Sciatica Pain – Symptoms, Causes & Treatment
What is Sciatica Pain?
Sciatica pain is the term used for the lower back pain that is usually initiated at the lower vertebral column, traveling down the buttocks and to the legs in severe cases. People experiencing sciatica pain complain about numbness or weakness in the lower body including buttocks, legs, and feet. Although there could be various problems related to the vertebral column and spinal cord that cause back pain. But the sciatica pain differs from other back pain in that it increases with movement and decreases with rest. According to Wegner et al., sciatica pain can be caused by different reasons, including the blocked sciatic nerve, muscle spasm in the piriformis, and disorders in lumber or sacrum regions of the vertebral column .
Causes of Sciatica Pain
- A herniated disc in the lumbar or sacral regions causes sciatica pain because of the blocked nerve by pushed out nucleus pulposus and ruptured annulus .
- Osteoarthritis makes the bones weak and brittle due to which the lower vertebral column gets degenerated or misaligned stimulating the sciatica pain .
- Spinal stenosis is the cause of sciatica pain in more than 18% of patients suffering from sciatica pain as the sciatic nerve is usually compressed or narrowed in stenosis .
- Piriformis syndrome is associated with the piriformis muscle through which the sciatic nerve is passed down. In the case of muscle spasm or restriction in the piriformis, sciatica pain is increased .
- Spondylolisthesis can also be a cause of sciatica pain because one or more vertebrae are slipped or misaligned in this condition .
- Other diseases like tumors in the spinal cord or cauda equina syndrome also cause severe sciatica pain but the incidence rate of these diseases is much lower.
Risk Factors of Sciatica Pain
- Lower back injuries and accidents is a vital risk factor for sciatica pain.
- Herniated disc increases the risk of sciatica pain so it should be cured instantly.
- Being obese or overweight boosts the burden and pressure at the back, hence it can be a risk factor for sciatica pain .
- People who are employed to lift heavy objects or who poorly handle heavy objects are at greater risk of sciatica pain.
- Diabetic patients are at risk of sciatica pain as the prolonged increased blood glucose level does not allow proper oxygenation of the bones and muscles affecting the structural integrity of all the nerves especially the sciatica nerve as it is passed through the piriformis muscle .
- Osteoarthritis in the vertebral column especially in the lower regions increases the risk of sciatica pain due to weakened, numbed, and tingling effects.
- People who follow a sedentary lifestyle or smoke are at severe risk of sciatica pain.
Normal Healing Cycle in Sciatica Pain
The healing cycle is started as soon as there is any disorder in the spine, vertebrae, disc, or piriformis muscle causing the sciatica pain, and consists of three phases i.e., inflammation, proliferation, and maturation phases .
The inflammation phase is the first line of action in the healing cycle that includes redness, swelling, increased temperature either at the affected site or the whole body. The primary aim of the inflammation phase is to recognize the affected region and to call the defense mechanism of the body to come and heal the pain .
The proliferation phase can be described as the cascade of events including scar tissue release, trigger points release, and fascia release. The scar tissue is a collagen network that covers and protects the affected region from more inflammation. The trigger points release informs the blood to start the process of fascia release. The fascia release is concerned with the muscular healing at the lower back in which the superficial and deep layers are triggered to regain their shape and elasticity [3, 4].
As soon as the proliferation phase reaches the fascia release, the maturation phase is completed by the excretion of scar tissue and maintaining the healthy tissues. However, in chronic conditions, the proliferation phase does not complete due to continuous inflammation or repeated problems such as in herniated disc .
Not Effective Treatments for Sciatica Pain
Although there are numerous pain management techniques through which you can relieve your sciatica pain at home but not all techniques of pain relief are effective for sciatica pain. For instance, heating and icing are supposed to be pain relief method but it does not work in sciatica pain. Moreover, Electronic Stimulator (EStim), massaging and Foam Roller are muscle stimulators that ease the muscular pains but for sciatica, it is not that effective. Exercises and stretching during the inflammation stage can increase the temperature and blood flow to the affected region due to which the healing process is slowed down, hence not much effective .
Effective Treatments for Sciatica Pain
Sciatica pain is remarkably decreased with complete bed rest with minimal movement of the back and legs. Rest provides enough time for the sciatica nerve to be healed naturally through the healing cycle .
Magna Heal is a wearable belt that encompasses a rare earth neodymium magnet in it to pass the magnetic field to the body so that misalignment in the vertebrae, spine, or disc can be corrected.
According to Jensen et al., sciatica pain can be managed at the inflammation phase by consuming an anti-inflammatory diet and restoring deficiencies through supplements of vitamins, minerals, iron, and calcium .
To release the scar tissue, trigger points, and fascia externally, Advanced Soft Tissue Release tools are effective to enhance the proliferation stage. For scar tissue and trigger points superficially, the A3 ASTR tool is used while for deep tissue release, A5 is used. For the superficial fascia layer, the A1 ASTR tool is best effective whereas, for deep layers of fascia layers in the piriformis muscle, the application of A5 provides the best results .
How to Treat Sciatica Pain at Home
To treat the sciatica pain at home, it is important to stabilize the core muscles and joints, maintaining proper posture during sitting, walking, and lying, lifting heavy objects considering the body mechanics, staying physically active and engaging in pain-free activities, using Magna Heal, consuming anti-inflammatory diet and nutritional supplements, using ASTR tools for scar tissue, trigger points, and fascia release to relieve the sciatica nerve .
- Wegner I, Widyahening IS, van Tulder MW, Blomberg SE, de Vet HC, Brønfort G, Bouter LM, van der Heijden GJ. Traction for low‐back pain with or without sciatica. Cochrane Database of Systematic Reviews. 2013(8).
- Ostelo RW. Physiotherapy management of sciatica. Journal of physiotherapy. 2020 Apr;66(2):83-8.
- Cass SP. Piriformis syndrome: a cause of nondiscogenic sciatica. Current sports medicine reports. 2015 Jan 1;14(1):41-4.
- Bernstein IA, Malik Q, Carville S, Ward S. Low back pain and sciatica: summary of NICE guidance. Bmj. 2017 Jan 6;356.
- Konstantinou K, Dunn KM, Ogollah R, Lewis M, van der Windt D, Hay EM, ATLAS Study Team. Prognosis of sciatica and back-related leg pain in primary care: the ATLAS cohort. The Spine Journal. 2018 Jun 1;18(6):1030-40.
- Jensen RK, Kongsted A, Kjaer P, Koes B. Diagnosis and treatment of sciatica. bmj. 2019 Nov 19;367.
- Santilli V, Beghi E, Finucci S. Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations. The Spine Journal. 2006 Mar 1;6(2):131-7.