Sciatic Neuritis, Sciatic Neuralgia, Lumbar Radiculopathy
Sciatica is a radiating nerve pain, which starts in the back and extends over the buttocks into the leg. It is a pain in the longest nerve of the body, the large sciatic nerve (nervus ischiadicus). The pain is caused by an irritation or inflammation of one or more nerve roots at the place where these nerve roots originate from the spinal cord.
Sciatica is caused by pressure on the nerve. It can be obtained by pregnancy and childbirth and by heavy lifting. In rare cases, sciatica can be caused by a hernia or a tumor. Stress can also play a role, because it makes the body change posture, causing a too heavy load on the back.
The following signs and symptoms are most characteristic for sciatica:
Even though there is severe pain, sciatica is almost never permanent. The pain will pass on its own. Pain in the lower back is often incorrectly called sciatica.
The doctor will determine whether there is sciatica, based on the symptoms and physical examination. In some cases, the diagnosis is not easy to make and an MRI or CT scan provides the necessary additional information.
In case of sciatica, it's wise to go to the doctor. It is thought that sciatica is a warning for an impending hernia, although not all doctors would agree. The pain may also be associated with a narrowing of the spinal canal (the Verbiest syndrome). The general practitioner will often recommend both dosed rest and exercises for the back muscles. He will also prescribe painkillers and refer the patient to a physical therapist. It’s wise to do no heavy lifting for a while. If the pain disappears and then numbness in the leg arises or if the patient is incontinent of urine, this should in any case be reported to the general practitioner. When, in rare cases, a hernia is the cause of the sciatica and there is no treatment that helps, hernia surgery may be needed.
Most back problems will pass on their own. With pain relief (only in the acute stage), rest and a responsible way of moving, a person can control back pain. However, the symptoms also recur regularly.