What Are the Symptoms of Sciatica?

SCIATICA

is the Latin word for "Pain down the back of the leg" Sciatica is referred pain usually caused by trapping the sciatic nerve in the lower back. Sciatica refers to pain that runs along the sciatic nerve. The pain usually affects only one side of the lower body at a time and often extends from the lower back all the way through the back of the thigh, down through the leg. Occasionally the pain may also extend to the foot or toes. It is often a reoccurring condition that seems to worsen with every episode.

What are the symptoms of Sciatica?

Buttock, hamstring and/or calf pain that is worse when sitting
Lower back pain that is worse for coughing or sneezing
Weakness, numbness or difficulty moving the leg or foot
Burning or tingling down the leg
A shooting pain that makes it difficult to stand up
Pain may be persistent or come in spasms

What causes Sciatica?

In young and early middle-aged adults most sciatica results from inflammation or pressure from a bulging disc which can be very painful. In older people, changes in the spine due to conditions such as osteoarthritis may be responsible. Aggravating factors of sciatica include:

Being overweight
Not exercising regularly
Wearing high heels

Without proper care, pinching of the sciatic nerve may result in months or even years of pain.

REFERRED PAIN. In between every vertebrae in the spine is a cushion of jelly (the disc) which acts as a shock absorber and cushions each and every step. When the disc bulges backwards it traps the nerve where it leaves the spinal canal. This causes pressure which results in pain but where the pain is felt depends on how much pressure the disc is exerting on the nerve. The body works like a telephone exchange. If there is a problem on the line you can only tell which phone line is out of order not where the fault actually lies. The body is very similar. If there is a problem between the brain and say the ankle the brain can not tell exactly where along the nerve the fault lies. The brain doesn't know whether you hit your ankle on a chair, or whether the nerve between the brain and the ankle is being trapped in the back. Each nerve is arranged so that the nerve fibres which have furthest to travel lie in the centre of the nerve and those which are going to branch off sooner lie around the outside. Therefore the more pressure the disc exerts on the nerve the further away the patient feels the pain. For example pain in the hip would result from less pressure on the nerve than pain in the ankle. This is called referred pain. When there is so much pressure on the nerve that its conduction of messages is affected the sensation of pins and needles is felt. If the pressure is enough to stop the nerve working completely the part of the body supplied by that nerve feels numb to the touch.

The sciatic nerve runs from the lower back down through the buttocks and along the back of each leg. Sciatica is pain along this nerve and is a relatively common form of back pain and is usually caused by pressure on the sciatic nerve from a herniated or bulging disc. The pain from sciatica can be anything from infrequent and irritating to severe and debilitating. Usually, it affects only one side, the pain radiating through the buttock and down the leg and is often associated with a constant pain on one side of the buttocks, pain in the leg and/or buttock that may be worse when sitting , burning or tingling down the leg, weakness, numbness or difficulty moving the leg or foot or a shooting pain that makes it difficult to stand up. While sciatica can be extremely painful and uncomfortable, it is rare that permanent nerve damage (tissue damage) results. Most pain is due to inflammation and will improve within a period of time. Nerve pain is caused by a combination of pressure and inflammation on the nerve root, and treatment is centered on relieving both of these conditions.

TREATMENT

Treatment for sciatica follows the lines of treatment for a slipped disc. (95% of back pain is a result of a slipped disc. The spine consists of 24 bones called vertebrae which sit on top of one another to form a column. Each vertebra has a cylindrical body in front with a wishbone-like structure sticking out behind forming the knobbly bits that can be felt down the backbone. Cradled within the arms of the wishbone is the spinal cord which carries nerve messages up and down from the brain to all parts of the body. In between every vertebra in the spine is a cushion of jelly (the disc) which acts as a shock absorber and cushions each and every step. When the disc bulges backwards it traps the nerve where it leaves the spinal canal and causes pressure and pain. Once the disc is on the move what we do with the spine changes what happens to the disc. Sitting on an easy chair like a banana allows it to bulge backwards further and cause more pain.)

Treatment withCONNECTIVE TISSUE MANIPULATION. Connective Tissue Manipulation is performed by the Physiotherapist using the soft pads of the fingers to move one layer of skin on the layer below. This movement creates a short, sharp, stretch reflex, creating an impulse, which spreads out through the connective tissue. The patient's brain translates this impulse as if it were a 'cut' or a 'scratch'. The tighter the connective tissue the bigger the stretch reflex and therefore the sharper the 'cut' feels to the patient. The reflex is a small impulse which passes through the fluid in the connective tissue and releases tension. The reduction in tension around the blood vessel walls allows more blood to flow into the damaged area and so reduces the inflammation. Softening the connective tissue also allows more movement to occur without causing irritation and therefore pain. Treatment often starts at a distance from the injured part gradually working closer to the source of injury. The benefits of Connective Tissue Manipulation are cumulative. Once the tension has been lowered by treatment the reduction is maintained. Further reduction in connective tissue tension occurs with each additional treatment. The degree to which the reduction in connective tissue tension is maintained is conditional upon the level of stress added to the system by the patient's lifestyle. Connective Tissue Manipulation is a technique learnt at postgraduate level in the UK and because of this it hasn't spread very rapidly around the country. At the last count, there were something like two dozen Physiotherapists in the UK actively practicing Connective Tissue Manipulation.