Is your back pain sciatica?

Driving for prolonged periods of time, over-exercising, lifting and bending or twisting suddenly can strain the sciatic nerve which results in lower back pain and also pain in the back of legs.

Five to 10 per cent of people having lower back pain suffer from sciatica. It is mostly seen in people in the age group of 18 to 35 years. The prevalence of sciatic symptoms varies considerably ranging from 1.6 per cent in the general population to 43 per cent in a selected working population.

Unfortunately, 30 per cent of patients approach specialists only after suffering for a year or more. In 90 per cent of the cases, sciatica is caused by a herniated disc involving nerve root compression.

Bed rest is the key
Not all patients suffering from lower back pain have sciatica. Lower back pain could be due to various reasons, more often it’s mechanical back pain that is commonly seen in sedentary workers with poor posture and not following ergonomics.

Causes of sciatica are spondylolisthesis, trauma, piriformis syndrome, spinal tumours and obesity. Dr Sunil Dachepalli, senior orthopaedic and joint replacement surgeon and sports medicine expert at Yashoda Hospitals said, “Sciatica can be debilitating at times when the episode is acute. At that time, it is very difficult to carry out day-to-day activities. Some patients are advised bed rest for three to four weeks so that their condition improves. Majority of the symptoms settle down with non-operative management, which involves extensive rest.”

Long-distance drivers at high risk
Long-distance drivers are at high risk of developing sciatica because of the constant jerks on bumpy roads weakening their discs. Good roads can prevent this. Height of the individual also matters as most of these discs rupture backwards when the person bends forwards. Taller people have to bend more and also when they bend their centre of gravity moves further away (forwards) from the spine.

The pressure on the spine is multiplied by the distance of the force, so there’s more pressure on discs in taller people when they bend.

Dr K. Sudhir Reddy, senior orthopaedic surgeon at Land-mark Hospitals said, “The main thing to be distinguished is whether the pain is coming from rupture of the disc or from the nerve root, the second condition is called sciatica. In sciatica, as long as there is no neurological deficit (leg or foot weakness or numbness or pins and needles), patients are given conservation treatment, which is medication, physiotherapy and precautions.”

Diagnosing emergence of pain is important
It is very important to diagnose the problem as to where the pain is emerging from. Dr N. Somasekhar Reddy, senior consultant orthopedic surgeon said, “When the pain is due to a common back problem, it requires simple medication and protection of the back with a corset. This helps to keep the back fit. Physiotherapy and exercise regime also helps. In 80 per cent of the cases where patients come on time, it is found that these simple remedies help them to get better with time.”

Symptoms of sciatica
Sharp pain along with numbness in the leg. The affected leg feels weak and also becomes thinner than the other leg.
A mild tingling, dull ache or burning sensation. The sensation is also felt on the back of the calf or on the sole of the foot.
The pain worsens when one lies down, or wakes one up at night.
An episode of back pain that has lasted continuously for more than four weeks.
Redness and swelling on the back or spine.

Remedies for Sciatica

• Use alternate cold and hot packs to reduce swelling.
• Stand up straight with your ears aligned with your shoulders, shoulders aligned with your hips and your buttocks tucked in. Knees should be bent slightly.
• Regular exercise imp-roves flexibility, helps prevent age-related degenerative changes.
• Always lift objects from a squatting position, using your hips, legs to do the heavy work. Never bend and lift with a straight back.
• Avoid sitting or standing for extended periods. Take regular breaks to stand and walk around. If you must be on your feet, prop one foot on a small block or footrest, and then switch feet throughout the day.
• Use proper sleeping posture. Take pressure off your back by sleeping on your side or on your back with a pillow under your knees.
• Avoid wearing high heels.
• Strengthen back muscles regularly. Lay face down and clasp your hands behind the lower back, then raise the head and chest slightly against gravity while looking at the floor. In the above position with the head and chest lowered to the floor, lightly raise an arm and opposite leg slowly, with the knee locked 2-3 inches from the floor.
• Walk or swim.