Health Solutions

Single Supplements

What is Sciatica?

Sciatica is the pain felt along the sciatic nerve, the longest nerve in our body that runs from the lower back to each buttock and down each leg. It is estimated that about 40% to 50% of people in the UK experience sciatica pain at some point in their lives. However, in most cases the pain is NOT due to any damage, pressure or pinching of the sciatic nerve (see below).

What are the Symptoms of Sciatica?

Sciatica symptoms can vary from person to person ranging from mild to very severe, debilitating pain. The pain can begin abruptly or develop gradually and is primarily located in the buttock region and often radiates down the back and lateral side of the leg to the lateral malleolus. Most people experience a constant dull, deep aching pain while others experience a sharp, burning or shooting pain. The pain may usually be influenced by increased pressure in the spinal canal (coughing, sneezing) which may indicate a herniated disc. Most people experience pain when sitting or standing for longer periods of time. A tingling feeling or numbness down the leg can also be present that may resemble or be due to the numbness caused by a herniated disc. Other symptoms can be restricted movement of the legs and decreased muscle strength.

What Causes Sciatica?

Sciatica typically develops in people between the ages of 30 and 55 and one of the most persistent myths is that it is due to compression of the sciatic nerve. Most often the pain in the "sciatica region" is caused by myofascial pain. Myofascial pain is pain caused by chronic inflammation in myofascial trigger points located in the gluteal muscles (gluteus minor and gluteus medius muscles) and not a "pinched" nerve. It is estimated that up to 93% of patients complaining of sciatica actually have myofascial pain.

Sciatica is most often triggered by:

• Tension, spasm, or fatigue of the muscles
• Excessive, repetitive or constant muscle contraction (overuse)
• Poor posture
• Depletion of anti-inflammatory and antioxidant nutrients
• Hip osteoarthritis
• Chronic back pain
• Systemic diseases (e.g. inflammatory bowel syndrome)
• Inactivity (e.g. a broken arm in a sling)
• Hormonal changes (PMS or menopause)
• Stress and anxiety
• Cold or draft

In more rare cases sciatica pain may be due to the following reasons:

• Herniated disc: Discs are found in between our vertebrae along our spine. They are filled with a gel-like substance that helps to keep the spine flexible and act as shock absorbers. A herniated disc can result in compression of the nerves in the spinal cord (including the sciatic nerve) and may cause pain or lack of function of the nerves that run beyond the compression site. According to the American Academy of Orthopaedic Surgeons, only about one in every 50 people will get a herniated disc at some point in their life
• Lumbar Spinal Stenosis: Spinal stenosis is the narrowing of the spinal canal, the space in the vertebrae that houses the spinal cord. When the narrowing occurs in the lower back, it is called lumbar spinal stenosis. This may compress nerve roots including the sciatic nerve and cause sciatica. Some cases of spinal stenosis are due to arthritis and the natural deterioration of vertebrae discs associated with aging, but can also be due to an injury
• Piriformis Syndrome: This is an extremely rare neuromuscular disorder that may be caused by compression of the sciatic nerve by the piriformis muscle. The piriformis muscle runs through each buttock and is attached to each thighbone (femur)
• Spondylolisthesis: Occurs when a lumbar vertebra (usually L5) slips forward onto another vertebra. If a vertebra slips forward a lot it can put pressure on the spinal cord (including the sciatic nerve)
• Tumours on the Spine: Sometimes tumours in the spinal cord can put pressure on the spinal cord (including the sciatic nerve) causing pain
• Trauma: Injuries to the back, falls and traffic accidents can cause direct or indirect damage to sciatic nerve roots (callus formation on fractured bones)

How is Sciatica Diagnosed?

A physical examination is usually conducted to help the medical practitioner find out what the cause of the problem is. This include a medical history including the exact location of the pain, type of pain, if there is any radiating pain, numbness, paralysis or other neurological symptoms, what movements provoke the pain and what eases the pain etc. A thorough physical examination including palpation of relevant myofascial trigger points is also conducted. Additionally, testing reflexes and sensibility and asking the patient to walk on their toes and heels, doing squats and raising legs is carried out. In some cases it may be relevant to do an X-ray, magnetic resonance imaging (MRI) or a computerized tomography (CT) scan.

What are the Treatments for Sciatica?

In about 85% of cases, sciatica will respond to self-care techniques, such as stretching exercises, hot/cold packs and non-prescription painkillers. Many people also find physiotherapy to be very helpful.

• Some people use analgesics (painkillers), such as paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs). These, however, have unpleasant side effects and paracetamol is the most common cause of severe liver damage and liver failure today. Pharmaceutical drugs including pain killers, even when taken correctly, are the 4th most common cause of premature death after heart disease, cancer and stroke respectively

In very rare cases where the cause of sciatica is due to a herniated disc, spondylolisthesis, a fracture or a tumour the treatment may be surgery:

• Surgery: Surgery is not usually the first choice of treatment but when pain is disabling, not improving and caused by a herniated disc, part of the herniated disc can be removed.

• Herbal Supplements: Chronic inflammation of gluteal muscle trigger points is the most common cause of sciatica. Chronic inflammation arises most often due to the combination of a trauma or overuse of the relevant muscles combined with a deficiency of natural anti-inflammatory and antioxidant nutrients in our body. Several scientific studies have revealed that chondroitin, glucosamine, methylsulfonylmethane (MSM), ginger root extract and omega-3 fish oils are an effective and side effect free treatment that help to ease and prevent chronic inflammation.
• Medical Acupuncture: According to a World Health Organization (WHO) consensus report, medical acupuncture of relevant trigger points is an effective treatment procedure.
• Acupressure of relevant trigger points.
• Chiropractic.
• Osteopathy.
• Yoga.

References: