Sciatica, it’s that ache that never seems to go away whether you sit, stand or lie down. It can range from an ache to an acute sharp jolt that stops you in your tracks. In some cases it can even affect the ability to move the leg foot or toes. Sciatica is a condition suffered by almost 3% of men and 1.3% of women over a lifetime. Pain can range from moderate to severe and duration can range from days to years.
What are the symptoms of Sciatica?
The symptoms include but are not restricted to:
- Leg pain and numbness
- Burning tingling sensation
- Pain that is worse when sitting
- One sided pain in the buttocks and leg
- Pain that is infrequent or constant
- Originates in the lower back and buttocks and runs down the leg
- Can affect the ability to move the leg foot or toes
What is the cause?
- Bulging or herniated disc
Too much sustained pressure on the discs that cushion the lumber vertebrae can cause the disc to deform and bulge. This can cause the disc to touch on the sciatic nerve, which runs down the leg creating pain, numbness tingling and problems with motor function. In severe circumstance the disc can herniate meaning the leading gel inside the disc leaks out and touches on the sciatic nerve resulting in the sciatica type symptoms.
- Spinal stenosis
This is where the hole in the vertebra that the nerve travels through narrows resulting in the sciatic nerve being aggravated. And you guessed it can cause pain numbness and tingling from the lower back to the buttocks and down the leg. In more severe cases the motor aspect of the leg can be affected meaning it doesn’t move as easily or properly.
When too much pressure occurs over a long period of time or in the case of an acute accident on the vertebra a fracture can occur on a part of the vertebra that provides forward movement stability. This results in the vertebra not being held in place and sliding forward. Move the vertebra too far and it will impact on the nerve creating symptoms that may be associated with sciatica.
- Piriformis syndrome
Spasm or irritation of the piriformis muscle which lies close to the sciatic nerve can result in irritation of the nerve leading to sciatica type symptoms. In some rare cases the sciatic nerve travels through the muscle leading to constant irritation of the nerve.
All of these conditions can lead to irritation of the sciatic nerve leading to sciatica type symptoms. In severe cases chronic pain can have a significant impact on the health of the individual leading to depression, listlessness and lack of motivation. These elements also need to be taken into account when looking at sciatica treatment.
What are some options to help?
- Physical therapy
Reducing the tension associated with the condition can help to take the pressure off the sciatic nerve and as a result relieve the associated symptoms
Providing the relevant stretching and strengthening techniques can also help to reduce the pressure on the region helping to reduce and in some cases resolve the issue.
A recent systematic review (2) has found acupuncture to be 2nd in effectiveness out of 21 interventions for global effect and pain intensity. The review showed acupuncture may be superior in effect to drugs and may also increase the effectiveness of drugs when used in conjunction (3). Another study suggested acupuncture may be superior to western medicine treatment in sciatic pain effectiveness and management however is currently considered low quality evidence
- The Clinical Effectiveness and Cost-Effectiveness of Management Strategies for Sciatica: Systematic Review and Economic Model.Health Technology Assessment, No. 15.39. Lewis R, Williams N, Matar HE, et al.Southampton (UK): NIHR Journals Library; 2011 Nov.
- McDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (Revised edition). © Australian Acupuncture and Chinese Medicine Association Ltd, 2017: http://www.acupuncture.org.au.
- Qin 2015 (SR & MA of 11 RCTs; 10 acupuncture vs medications; 1 acupuncture vs sham): Acupuncture may be superior to drugs and may enhance the effect of drugs for patients with sciatica; low quality evidence
- Ji 2015 (SR of 12 RCTs): Acupuncture superior to conventional Western medicine in outcomes effectiveness, pain intensity and pain threshold; low quality evidence
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