Sciatica describes a condition characterized by pain that runs along the sciatic nerve---the large nerve that begins in the lower back, travels through the buttock and down the leg. Conditions that compress the sciatic nerve can cause sciatica pain, which can range from mildly irritating to disabling. Although doctors treat the pain of sciatica with rest and medications, to keep the pain away they must treat the underlying condition.
Causes
Several conditions in the spine can compress the sciatic nerve and lead to sciatica. The most common cause, intervertebral disc herniation, occurs when the soft fluid-filled disc that provides a cushion between each vertebrae bulges into the spinal canal and presses on the sciatic nerve. Osteoarthritis, also known as degenerative joint disease, describes a condition in which the cartilage in the joints breaks down. This can lead to the formation of osteocytes, or bone spurs, that develop near the ends of the bones, as described by the Arthritis Foundation. In the spine, these bony protrusions can invade the spinal canal and compress the nerve. Although more rare, the formation of a tumor or abscess in the spine can cause sciatica, according to the Merck Manual.
Symptoms
Pain, the main symptom of sciatica, radiates along the nerve, causing a burning, stabbing or tingling sensation down the leg. The constant pain can result in numbness or weakness of the affected leg. Sciatica may also cause pain in the lower back, which may worsen during sudden movement, such as coughing. Although a symptom of a more complex condition of the spine, patients usually focus on alleviating the pain from sciatica.
Self-Care
The pain of sciatica can often be relieved by implementing some self care measures. Acute pain can often be alleviated with bed rest, according to the Merck Manual. The patient should rest with his head elevated to take the pressure off the sciatic nerve. When muscle spasms in the back contribute to sciatic pain, the use of cold packs, alternated with heat, can help to relieve the pain. Exercises can help to correct posture and strengthen muscles to support the spine and increase flexibility, as described by the MayoClinic.com.
Medications
Taking analgesic medications, such as acetaminophen, can temporarily alleviate the pain of sciatica. In addition, non-steroidal anti-inflammatory medications, such as ibuprofen or naproxen, may provide relief, as they reduce both pain and inflammation. For more severe pain, prescription medications that relieve neuropathic pain, such as the drug gabapentin, which is used to treat seizures, may provide relief.
Medical Intervention
If the sciatica pain fails to respond to conservative measures, doctors may need to try more aggressive medical treatments. Injecting corticosteroid medications directly to the affected area in the back can help to reduce inflammation and therefore relieve the compression on the sciatic nerve. For those with sciatica due to a herniated disc, a surgical procedure known as a diskectomy may be required. To perform a diskectomy, surgeons remove the portion of the disk bulging into the spinal canal through a small incision in the back.
