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What Is Sciatica

Sciatica is not a specific disease, instead it is a condition characteristic of several different diseases. Simply put, it is a mild to intense pain in the left or right leg. Sciatica is caused by a compression of one or more of the five sets of nerve roots in the lower back. These compressions are typically caused by a disc rupture or bone spur in the lumbar spine. It causes pain, numbness, tingling, and weakness in the arms or legs. This is referred to as radiculopathy. If the nerve root causing the problem is in the neck it is called cervical radiculopathy. Sciatica is called a lumbar radiculopathy since it occurs in the lower back.


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Essentially what is happening is that there is some nerve or nerves are getting irritated. A common reason is due to your spinal discs. They're supposed to hold onto liquid and slowly compress throughout the day. If you have a burst disc or one that is too low, your vertebrae will actually grind together and most likely on a nerve. You can also experience the pain of sciatica when a tight muscle compresses on a nerve. The idea of the exercises is to help get the stress off the nerves and get rid of the pain.

There are many different treatments for sciatica and it is important to discuss these with your health practitioner. Accurate diagnosis to determine the exact cause of sciatic pain is also equally important. The most conclusive diagnosis is usually gained by a having an MRI scan. However having said that skilled medical practitioners, and I include Osteopaths and Chiropractors, are often able to determine the suspected cause by carrying out a physical examination

In extreme cases spinal injections of corticosteroid into the epidural space (the area around the spinal nerves) or facet joint (between vertebrae) may be given. This is usually carried out by a specialist with follow up injections at a later date.

Piriformis syndrome is a condition in which the piriformis muscle irritates the sciatic nerve. The piriformis muscle is a small muscle behind the gluteus maximus. Piriformis syndrome is most common among women, runners and walkers.

Spinal stenosis is the name given to the narrowing of the nerve channel (vertebral canal) of the spine. This narrowing causes compression of either the spinal cord within the vertebral canal, or the nerve roots that exit the spinal cord. People with spinal stenosis experience sciatic pain symptoms in the legs and feet. It usually results from degenerative arthritis causing a narrowing of the spaces in the vertebral canal. Manual workers are more prone to developing symptoms of spinal stenosis but it seldom affects people under 30 years of age - unless it is due to traumatic injury to the vertebrae.

I wanted to talk to you about sciatica exercises that relieve back pain. Most people would say that back pain is probably about the worst pain that you could ever experience. It's not like a paper cut that effects a tiny fraction of your body. Back pain is an electrical storm of pain that travels across your back. It's crippling in a way because any little movement could lead to it. You could be reaching into your refrigerator and you feel the sharp pains spread throughout the back. It's a rough time and being able to get easy relief is important. This is why I wanted to share with you sciatica exercises that relieve back pain.

Sciatic pain is usually nerve related and responds well to treatment with low doses of tricyclic anti-depressant drugs like amitriptyline, dothiepin, nortriptyline, lofepramine, desipramine, clomipramine or imipramine combined with acupuncture or the use of TENs machines. The low dosage of the tricyclic drug acts by closing "a pain gate" blocking the message to the brain.

For example, while commonly recommended to people with sciatica, exercises such as hamstring stretches and the yoga position, "downward facing dog" can be beneficial as part of managing one's condition once the pain is reduced, these exercises can place tension on the sciatic nerve and aggravate an already inflamed and sensitive condition. In general, any exercise that causes pain to increase in the leg and/or extend further down the leg should be completely avoided during the acute phase of sciatica.

Sciatica is usually caused by a prolapsed or 'slipped' disc bulging and pressing on to a nerve. It doesn't usually cause permanent nerve damage since the spinal cord is not present in the lower part of the spine and a prolapsed or herniated disc in this area does not pose a risk of paralysis.

Other treatments to manage sciatica include traction; manipulation by a skilled osteopath, physio therapist or chiropractor; Chemonucleolysis (injection of a special enzyme into the disk).

The discs which cushion the vertebrae in the lower back become progressively thinner and harder as we get older. This stresses the lower back and often causes a variety of lower back pain disorders, including sciatica.

McKenzie practitioners use the word "centralization" when the pain and other symptoms are relieved in the areas the greates distance away from the spine. To give an example, in a person with sciatica all the way down the leg to the foot, centralization might occur in which the pain left the foot and lower leg and then only extended down to the knee. Or, if sciatica symptoms started out going as far as the knee, centralization would be if the symptoms left the thigh and only went as far as the hip area.

