit the sacral segment. All five of these nerves bundle together to form the sciatic nerve and then branch out down each leg. Specific symptoms of sciatica will occur depending on which spinal nerve is affected. For example:
- L4 nerve root sciatica: This usually affects your thigh. It may be difficult to straighten your leg and you may have diminished knee-jerk reflexes.
- L5 nerve root sciatica: Usually, symptoms extend to the big toe and ankle – referred to as foot drop. You will often feel pain or numbness on the top of the foot and in the web of skin between the big toe and the second toe.
- S1 nerve root sciatica: This impacts the outer part of the foot and may radiate into the little toe or toes. You may notice weakness when you try to raise your heel off the ground and stand on your tiptoes. The reflex involving the ankle-jerk response may be limited.
In some cases, more than one nerve root may be compressed, leading to a combination of the above-mentioned symptoms.
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When to Contact Your Doctor About Sciatica
Sciatica is rarely serious. However, there are times when symptoms worsen quickly and may actually need to be surgically corrected. If you have any of the following, please see your doctor immediately:
- Your sciatic pain is getting worse and not improving. This may indicate nerve damage, particularly, if you are having leg weakness.
- Symptoms are happening in both legs (called bilateral sciatica) and are affecting bowel and bladder function. You may also notice a dysfunction or altered sensation in the genital area. This can indicate cauda equina syndrome, which is very rare. It can eventually cause paralysis and should be taken seriously.
- Sciatica that happens after a trauma or accident and is accompanied by fever or loss of appetite or other abnormal symptoms should be a reason for contacting your doctor.
Caring for Sciatica
There are some nonsurgical ways to care for sciatica that may ease your pain. However, unless the nerve compression issue is addressed, it will more than likely continue to occur. Here are some things to try:
- Heat and ice: Heat or ice is usually applied in 20-minute increments. Most will use ice first but may find more relief with heat. It is a good idea to use them alternatively. When using ice, be sure to keep a cloth or towel between the ice and your skin so as not to get frostbite.
- Pain medications: Over-the-counter or prescription medications may help reduce the pain temporarily. Nonsteroidal anti-inflammatories, such as ibuprofen or naproxen, can help reduce inflammation. Muscle relaxers or narcotics may be used for short-term relief.
Natural, Side-Effect-Free Care for Sciatica
One option that more and more people are moving toward is that of upper cervical chiropractic care. It may seem odd to correct the bones of the upper neck in order to find relief for the lower back, but it has proven to be effective. This is because sciatica can be related to a misalignment in the top bones of the neck, the C1 and C2 vertebbrae. If a misalignment occurs here, the entire spine must shift to compensate for the weight of the head becoming off balance. When the spine shifts, it is easy for the nerve roots of the sciatic nerve to become pinched or compressed and cause sciatica.
We use a gentle method, here at 1st Place Chiropractic in St. Charles, Illinois, to help the bones of the neck move back into place. We do not have to pop or crack the spine to get results. Our patients report seeing an improvement in their sciatica and, sometimes, it goes away entirely and does not return.
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if you are outside of the local area you can find an Upper Cervical Doctor near you at www.uppercervicalawareness.com.