Sciatica, what is it, how does it occur, what are the symptoms, how is it treated?

Sciatica or sciatica is a condition that refers to pain caused by irritation or compression of the sciatic nerve, the largest nerve in the human body. The sciatic nerve starts in the lower back, runs through the hips and buttocks, and then runs down each leg. Irritation of this nerve can cause pain that extends from the lower back, through the buttocks, all the way down the leg, and sometimes all the way to the foot. Sciatica is not an independent disease, but a symptom that indicates a problem in the lumbar spine, such as disc herniation, degenerative changes in the spinal vertebrae or narrowing of the spinal canal. This pain can vary from mild and occasional symptoms to severe pain that significantly affects daily life.

A patient suffering from sciatica usually feels pain that starts in the gluteal (buttock) area and spreads down the hip of the same leg. The pain can continue along the back of the leg, going down to the calf and in some cases even to the toes. This pain is often accompanied by tingling, burning or loss of sensation in the affected parts of the leg.

A patient with sciatica often takes the position of the body in which the pain is least pronounced. It is the body's natural reaction to reduce discomfort.

One of the characteristic symptoms of sciatica is increased pain during exertion, such as sneezing, coughing or laughing. This phenomenon occurs due to increased pressure on the sciatic nerve during these activities, which can further irritate the nerve and cause more intense pain.

The pain associated with sciatica can vary in intensity - from mild and occasional symptoms to severe and persistent pain that significantly impairs daily activities. In addition to pain, patients may notice weakness in the leg muscles, which can make it difficult to walk, climb stairs, or even stand on tiptoes.

In some cases, sciatica may be accompanied by a feeling of heaviness in the leg, and in more severe forms, there may be a loss of reflexes or control over the leg. Understanding these symptoms is key to timely diagnosis and treatment to avoid long-term complications.

• Increased body weight
• Improper lifting technique
• Stretching of muscles or ligaments
• Physical inactivity

Sciatica can result from various conditions and risk factors that lead to irritation or compression of the sciatic nerve. The most common causes include:

Risk Factors:

Prolonged Sitting: Sitting in an uncomfortable position or on inadequate chairs, especially for extended periods, can increase pressure on the lower back and trigger sciatica.

Physical Inactivity: Lack of physical activity weakens the muscles that support the spine, which can increase the risk of injury and the development of sciatica.

Obesity: Excess body weight places additional pressure on the lower spine, which can lead to nerve compression and pain.

Improper Physical Activity: Activities such as lifting heavy objects without proper technique, as well as performing yoga exercises incorrectly, can cause excessive strain on the spine and lead to sciatica.

Wearing High Heels: Prolonged wearing of high heels can alter the position of the spine and place additional pressure on the lower back, increasing the risk of sciatica.

Muscle or Ligament Strain: Injuries or strains in the muscles and ligaments of the lower back can press on the nerve roots and cause pain that radiates down the leg.

Specific Causes of Sciatica:

Spinal Canal Stenosis: Narrowing of the canal in the lower back (lumbar stenosis) can compress the nerve roots, including the sciatic nerve, leading to pain that radiates down the leg.

Degenerative Disc Disease: Damage or wear of the disc between two vertebrae (degenerative disc disease) can reduce the space between the vertebrae and press on nerves, including the sciatic nerve.

Herniated Disc: This is one of the most common causes of sciatica. When the inner part of the disc protrudes through the outer layer, it can press on the corresponding nerve root. The patient then feels pain radiating down the leg. A herniated disc often occurs due to improper lifting of objects or sudden movements that cause the disc to rupture.

Piriformis Syndrome: The piriformis muscle, located in the buttocks, can press on the sciatic nerve if it becomes inflamed or tense, causing sciatica.

Sciatica can manifest in various forms, depending on the duration of the pain, which can be classified as acute (pain lasts less than 6 weeks), subacute (6-12 weeks), and chronic (more than 12 weeks). In most cases, acute pain may spontaneously subside after a few days of rest. However, this does not mean that the discs in the spine have returned to their original position—pain reduction often indicates only temporary relief of pressure on the nerve roots.

A more complex situation arises in patients whose pain does not subside after a week. If the pain intensifies and spreads down the leg, treatment requires more comprehensive measures than just medication. In such cases, detailed diagnostics, such as an MRI of the lumbar spine, is necessary to precisely determine the cause of the problem.

Treatment of sciatica typically begins with medication therapy, including anti-inflammatory drugs, analgesics, and muscle relaxants. The goal of this therapy is to reduce inflammation and pain, but if it does not produce the desired results, physical therapy may be initiated after a specialist consultation with a physiatrist.

Physical therapy aims to directly address the cause of the pain. The advantage of this approach is that the therapy works locally, at the site of the injury. In our center, we also apply DTS spinal decompression, which aims to restore the microscopic spacing between vertebrae and allow the disc to return to its place. This therapy helps reduce pressure on the nerve roots and alleviates sciatica symptoms.

After the pain subsides, it is necessary to implement appropriate kinesitherapy, which includes specific exercises. The goal of these exercises is to restore balance to the body by stretching the shortened muscles that have been tense and painful and strengthening the weakened muscles, especially those in the thighs, trunk, and muscles along the spine.

These exercises help create a muscular "corset" that stabilizes the spine and prevents further deformities. All exercises are conducted under the constant supervision of a certified physiotherapist to ensure proper technique and achieve optimal results.

Sciatica is a condition that is difficult to completely prevent, and if not treated properly, there is a high likelihood that it will return with even more severe or similar symptoms. We advise patients not to ignore the first symptoms, as timely treatment can prevent further disc displacement and reduce the need for invasive interventions.