All About Sciatica – A Pain in the Neck...and Back, and Leg!

The prevalence of sciatica among the Indian population varies significantly, with rates of 3.8% in the working demographic and 7.9% in those who are not employed. So, what exactly is sciatica? Imagine the sciatic nerve as a long, delicate wire that runs from your spine to your foot. When this wire gets pinched or irritated, it sends shockwaves of pain down your leg, much like a faulty electrical wire sparking and zapping.

“It’s not uncommon to see patients at the clinic complaining of sciatica,” says Dr Rajeev Vohra, MS, DNB (Ortho), NMAMS, a senior consultant at the Amandeep Group of Hospitals. However, “sciatica is a symptom, not a condition in itself. It is caused by irritation or compression of the sciatic nerve, which starts in the spine and extends to the foot. For this reason, the pain begins in the back and radiates down to the foot. It may also be accompanied by tingling or numbness,” the specialist explains.

One of the most common symptoms involves pain along the sciatic nerve. This nerve begins at the spinal cord and runs through the buttocks before branching down the legs. Sciatica is used to describe pain that can be a result of damage, irritation, or injury caused to the sciatic nerve and includes the following symptoms:

• Shooting or radiating pain: Often feels like burning or an electric shock, usually radiating down one leg. It can worsen with coughing, sneezing, or lifting your legs when lying down.
• Feeling of numbness: Loss of sensation on the skin of the affected area due to disrupted signals reaching the brain.
• Muscle weakness: A more severe sign indicating that muscle signals are struggling to reach your back or legs.
• Tingling or ‘pins and needles’: Feels like when your leg ‘falls asleep’ after sitting cross-legged.

Dr Vohra notes, “It is important to diagnose the cause of sciatica as early as possible because long-term affection of the nerve can cause lower limb weakness as well as loss of sensations, and in some tumours of the spine, it may be the first symptom.”

Any condition that impacts the sciatic nerve can result in sciatica. Dr Vohra adds, “Several diseases can cause sciatica, especially degenerative conditions of the spine and herniated discs. Sometimes an injury to the nerve or tumours of the spine and nerve itself can cause sciatica.”

Some of the most common sciatica causes include:

• Herniated disc: Happens when a disc, a key component of the spinal column, is pushed out of its place.
• Lumbar spinal stenosis: Causes compression of the nerves in the spinal column, especially in the lower back area.
• Spondylolisthesis: Occurs when one of the vertebrae in the spinal column slips out of its position, causing acute pain and discomfort.

1. Pregnancy
2. Age-related wear and tear
3. Back injury

“Sometimes weak muscles, abnormal posture, improper exercises, and weightlifting can also cause sciatica-like symptoms which are actually not due to nerve involvement. These conditions are easily amenable to diet and lifestyle modification, regular exercises, and physiotherapy,” explains Dr Vohra.

Lifestyle changes that can help with sciatica symptoms include:

• Regular exercise
• Proper posture
• Weight maintenance
• Weight lifting under guidance using correct techniques

The most common complication is the impact on spine functionality and mobility. It can affect the way you walk, carry weights, or the way you sit. Dr Vohra insists, “Early treatment of the disease responsible for sciatica is essential. It’s important not to wait too long to talk to a healthcare provider.”

Some of the most common risk factors also include:

• Sedentary lifestyle
• Smoking
• Lack of proper sleep
• Obesity
• Diabetes
• Weak core

Four commonly known stages of sciatica are categorised according to the level of pain.

• Acute: This is most common and occurs when the sciatic nerve gets compressed or irritated. It is accompanied by pain, muscle weakness, and tingling in the legs and back. 
• Subacute: A mild to moderate pain that persists for weeks, accompanied by intermittent muscle spasms.
• Chronic: When the pain extends for more than six weeks, it is categorised as chronic and is often followed by numbness. 
• Resolution: The final stage is marked by decreased pain or complete ‘resolution’ of the symptoms. 
  

Dealing with sciatica pain can be difficult, but understanding its symptoms and taking proactive measures can lead to better management and relief. By maintaining a healthy lifestyle, practising proper posture, and seeking timely medical advice, you can minimise the risk of sciatica and improve your overall spine health.

Some of the most common causes of sciatica include a herniated disc, lumbar spinal stenosis, spondylolisthesis, pregnancy, age-related wear and tear, or a back injury. These can cause the sciatic nerve to compress or get irritated, leading to sciatica. 

Most sciatic pain goes away within 4 to 6 weeks with the help of simple exercises and physiotherapy. However, it is crucial to see a specialist for the right treatment.

A tingling sensation accompanied by numbness or radiating pain shooting down the legs are symptoms of sciatica.

The quickest way to stop sciatica is to avoid being in the same position for long intervals and take short and regular walks. Maintaining good posture and simple lifestyle changes like regular exercise, not smoking, and getting enough sleep help.

A good posture combined with light exercises like yoga, pilates, and walks helps fix sciatica naturally. Applying ice packs and heat pads is also known to help.