Your doctor can diagnose sciatica by asking about your symptoms – such as radiating pain – and conducting physical exams of both your back and legs. Additional tests such as an MRI scan or EMG assessment may also be administered.
Over-the-counter pain medications, including ibuprofen (Advil) and acetaminophen (Tylenol), may provide temporary relief. Your physician may suggest heat/cold therapy or physical therapy exercises to manage the condition.
Causes
Sciatica usually resolves itself through conservative treatment; however, people experiencing moderate or severe symptoms – including numbness and weakness in one leg – should seek medical advice immediately.
Sciatica may be caused by a slipped disc or bone spur. Other risk factors for sciatica may include sitting for extended periods, obesity and diabetes which increases nerve damage risk. People whose work involves twisting their backs while carrying heavy loads might also be more prone to sciatica than usual, pregnant or recently had surgery women may also be at greater risk for it.
Over-the-counter pain relievers such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) may provide temporary relief for sciatica symptoms. Cold therapy for several days followed by hot therapy can be effective; cold therapy numbs and reduces inflammation while heat helps stretch muscles. Physical therapy or alternative therapies like yoga or massage may also help. If these methods don’t provide relief, consulting a health care professional might recommend injections to reduce swelling around the sciatic nerve or other medications to relieve stabbing pain.
Symptoms
Sciatica typically manifests itself with pain that radiates from your lower back or buttock and down one leg, whether dull ache, throbbing or burning sensations. Sometimes accompanied by numbness or “pins and needles”, as well as weakness in leg muscles.
Your doctor will conduct a physical exam to ascertain what’s causing your symptoms, asking about frequency and location of pain as well as factors like activities/positions that seem to ease or worsen it, plus anything that makes your discomfort disappear or worsen over time.
Your doctor may conduct an X-ray or magnetic resonance imaging (MRI) scan to look for signs of herniated disk in your spine, and an electromyography and nerve conduction study (EMG and NCS). These tests use thin needles to record electrical activity in muscle cells to help locate where injuries may have occurred in your body.
Treatment
Your doctor diagnoses sciatica by asking about your pain, examining your back and legs, and testing how well you move. He or she may ask you to walk on toes and heels or raise both legs straight out at the sides while lying down – any changes should worsen as soon as the sciatic nerve is being pinched off.
X-rays, magnetic resonance imaging (MRI), and computed tomography scans of your spine can help diagnose sciatica by detecting bone fractures, herniated disks, or other issues that press on the sciatic nerve. Other tests such as an electromyogram and nerve conduction study can measure how well your spinal cord and nerves are working together.
Many individuals with sciatica find relief through home treatments such as cold/hot packs, over-the-counter pain relievers and exercises designed to strengthen back and leg muscles. Other therapies, including massage therapy, chiropractic adjustments, or acupuncture may also help.
Prevention
Sciatica occurs when one or more spinal nerves becomes pinched, creating pins-and-needles sensation and pain in a specific leg. Sometimes it may also result in weakness, numbness, or loss of control over bladder or bowel functions.
Sciatica is a chronic condition, but symptoms often decrease over time. Wake Forest spine specialists typically recommend painkillers and physical therapy as well as low-stress exercise regimens to alleviate back strain and decrease strain on the spine. Steroid injections into the spine may also help decrease inflammation; surgery should only be considered if symptoms interfere with work and daily activities.
Regular exercise can help alleviate many conditions, including sciatica. Regular activity helps delay age-related spine damage, strengthen back and hip muscles, promote proper posture and aid good body mechanics. Avoid prolonged sitting for extended periods – try standing up and moving around every 30 minutes (if possible). Strong abdominal muscles also support your spine.