Sciatica: A literal pain in the rear end
Signs of sciatica include sharp pain in the legs, back and glutes.
“My sciatica is acting up again!”
It’s a common phrase uttered by people who experience that tell-tale sign: a sharp pain starting in the lower back, hips or rear end that continues down one or both legs.
They’re talking about sciatica. This medical condition happens when something compresses or “pinches” part of the sciatic nerve. This nerve stretches from the spine, hips, glutes and down each leg to the feet.
Where does the pinching come from?
In older adults, sciatic pain is often caused by age-related issues. These might include arthritis or a condition that wears down discs (the cushions between the bones in the spine). In younger people, sciatic pain usually results from an injury that presses on the nerves in the back. This could be a bulging disc or other spine-related condition. No matter the cause, the pain can be unbearable.
“Sciatica in simple terms is what we call nerve pain that shoots down the leg,” explains Kelsy Parker, MD, a PeaceHealth physical medicine specialist in Vancouver, Washington. “More often than not, the problem starts in the lower back even though most people feel pain in the leg. The location of the pain in the leg gives us an idea where to look along the spine for the source of the problem.”
Pay attention to the pain
The nervous system is a remarkable piece of our anatomy. Nerves carry electrical impulses between the brain and the rest of the body. These signals help us move our muscles and are involved in a host of other basic functions, like breathing or digesting food.
These electrical impulses also allow us to feel different sensations.
With sciatica, these sensations include pain, tingling, numbness and muscle weakness. And these can be felt anywhere along the sciatic nerve.
For the lucky ones, sciatic pain goes away on its own. However, if the pain lasts a while, it might be due to something more serious. That means a visit to the doctor to diagnose and treat it.
“Unfortunately, most people try to push through the pain until they reach a breaking point and it really starts to affect their quality of life,” says Dr. Parker. “At this point, they’ve been limping or bending in different ways to lessen their pain.
“We often use physical therapy to help ease pressure on the nerves. This reactivates the muscles you haven’t been using correctly. It also improves and supports the way the body is meant to move the spine and legs.”
Signs of severe sciatica
In more serious cases, the nerve pressure can make it hard to walk. That’s when physical therapy alone may not be enough. It’s then likely time for some advanced imaging (X-rays, CT or MRI scans).
Your doctor will use the results of these scans to find the root of the problem and to suggest what might work best to treat it, such as injections or surgery. In all cases, the goal is to make life better and prevent permanent nerve damage.
“Worsening weakness is a major red flag you don’t want to miss,” says Dr. Parker. “People with severe sciatica are at risk of losing their ability to move their legs properly. They may even start to lose control of their bladder or bowels (incontinence). A nerve that’s compressed for too long can lead to permanent symptoms.”
If you experience pain that you think may be related to sciatica, don’t wait. It’s best to talk to your doctor as soon as possible, so you can begin diagnosis and treatment.
