by Pregnancy.org Staff
Sciatic nerve pain often comes on suddenly, creating immediate distress. And while it usually resolves in a few weeks, the pain may linger for months or years, disrupting lives. This develops into a condition called Sciatica. You can probably name several examples from your own experience, or maybe you've had sciatic nerve problems yourself.
At least 80% of the world's population suffers from lower back pain, with or without sciatica, at some time in their lives. The pain often comes suddenly, creating immediate distress. And while it usually resolves in a few weeks, it may linger for months or even years, changing lives and lifestyles. Potentially the most serious of lower back problems, sciatica results from compression of the sciatic nerve, the largest nerve in the human body.
About the width of a thumb when it branches out from nerve roots on the lower spine, the sciatic nerve threads its way behind the hip joint, deep into the buttocks, down the hip and along the back of the leg all the way to the foot. Typically, the pain results when the nerve on one side becomes stretched or pinched usually by something which narrows its passageway such as arthritis or a bulging or herniated disk. The result can be sharp pain in one part of the hip or leg but is more likely to be some combination of pain, numbness, burning, tingling or needles and pins sensation anywhere from the hip to the toe usually on one side only. The pain typically gets worse after a long period of standing or sitting such as riding in a car and it may also be aggravated by coughing, sneezing or laughing.
Some studies have found sciatica more prevalent among sedentary persons particularly smokers and those who spend many hours behind the wheel of a motor vehicle. But as the JAMA and Lancet articles indicate, highly active persons are also vulnerable.
A study showed that bed rest offered no benefits over gentle movement and actually has negative effects such as tightening of muscles and loss of strength and flexibility. Even as recently as 1997, bed rest was considered a routine part of early therapy. That changed with the publication of a study in the New England Journal of Medicine [February 11, 1999] showing that bed rest failed to provide any benefits over gentle movement in terms of resolving pain and speeding the healing process.
And because bed rest has negative effects such as tighter muscles and loss of strength and flexibility most doctors today tell their patients to keep moving as much as they can while avoiding heavy lifting, bending from the waist, stooping and other activities that might stress the lower back. Sitting also stresses the lower back, and soft chairs are usually considered off limits.
Anti-inflammatory medications such as ibuprofen help reduce the pain and inflammation. [Editor's note: Pain relief medications such as aspirin and ibuprofen are not recommended during pregnancy.] And in bed, a firm surface is recommended, lying on one's side back with knees bent. As always, do not take medicine without consulting your doctor first. Some studies have found bulging or protruding discs on the scans of 60% of individuals with apparently healthy backs. Lower back pain with sciatic nerve involvement is generally more serious than simple back pain. Nevertheless, about half of patients get better in the first two weeks and 70 percent recover within six weeks. When the problem lingers or recurs, however, the treatment challenge is substantial.
Non-surgical treatments include exercise, chiropractic manipulation, steroid injections, massage, ice, heat, physical therapy, acupuncture and pain management measures such as biofeedback and relaxation therapy. The trend is to focus on helping patients improve their tolerance to physical activity rather than merely fighting the pain. Physical activity has many benefits, both physical and emotional, while inactivity accentuates pain and causes weakening and shortening of connective tissues. However, the type of exercise may have to be adjusted to the symptoms of the patient. High impact activities such as running, for example, are sometimes considered risky.