From time to time, a customer comes into SIMI PHARMACY and asks for a heavy-duty painkiller … “something stronger than naproxen or ibuprofen”. To give our best advice on what medication will benefit them, we ask them what hurts and what kind of pain they’re suffering from. A very frequent answer is “my sciatica is acting up again.”
It is common to call any pain in the back, hip or leg “sciatica”. Common, but not necessarily accurate.
Sciatica is not the name of a condition; it is the name of the longest nerve in the body. Five nerve roots in the lower spine come together to form the sciatic nerve which passes deep in the buttock and down the back of the thigh all the way to the heel and sole of the foot. It is a motor nerve, which means when you want to move your legs, the “move” message from the brain passes down the sciatic nerve to the large muscles in the back of the thigh, down to the calf muscles, anterior leg muscles and on to muscles in the feet. It is also a sensory nerve: if you step on a thorn, the pain message from your foot travels up the sciatica nerve to the brain.
Not every back pain is a sciatic pain. Several quick, simple tests of flexibility tell a doctor whether or not a pain in the back or leg is related to the sciatic nerve or is caused by something else. For most people, sciatic pain is a shooting or shock-like pain that blitzes from the lower back down the leg to the foot, along the sciatic nerve. A dull, persistent ache in the back is caused by something else.
If the sciatic nerve is indeed the cause of your misery, then you are a member of a very large club: four out of ten Americans will suffer from this type of pain at least once in their life. People most likely to be affected are between 30 and 50 years old and male. Sciatic nerve pain strikes people in strenuous jobs who do a lot of lifting … but it is also likely to affect people whose occupation requires sitting for long hours with little opportunity for exercise. The actual name of this condition is lumbar radiculopathy.
A look at the spine in the lower back reveals why that big nerve can give big trouble. The spine is a stack of bones called vertebrae. Placed between the vertebrae, like shock absorbers, are rubbery cushions called discs. Each disc has a soft, jellylike center (nucleus) encased in a tough, rubbery exterior (annulus). When a part of the nucleus pushes out through a tear in the annulus, it is a herniated, or ruptured, disc. Also called a slipped disk. When the injured disc presses on the sciatic nerve, it hurts – seriously ! Nine out of ten cases of sciatic nerve pain are caused by herniated disk.
There’s another cause. Foramina are little openings inside the body that allows key structures to connect one part of the body to another. The small nerves in the lower back that merge into the big sciatic nerve come out from between the vertebrae by way of such foramina. If these opening become narrow (in Greek, the word is stenos) then the nerves are pinched.
Doctors call this foraminal stenosis and the result is pain all up and down the sciatic nerve.
More rarely, the problem is that the spine in unstable: one or more vertebrae become deformed or dislocated and pinch the roots of the sciatic nerve. Very, very rarely, the sciatic nerve is compressed by tumors, cysts, infections, or abscesses in the lower spine or pelvic region.
Over-the-counter painkillers for people with lumbar radiculopathy are useful and so are hot or cold compresses to soothe the lower back. A back brace can also help. These braces are designed specifically to protect the sciatic nerve. They provide enough compression and support to prevent further injury and encourage healing.
A brace works like a crutch to assist your core muscles in responding to the pushes and pulls of getting up and down, walking, bending and turning. However, just as crutches should be temporary, a back brace shouldn’t be used as a long-term pain management strategy.
SIMI PHARMACY stocks many products for symptomatic relief. We also frankly advise people that symptomatic relief is not cure.
Regaining a life free of sciatic pain will most likely involve two long-term treatments: Treatment Number One consists of four to six weeks of sessions with a physical therapist to improve muscles, correct posture and learn movement habits that minimize damage to the vertebrae or discs.
Treatment Number Two focuses on substituting healthy habits for bad habits. Chiefly, this mean achieving and maintaining correct weight, and giving up smoking,
Giving the back a rest might seem like the logical way to overcome sciatic nerve pain but, in truth, rest is not what helps. The better option is a structured exercise routine –
– not just any exercise but those movements that avoid putting pressure on the spine but instead restore the spinal discs, improve muscle and bone strength, and tone up the sciatic nerve.
A quick search on the internet – specifically YouTube – will turn up many sites that demonstrate exercises that lead to reduction in lower back and leg pain. The common sense rule for any exercise routine is Start Easy, Persist Day-by-Day, Build the Body’s Capability Step-by-Step. This is particularly valid for back pain sufferers who are determined to launch into Do-It-Yourself treatment.
If sciatica pain does not go away, but increases, or if there are any red-flag signs such as weakness or loss of control of bowel or bladder, it calls for immediate medical intervention.
Many products can give relief from sciatic nerve pain:
pain relief ointments
bags, warm and cold
deep tissue massagers
lumbar support cushions
DO SOMETHING NICE FOR YOUR BACK:
Come in to SIMI PHARMACY and let us help you.