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Sciatica: Symptoms and Causes

Low back pain effects approximately 50% of people in the United States. Not all back pain is related to or considered sciatica. Sciatica is a common symptom where people experience shooting pain and numbness and tingling into the back of the leg due to irritation of the sciatic nerve. The National Center for Biotechnology Information (NCBI) states that the peak age for sciatica symptoms are 45-64 years old. Typically pain only occurs on one side of the body. According to Mayo Clinic, it effects more than 3 million people per year. In more severe cases, sciatica can even cause numbness and tingling into the toes, heel and calf pain and even weakness of the leg.

Sciatica occurs when there is irritation of the sciatic nerve. Irritation can occur from tightening of muscles, such as the piriformis. This muscle sits on top of the nerve and in some cases, the nerve actually travels right through the belly of the muscle. Frequent sitting at a desk or driving a car can cause and aggravate sciatica. Along with muscle tightening, sciatica can also occur due to degeneration of the discs in the lumbar spine, bone spurs, also known as osteophytes, disc bulging, or from a disc herniation. Spinal nerves in the lumbar spine branch from the spinal cord and come together to form the sciatic nerve. The L3 nerve root is the most common area to cause sciatica when compressed or irritated. Sciatica is also common in pregnancy. According to the American Pregnancy Association, it is thought that it occurs due to the uterus lying on top of the sciatic nerve and as the baby grows, it places more pressure on the nerve.

Evaluation of sciatica usually involves a health history, postural exam, range of motion testing, neurologic, and orthopedic testing. If degeneration, disc bulge, or herniation is expected, spinal x-rays or MRI may be warranted. Depending on the cause, sciatica may resolve on its own, but there are several treatment options that can help manage and reduce symptoms. Conservative methods, such as heat,cold, stretching, and massage therapy can help reduce muscle spasm. Chiropractic adjustments can help reduce pressure on the the spinal nerves, as well as the sciatic nerve, restore function, range of motion, reduce pain and improve strength. NCBI recommends that if symptoms do not resolve within six to eight weeks, that a referral to a neurologist or orthopedic surgeon may be necessary.

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