Sciatica exercises are an important part of both short and long-term treatment, but it is critical to choose the right exercises. Even commonly-recommended exercises for sciatica may not be indicated during times of severe acute symptoms, and some exercises may only make things worse.

Stretching and exercising are a must if you really want to progress along the road to rehabilitation and if you are in extreme pain this is probably the last thing you will contemplate doing.

The simplest of the McKenzie exercises for alleviating sciatica is done by simply lying on one's stomach on the floor or a firm surface and propping one's chest up on the elbows. This places the lower spine in a gentle extension, which can help relieve sciatica by pushing bulging spinal discs forward, and away from the nerve roots that form the sciatic nerve, reducing pressure and irritation. Although you can maintain this position for relatively long periods of time, I recommend doing it for short periods of one or two minutes with a rest break of at least a few minutes in between. The frequent breaks prevent the low back muscles from tightening up as much, and yet still allows for good overall results. For more complex sciatica exercises, getting detailed instructions either through an illustrated guide or an experienced health care practitioner is advised.

There are six typical causes of Sciatica. Spondylolisthesis Spondylolisthesis is usually found at birth, early childhood or acquired from physical trauma such as weightlifting. It is a disorder that most often affects the lumbar spine. Spondylolisthesis is characterized by one vertebra slipping forward over an adjacent vertebra. Often sciatic leg pain is caused when a nerve root compresses due to the vertebra being displaced and slipping.

If you think you may be suffering from sciatica, be sure and contact your physician to get a proper diagnosis! Liana Mirkin is the IT Director for Spina Systems International, Inc., a company which specializes in distributing the

Spinal stenosis related to age is the more commonly acquired form. This form of the stenosis condition may cause various spinal components to sag or bulge from arthritis. Discs, joints, and ligaments can be affected. These changes, which occur with age, can have the effect of narrowing the spinal canal and thus trigger spinal stenosis pain.

During the acute phase of sciatica pain, McKenzie exercises provide one of the best and safest treatment approaches available - more effective than medication and epidural steroid injections in many people. Though often associated with spinal extension and mistakenly called the "McKenzie Extension Exercises", McKenzie method may involve any number of spinal positions/movements. The whole point of the McKenzie method is to evaluate different positions/exercises to find what best produces "centralization" of symptoms.

Lumbar Spinal Stenosis The condition of spinal stenosis results in the spinal canal narrowing. The narrowing causes pressure on the spinal cord and spinal nerves. Common in patients over the age of 50 and with causes that are not clear, spinal stenosis has two different types frequently described. A common complaint of spinal stenosis patients is leg pain which gets worse with walking. Another complaint is back pain. Sitting and bending can sometimes alleviate these pains.

 
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Spinal Tumors Spinal tumors can be benign or malignant, but are fairly rare. They cause sciatica due to pressure on the disc. Trauma

Another cause of sciatica is trauma caused by accidents. The impact may injure nerves or cause fragments of bone to compress the nerves (lumbar or sacral spinal nerve roots)

The spine is made up of a series of connected bones called "vertebrae." Spondylolisthesis or isthmic spondylolisthesis occurs when a cracked vertebra slips over the vertebra below it. Poor posture and curvature of the back or weak abdominal muscles can contribute to this slippage, which can press on the nerve. The presence of this spondylolysis usually does not represent a dangerous condition in the adult and most treatments concentrate on pain relief and increasing the patient's ability to function.

What it is Sciatica is the name people give to a pain in the buttock, leg or foot brought on as a direct result of some form of irritation to the sciatic nerve. The sciatic nerve is the longest nerve in the body. It runs all the way from the lower back splitting at the base of the spine and terminating in the foot.

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This information in this article should not be used to diagnose, treat, or prevent any disease. You should always consult with your health care professional especially relating to the suitability of supplements or drugs and on all health matters that may require diagnosis or medical attention. If you suffer from progressive weakness in the leg or bladder or bowel incontinence this constitutes a medical emergency and you should seek immediate medical attention - you may have cauda equina syndrome a serious condition due to compression of the nerve roots in the lower end of the spinal canal.

Recent studies have shown that bed rest is not necessarily the best way to treat sciatica. It is better to remain active, starting off with some gentle stretching and exercise. Swimming is particularly useful, as it is not a weight bearing exercise. The good news is that herniated spinal discs usually do heal on their own, given time.

Bill Morrison has his own website http://www.help4urback.com where he describes his own personal experiences coping with lower back pain and sciatica. He also includes personal recommendations for people who suffer from sciatica or lower back pain including what books to buy, TENs machines, and what web sites to check out.

