Sciatica – causes and treatments

Back pain getting on your nerves?

In our latest Ask the Expert health article, also featured in the West Essex Life Magazine,
Mr Ahmed Ibrahim, Consultant Neurosurgeon at The Holly Private Hospital answers your frequently asked questions on a condition that affects millions of people every year, sciatica.

What is sciatica?

Sciatica is a commonly used term used to describe pain which starts in the back and spreads down the back of one or both legs which in some can reach the feet. The sciatic nerve is the largest single nerve in the human body; running from each side of the lower spine through the buttock into the back of the legs and into the feet. It serves a vital role in communicating movement and conveying sensation to the brain.  Sciatica occurs when fibres that make up the nerve are compressed.

What are the symptoms of sciatica?

Sciatica is a sharp, shooting type of pain that starts in the lower back radiating to the buttocks, back of the legs and the feet.  Typically pain is worse after sitting, walking, sneezing or coughing. There can also be pins and needles, tingling sensation, numbness or weakness in the areas affecting by the pain.
Patients with sciatica often report that the leg pain is worse than the back pain.

What are the causes of sciatica?

There are three main causes of sciatica:
1) Slipped, prolapsed or herniated disc
Pain caused by disc herniation often starts suddenly after lifting heavy objects, twisting, turning, or even when coughing or sneezing. At first the pain can be localised in the lower back before beginning to radiate down to the legs.  The pain results from compression of part of the sciatic nerve
2) Canal stenosis
In this age-related condition patients develop narrowing of the spinal nerve channels.  Often, both legs are affected. Pain is brought on by walking variable distances which with time becomes progressively shorter.
3) Foraminal stenosis
This is also an age-related condition which results from gradual loss of disc material resulting in compression of the nerve as it leaves the spinal canal.
Is there anything I can do to help my sciatica myself?
  • speak to your pharmacist about which painkillers can help (paracetamol may help but may be insufficient)
  • carry on with your normal activities as much as possible
  • regular back stretches
  • start gentle exercise as soon as you can
  • sit down for long periods – moving can help reduce the pain
  • use hot water bottles to ease the pain – you could scald yourself if your skin is numb
  • carry, pull or push heavy objects
  • go on long drives.
What treatments are available for sciatica?
If the above simple measures fail then you will need to obtain a prescription for stronger pain killers from your GP.  Your GP may also suggest exercises and stretches, refer you for physiotherapy or for psychological support to help you cope with the pain.
Specialist care
Persisting or severe pain for 6 weeks or longer will need to be assessed by a specialist with or without an MRI scan of the spine.  If appropriate, patients will be offered spinal nerve root injection or as a last resort surgical intervention.
Is there anything I can do to prevent sciatica in the first place?
Learning to lift heavy objects in a manner that causes the least stress on the back is crucial.  Bending and twisting to lift objects should be avoided.  Health safety training for manual jobs is helpful. Taking regular exercise and physical activity is an excellent way to maintain and regain a healthy back.

How can I lessen the chances of sciatica coming back?

There are a number of things you can do to lessen the chances of sciatica coming back:
  • stay active by taking regular exercise
  • sit correctly when using a computer
  • try to maintain good posture when sitting and standing
  • don’t smoke – smoking increases your risk of developing sciatica by blocking the body’s ability to deliver nutrients to the discs
  • be careful when lifting heavy objects and use safe lifting techniques
  • make sure you maintain a healthy weight
Mr Ibrahim has clinics at The Holly Private Hospital on Thursday afternoons. 
Consultations costs from £250. 
To book an appointment call our friendly appointments team on 020 8936 1201. 
Date: 05/02/2018