What is sciatica?
Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body.
Sciatica most commonly occurs when a herniated disk, bone spur on the spine, or narrowing of the spine (spinal stenosis) compresses part of the nerve. This causes inflammation, pain, and often some numbness in the affected leg.
How bad is my sciatica?
We break it down into three categories depending on how severe it is:
Mild: It means mild back pain, occasional numbers, and weakness in the leg. Most of the time, it can be safely managed at home by following the tips in the mild sciatica section below.
Moderate: It means moderate back pain, frequent shooting pain, and numbness in the leg. Moderate sciatica can sometimes be safely managed at home but may require the attention of your medical team.
Severe: This means severe back pain, numbness, and weakness in the lower back, leg, or feet. Severe sciatica may be an emergency and require additional medical interventions.
How to manage mild sciatica?
It’s not always possible to prevent sciatica, and the condition may recur. The following can play a key role in protecting your back:
- Exercise regularly. To keep your back strong, pay special attention to your core muscles — the muscles in your abdomen and lower back that are essential for proper posture and alignment. Ask your doctor to recommend specific activities.
- Maintain proper posture when you sit. Choose a seat with good lower back support, armrests and a swivel base. Consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Keep your knees and hips level.
- Use good body mechanics. If you stand for long periods, rest one foot on a stool or small box from time to time. When you lift something heavy, let your lower extremities do the work. Keep your back straight and bend only at the knees. Avoid lifting and twisting simultaneously.
- Over-the-counter painkillers
- Physical therapy
- Cognitive behavioral therapy (CBT) helps manage chronic pain by training people to react differently to their pain
Surgery may be an option if symptoms have not responded to other treatments and continue to intensify. Surgical options include:
- Lumbar laminectomy – widening of the spinal cord in the lower back to reduce pressure on the nerves.
- Discectomy – partial or entire removal of a herniated disk.
How to manage moderate and severe sciatica?
Mild sciatica usually goes away over time. Call your doctor if self-care measures fail to ease your symptoms or if your pain lasts longer than a week, is severe, or becomes progressively worse. Get immediate medical care if:
- You have sudden, severe pain in your low back or leg and numbness or muscle weakness in your leg
- The pain follows a violent injury, such as a traffic accident
- You have trouble controlling your bowels or bladder
What causes sciatica?
- A ruptured intervertebral disk
- Narrowing of the spinal canal that puts pressure on the nerve, called spinal stenosis
- An injury such as a pelvic fracture.
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