Understanding Sciatica

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Anyone who has suffered from sciatica knows just how painful and debilitating it can be. Mild sciatica can have a major impact on your fitness regime, serious sciatica will stop you in your tracks.

Sciatica is caused when the sciatic nerve, which is made up of five branches of nerves branching from your lumbar and sacral spine is damaged or irritated.

There can be many causes. A prolapsed disc also referred to as a slipped, ruptured or protruding disc can cause sciatica. In this instance the discs doesn’t actually slip but splits open releasing fluid, which presses against the nerve. Spondylolisthesis is a condition in which a bone (vertebra) in the lower part of the spine slips out of the proper position onto the bone below it. Stenosis which can be congenital or may develop over time is a narrowing of the spinal canal. This can form lesions, which protrude into the canal and press against the nerve. Pregnancy, weak abdominal muscles, curvature of the spine and poor biomechanics can all lead to the condition in some people.

The nerve, the longest in the body starts in your lower back, goes down the back of your thighs then splits into two branches just above the knee. It then carries down all the way to your feet.

The pain normally starts with acute back pain. This may improve but still leave you with chronic pain, tingling or numbness in the hamstring, calve or toes. The pain varies. Some people may find it just a little troublesome, but others may find they cannot bend, twist or even sit for any length of time without being in agony. However it can be so bad that it can result in you being bedridden. The good news is that this kind of sciatica is uncommon and permanent nerve damage is rare. It can cause you to have bowl/bladder incontinence. This is called Cauda Equina Syndrome and is a medical emergency. The good news is that the spinal cord does not run through the lower back so damage to a nerve or disc in this area will not cause paralysis.

Treating Sciatica
There are many treatments available and the one you choose will depend on the severity and the length of time you have had the pain.
The first port of call is your doctor to get the symptoms professionally assessed. Pain is caused by pressure and inflammation on the nerve. You may be offered over the counter or prescription anti-inflammatory drugs, muscle relaxants and painkillers. Ice packs applied to the painful area can help reduce inflammation. Heat packs help keep a healing blood flow through the muscle. A combination of both applied for 20 minutes every two hours can be very effective. In severe cases an epidural can be administered. Physiotherapy or manual manipulation by an osteopath or a chiropractor may help some people. Just make sure that they are qualified as poor practice could make your situation much worse. Core exercises using Pilates, Yoga or strength training to increase flexibility and abdominal strength may be recommended.

Unfortunately for some people none of this works and the result is years of chronic pain and for those sufferers surgery is the only cause of action. Even after surgery there are no guarantees and some people just have to learn to live with it. Luckily for most people sciatica pain is short lived, lasting just a few days. For others it may be two or three months but it eventually goes away. But from then on the back can never be taken for granted. There will always be a hidden weakness so never lift without thinking twice, use the legs to lift and never twist and lift at the same time.

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