Sciatica

Introduction 

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This animation explains what sciatica is and what causes it

Sciatica is the name given to any sort of pain that is caused by irritation or compression of the sciatic nerve.

The sciatic nerve

The sciatic nerve is the longest nerve in your body. It runs from the back of your pelvis, through your buttocks, and all the way down both legs, ending at your feet.

Anything that compresses or irritates the sciatic nerve can cause a pain that radiates out from your lower back, and travels down your leg to your calf. Sciatic pain can range from being mild to being very painful.

A slipped disc can cause sciatica

Sciatica can have a number of causes, such as a herniated disc (often referred to as a slipped disc). This occurs when one of the discs that support the vertebra (the individual bones that make up your spine) gets temporarily pushed out of position and presses on your sciatic nerve.

In many cases of sciatica, there is no obvious cause. However, in some people, it is thought that a combination of muscle, joint and bone strain may lead to sciatica.

Types of sciatica

There are two types of sciatica:

  • Acute sciatica: lasts up to six weeks.
  • Chronic sciatica: lasts longer than six weeks.

Most cases of acute sciatica will pass without the need for treatment. Using a combination of over-the-counter (OTC) painkillers, exercise and hot or cold packs can often help to relieve the symptoms of sciatica.

In the case of chronic sciatica , you may require some structured physical exercise under the supervision of a physiotherapist. In very rare cases, surgery may be required to control the symptoms.

  • show glossary terms

 

Pain


Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.

 

 

Spine


The spine supports the skeleton, and surrounds and protects the delicate spinal cord and nerves. It is made up of 33 bones called the vertebrae

 

 

Joint


Joints are the connection point between two bones that allow movement.

 

 

Acute


Acute means occuring suddenly or over a short period of time.

 

 

Chronic


Chronic usually means a condition that continues for a long time or keeps coming back.

 

Last reviewed: 29/07/2008

Next review due: 29/07/2010

What are these?

alicesprings said on 07 February 2010

Hi, I'm new to this site. regarding sciatica, the low back pain's subsided a bit (or at least now I know how to stand/sit to lessen it!) but I'm left with a kind of stinging sensation on the inner thigh which I can't avoid because it's just always there, stinging away. Tights/trousers make it feel as though they're rubbing and it feels like the skin will be red raw, but there's no outward sign of the stinging. Any ideas how to help alleviate this? Is this part of sciatica, or something else? Thanks.


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squirley said on 01 February 2010

I have been suffering from back pain and sciatica predominantly in my right leg since July 07. In July 08 i had surgery for spinal decompression which did not alleviate the pain and so in Dec 09 i had a spinal fusion L4/L5 involving metal cage and screws.
5 days after surgery i started to have an unberable pain in my left leg and foot which follows the sciatic nerve and is causing severe pain, weakness, numbness and burning. This is in addition to the extremely painful back pain following my recent surgey.
My consultant thionks its a rare condition where he thinks a piece of the bone fragment from the fusion site has dropped and is pressing on the nerve. I am booked in for a CT scan next week but wondered if anyone has had the same experience and/or can give me some more details.
Many Thanks

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papa_freak said on 26 January 2010

I've put up with pain running down my left leg since August. It gradually became excruciating so I finally went to the Dr.'s in November. Who told me I have Sciatica and has referred me to the back specialist clinic at the hospital. Its a 16 week waiting list. I've been off work on the sick for 2 months now and still nothing.
I take Dihydrocodeine, Diclofenac and Paracetamol. This combination has taken the edge off the pain. I can now at least have a shower and go to the toilet without being in agony.
I have tried 2 other alternative therapies, of which I had to pay for.
Firstly, The Bowen technique, I know a few people who swears by this but it did not do anything for me. If you don't notice any difference after 3 sessions then you should know if its for you or not.
Secondly I tried Acupuncture. Again I know a few people who swears by this too. After my first session it totally wiped out all pain. I was amazed. This turned out unfortunately to be short lived. However I had no pain for a few hours. I stopped going after the second session didn't really do anything.
This does not mean these therapies won't work for you though. Anything to take the pain away is worth a try.
I can totally emphasis with anyone having this debilitating condition.
Its real sh1t.
Hang on in there and good luck to you all....

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Ang3l said on 17 January 2010

Hi all I too suffer with terrible chronic sciatica amongst other things. The only help given by the NHS is pain medication (MST - Morphine Sulphate Tablets, and Amitryptyline) the reason for my sciatica is due congenital kyphosis and lower flat back due to another congenital spinal abnormality - (failure of segmentation of the Lumbosacral junction L5-S1) which in laymans terms means that my pelvis is tilted backwards, so whenever sitting I'm sitting on the sciatic nerve, the only relief comes from trying to force my pelvis to tilt forwards,when standing and too stretch my hamstrings as much as humanly possible, but this is very short term, as soon as the muscles are relaxed the pelvis returns to its orignal position and the sciatic nerve is pinched again. The NHS know all this from MRI's and X-rays done after an accident fractured my spine, but instead of treating the cause at a short term high cost, they choose to treat the symptoms (poorly) at a much higher long term cost, thats the problem with the NHS they look to minimise their year to year costs to look good on their financial year end reports, but in the long term the cost is increasingly leading to crippling the NHS, it's not even the Dr's at fault, they are forced into this by beauracratic mid-level managers who only care about the money they can save in the short term, I'm sure that Dr's, Nurses, consultants are frustrated as well by all this. But I guess all we can do as patients is take whatever limited help they try to provide, what a shameful situation. I honestly think that it would be better if we had a private health system like the US, it's not free granted, and medical insurance is a must, but in essence we already pay medical insurance in the form of National Insurance contributions, and look at the service it gets us....!! In the meantime my symapthy go's out to anyone who is sueffering from this condition, and if anyone has any suggestions on ways to help, PLEASE post details here.