Since getting mobile and becoming flexible is extremely important you might require some pain management to help you get going. For mild cases of sciatica your doctor may start off by recommending non prescription medications like aspirin, ibuprofen, or naproxen, known as non steroidal anti-inflammatory drugs, or NSAIDs. A downside of these drugs is that they may cause stomach upsets or bleeding.

The cause The most common cause of sciatica is a prolapsed (slipped) disc, pinched nerves or some form of arthritis. It usually starts with back pain which sometimes improves only to be followed by hamstring or calf pain. It may also include numbness in the toes depending on which branch of the sciatic nerve is irritated.

It is also important to maintain a reasonable body weight, ensure you have a good posture, sleep on a mattress that is neither too soft nor too hard, be careful when bending or lifting heavy weights.

There is a fairly new procedure called IDET which stands for Iintro Discal Electrothermy). When a disc is herniated the water content of the inflamed disc causes it to bulge and press against the nerve. IDET dries up the disc very quickly, in less than 20 minutes, a process which might take weeks or months if left to dry up naturally

Other medications like Corticosteroids taken orally or by injection are sometimes prescribed for more severe back and leg pain because of their very powerful anti-inflammatory effect. Corticosteroids also have side effects and the pros and cons of taking them should be fully discussed with your doctor.

Piriformis Syndrome Due to the lack of MRI or x-ray findings, it may be difficult to diagnose and treat piriformis syndrome. The piriformis muscle connects to the thighbone, assists in hip rotation and is located in the lower part of the spine. When muscle spasms develop in the piriformis muscle thereby compressing the sciatic nerve, Piriformis syndrome develops. The sciatic nerve runs beneath the piriformis muscle. Piriformis syndrome is named for the piriformis muscle and the pain caused when the muscle irritates the sciatic nerve. Lumbar Bulging or Herniated Disc

As a last resort you may consider surgery to remove fragments of the prolapsed disc are then removed. As I mentioned earlier it is important to stay active and continue with an exercise and stretching program. Especially do exercises to develop your back and stomach muscles. This will help stabilize your spine and support your body.

A position or exercise that results in symptom centralization is one that will be beneficial, even in situations where symptoms increase for a time in areas closer to the spine. For example, if you had sciatica and low back pain and tried one of of the McKenzie exercises and the sciatica completely went away but the back pain got worse, the exercise would still be considered beneficial and it would be recommended to continue using it. In the long run, a sciatica exercise that produces centralization will usually eventually result in improvement in all symptoms, even if more central (closer to the spine) symptoms get worse at first.

The Cure Some cases of sciatica which result from inflammation get better with time and heal themselves perhaps within six weeks to three months.

When the nucleus breaks through the annulus a herniated disc occurs. It is called a 'non-contained' disc disorder. A bulging disc is also known as a contained disc disorder. This means the nucleus pulposus (gel-like center) remains 'contained' within the annulus fibrosus (tire-like outer wall) of the disc. Because a herniated disc is a 'non-contained' disc disorder, the consequences of a herniated disc are worse. Whether a disc or herniates or bulges, disc material can press against an adjacent nerve root and compress delicate nerve tissue and cause sciatica. Irritation and nerve compression cause pain and inflammation often leading to extremity tingling, muscle weakness and numbness. The disc material itself also contains an acidic, chemical irritant (hyaluronic acid) that causes nerve inflammation. The herniated nucleus causes direct compression of the nerve root against the interior of the bony spinal canal.

The sciatica exercises that relieve back pain are really easy. The first one involves you laying on your back and pulling your knees up to your chest, giving them a hug. The idea here is to stretch out the lower back, which rarely ever gets a stretch. The other exercise is grabbing onto something above you and allowing it to stretch out your upper body. It's sort of like hanging on the monkey bars.

If your pain is not relieved by analgesics or NSAIDs, your doctor might prescribe narcotic analgesics (such as codeine) for a short time. Side effects of these include nausea, constipation, dizziness and drowsiness, and continued use may result in dependency.

There is one type of spinal stenosis that exists where individuals are born with a narrow spinal canal. In people that have this condition even minor structural changes to the spine can cause severe spinal stenosis.

About the Author:

Dr. George Best has been treating sciatica patients for over 15 years. For a free e-book on sciatica exercises and to access his informational online video series on sciatica and the treatment options for it, visit his website on sciatica self care.


 
 
     
 
 





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