By: Erin Ritterbusch, MS CPT and Marc Zboch
What starts as low back pain could progress into sciatica, which is normally brought on by a herniated disc with nerve root compression. The reason why it is called sciatica is because the nerve being compressed or irritated is called the sciatic nerve. This large nerve originates in your lower back and travels down the leg. Besides the common cause of a herniated disc, sciatica can also be the outcome of other events. The degeneration or atrophy of tissues that are in the lumbar spine, narrowing of the spinal canal (lumbar spinal stenosis), and spondylolisthesis, which is caused from a small stress fracture in the vertebrae, are also possible conditions [1].
The main symptom, and the indicator to health providers to determine if it is a result of sciatica, is radiating leg pain. Other symptoms include numbness or weakness in the lower back, buttock, or down the leg, pain with movement, loss of movement, a “pins and needles” feeling in the legs or feet, or even loss of bowel and bladder control (caused by cauda equina syndrome) [2]. These symptoms may be exacerbated by different movements such as trying to stand up, bending forward, twisting the spine, and lying down [1]. Sciatica is diagnosed first by a physical exam that usually will include a straight leg test and based on findings, may be followed up by imaging and other tests such as an x-ray, MRI, CT scan, electromyography, and/or a myelogram. Luckily, 80 to 90 percent of people with sciatica will improve without needing surgery and close to half of them will fully recover within 6 weeks of having the episode [2].
It is said that close to 40% of people in the U.S. will experience sciatica to a degree at some point in their lifetime [2]. So you may be asking, am I at risk for developing sciatica since I am currently experiencing low back pain? Well, there are several risk factors that can contribute, including personal and occupational factors.
According to the Cleveland Clinic as well as an article from the Physiotherapy Research International journal, there are modifiable factors, or those that can be changed, that can play a part in the development of sciatica. Besides a previous low back injury, these include smoking, obesity, occupational factors and health status [3].
Smoking can cause bones to weaken, accelerate the natural progress of vertebral disc breakdown, and damage to spinal tissue because of the nicotine in tobacco. Being overweight or obese can cause unnecessary strain on the back, leading to strains, pains, and other issues. In terms of occupational factors, these can include jobs that require a lot of heavy lifting or on the other side of the spectrum, those jobs that involve prolonged amounts of sitting. Your health status could include diabetes, osteoarthritis, or even just plain daily inactivity. Having diabetes increases your risk of nerve damage, osteoarthritis can put nerves at risk of injury because of its ability to damage the spine, and an inactive lifestyle causes loss of muscle tone from lack of movement and exercise, which can increase that risk as well [2].
Non-modifiable or non-preventable sources of sciatica can include your age, gender, social class [3], degenerative disc disease, development of sciatica due to pregnancy or an accidental fall [2].
You can focus on ways to protect your back in order to help reduce the risk of developing sciatica later on. Maintaining good posture throughout your day; exercising regularly with a major focus on core stability and endurance will help you achieve that. When it comes to exercise and every day movements, you want to keep your spine neutral and use your hips when bending and/or lifting while engaging the core to help protect your low back. If you do develop sciatica, it is highly recommended that you contact your healthcare provider for immediate medical attention in the following situations: severe leg pain lasting more than a few hours that is unbearable, numbness or muscle weakness in the same leg, bowel or bladder control loss, or sudden and severe pain from a traffic accident or some other trauma [2].
[1] Hochschuler, Stephen. “What You Need to Know About Sciatica.” Spine-health, 2019, https://www.spine-health.com/conditions/sciatica/what-you-need-know-about-sciatica. Accessed 16 December 2021.
[2] “Sciatica: Causes, Symptoms, Treatment, Prevention & Pain Relief.” Cleveland Clinic, 25 March 2020, https://my.clevelandclinic.org/health/diseases/12792-sciatica. Accessed 4 January 2022.[3] Cook, C. E., et al. “Risk factors for first time incidence sciatica: a systematic review.” Physiotherapy Research International : the Journal for Researchers and Clinicians in Physical Therapy, vol. 19, no. 2, 2013, pp. 65-78. doi:10.1002/pri.1572.