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materialgirl said on 11 January 2010

I suffer from sciatica - have done for a few years and it is getting worse. Some days I can barely move. I now have the flu and the pain is out of this world unbearable. Sometimes I think that cutting my leg off would be less painful.
I've been to an osteopath who was useless - I've had physio which only causes temporary relief. The doctor gave me anti-inflammatory which does not help and another drug which takes the edge off.
When I go to doctors I get made to feel that it's just something I have to get one with. But it's not funny anymore - I really need to get it sorted out once and for all. I've never even been sent to hospital for more investigative procedures like MRI - perhaps I should insist on it.

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guitarman said on 05 January 2010

id just like to add pregablin starts at low dosesages if it dont work on lower dosages go up to 150mg another thing try useing ralgex cold spray and massageing the leg it stimulates the nerve i have been dealing with my wifes pain 4 years with bone cancer and nerve pain try these things i suggested and let me now if they work another thing try useing hot water bottle on leg this might work on some people not all thank a warren consultant

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guitarman said on 05 January 2010

i suggest u ask your doctor for pregablin this is a drug used for nerve pain my wifes got cancer in her back witch causes a lot of nerve pain these tablets work well

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lazybeat said on 27 December 2009

Sciatica treatment is vastly varied depending on the level of damage. I found the NHS did not help me at all. They prescribed me pain killers and sent me home. Since I have had an MRI scan done and found the exact problem via BUPA. My Pain was so bad it was worse than the time when I had been stabbed when trying to stop a fight. The epidural is only 1 of many options in the private medical field. What I do recomend is when your epidural has been administered wait a few days and then exercise like mad. This way your body will not have as many problems in the future. Exercise and weight loss is a must. Look at some of the back exercises and arching the back as well.

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jannb said on 22 December 2009

i have just had a week in hosp, with sciatica. in so much pain, i was given oromorph, and diazapam, i had an mri scan. the orthopedic surgeon told me they can not help me,as i have had 2 previouse ops for ruptured disc and also an op to remove scar tissue. The orthopedic surgeon thinks that any more surgey is not an option. so do i live in so much pain, and high with the pain relief, all the time.i am in so much pain i cant walk, cant sit and litteraly dont know what position to put my self in.its so pain full i could scream. what are my altenatives.even with the medication i am not with out pain

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xmas09 said on 17 December 2009

i'm sorry to say this Jarileigh, but so far the treatment that i have received for my sciatica has been virtually none existant. Very slow progress and made to feel that I should just get on with it. i popped a disc last April and have been riddled with the most chronic sciatica since August. The pain almost brings me to tears. Sitting is the most difficult for me, so being in work and driving are absolute hell. I am due to see an orthopedic specialist soon, so hopefully they will point me in the right direction. until then I will continue to take copious amounts of painkillers/anti inflamatories and nerve pain tablets, all of which are very strong with unpleasant side effects. physio has made it worse and all the osteopath releived me of was £70!! good luck to anyone who suffers from this most debilitating agony which is so painfull its difficult to put into words.

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Jarileigh said on 17 December 2009

I am horrified to hear this. I am a athlete (former) who has had ultrasound, manipulation, etc and most of all the exercises made my situation so much worse and so much more painful! I am American and new to the UK, can anyone tell me if this is truly how the NHS views and treats sciatica? I am unable to walk without painkillers due to the intense pain, & the fact it has been getting progressively worse through the years. In the US, I was told in 2007 that only surgery would help, but my disc was too damaged to be partially cut on & needs to be completely removed surgically. I can no longer move my left leg without painkillers. I also can't believe they say the reason is unknown, mine is due to a epidural in 1990 that went horribly wrong and damaged my disc and/or nerve, then a auto accident in 2006 made it impossible for me to function afterward. PLEASE, can someone tell me what the NHS offers as treatment options for this condition? Any help would be greatly appreciated!!!!! Good luck to all you who suffer from this condition, may God be with you, and may you all receive relief from this condition!

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scienceshorts said on 06 December 2009

I too suffered from sciatica and was given ULTRASOUND TREATMENT. I am now pain free; please ask your doctor about this treatment and good fortune attend you.

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sal123 said on 05 August 2009

"In many cases of sciatica, there is no obvious cause. However, in some people, it is thought that a combination of muscle, joint and bone strain may lead to sciatica."

No, there are always causes but they are simply not recognised by national health service doctors. For example SI Joint disfunction seems only to be treated (successfully) privately with prolotherapy -- it wouldnt cost much for the nhs to provide this and save sufferers of this chronic painful condition a life of agony. SIJ disfunction and pelvic imbalance according to the nhs is simply classed as "sciatica" with "no obvious cause". Please, which century are we living in?!!!

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ollypocknell said on 03 August 2009

I'm with practicalmagic on the CBT as a treatment. What a load of old codswallop.... My pain is horrendous but I am about the most positive person I know, yet it still hurts like hell. I can't compare it to childbirth though, not until men can have babies but it is like a kick in the you know where's!!! Thinking about it ain't gonna make it better is it.

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practicalmagic said on 16 July 2009

What a load of rubbish !! im sorry but i WOULD NOT accept being offered cognitive behaviour therapy!
as a "treatment" to help my slipped disc & sciatica!!!
teaching you to try & ignore & manage your pain & have a more positive outlook!
its the body's natural response to send painwaves to the brain! its saying "fix me" deal with this problem!
when im in the grip of my sciatica , im in more agony than i was in childbirth!
will they be offering mind over matter therapy for that next!
ridiculious !

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