Also known as Sciatica, it is a pain in the lower back that can radiate down to the buttocks and the legs, and occasionally to the feet as well. Also known as lumbago or lumbar radiculopathy, the pain occurs as a result of pressure on the sciatic nerve, which is formed from lumbar roots that emerge from the spinal column. It rises into the pelvis, and travels down the buttocks, the legs, and into the feet. Occurring on both sides of the body, these nerves are the largest in the body, with diameter as much as a finger, they branch out at several points along their path. Sciatica occurs when these nerves become irritated, most often because of a herniated vertebral disc that puts pressure on the sciatic nerve as it emerges from the spinal column.
Sciatica causes pain that may be constant or intermittent, and it may include numbness, tingling or even a burning sensation. Coughing, sneezing, bending over, or lifting heavy objects often increases the pain. In certain cases, weakening of muscles in the buttocks, legs, and/or feet may take place.
Sciatica is one of the most common forms of back pain in the world. It occurs in about 5% of people who visit their doctor with back pain problems, and in about 1$%:3% of the general adult population. It is commonly found in people who are between 30 and 50 years of age, as those are the ages most prone to herniating vertebral discs. After age 30, the tough exterior of the vertebral discs undergoes a natural thinning, making it easier for the gel-like inner core to rupture it. After the age of 50, the interior of the vertebral disc becomes slightly hardened, making it less likely to protrude out.
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Another common cause of sciatica is lumbar spinal stenosis, or narrowing down of the spinal canal, which puts pressure on the roots making up the sciatic nerve. Degenerative disc disease causes sciatica when the disc weakens enough to allow excessive movement of the vertebrae near the sciatic nerve. Additionally, the degenerated disc may leak proteins in the vicinity of the nerve. Although isthmic spondylolisthesis is relatively common in adults, it rarely causes sciatica. This occurs when a vertebra suffers from a stress fracture and slips, slightly impinging on the sciatic nerve as it exits the spine. Piriformis syndrome may cause sciatica when the sciatic muscle is irritated as it runs under the piriformis muscle in the buttocks.
In most cases, conservative treatments are effective enough for sciatica. A short period of rest, coupled with the application of cold packs and heat packs to the affected areas, can reduce the inflammation of the nerve. Non-steroidal anti-inflammatory medicines can also be taken to decrease the inflammation. Injection of corticosteriods may sometimes be recommended to reduce the swelling of the nerve. Physical therapy and short walks are also helpful.
If after three or more months, sciatica continues and becomes progressively worse, surgical techniques can be used to relieve the pressure on the sciatic nerve. Surgery is often quite effective in relieving pain, although results may vary depending upon the cause of sciatica. On an average, about 90% of patients undergoing surgery for sciatica pain receive some relief.
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