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What is Sciatica?

Sciatica is the name given to the pain in the leg that radiates from the lower back and buttock, down through the thigh and calf, sometimes reaching the toes. Sciatica literally means pain from pressure on the sciatic nerve.

This pain can be felt as an aching, burning or stinging. It can be so severe that it makes every movement, including sitting, coughing and sneezing excruciating. It can be accompanied with feelings of numbness, pins and needles, spasms and cramp. Some people report no back pain, but the origin of the problem is in the spine.

More common than true Sciatica, is "referred" pain in the leg, the back pain may be so intense that it "overflows" to the buttock, groin and leg. It is not caused by nerve pressure but by pain in a disc or facet joint or the surrounding soft tissues.

What causes Sciatica?

These confused messages sent via the nerves can be caused by an injury, for example a fall, damage caused by vibration and by cumulative strain, or by disorders such as spondylosis (the degenerative change to the vertebrae), facet joint inflammation or spinal stenosis (narrowing of the spinal canal).

Some occupations are more commonly affected; long distance lorry drivers, sedentary and manual workers. People who are either tall, smoke, or have a family history of disc problems, are more at risk.

The onset of pain

Many people will need pain killers for an attack of sciatic pain, and should take it easy for the first 24 48 hours of its onset, but remember, bed rest is not a treatment in itself. You should continue with your life as much as the pain allows, it is sometimes necessary to stop for a while to relax and recover, but this does not mean become immobile and you should start a gradual return to normal activities and gentle exercise as soon as possible.

What can be done?

It is important to know that half of the people with nerve root pain recover within six weeks and that only one in a hundred of those referred to hospital out patient departments require surgery. Treatment options obviously depend on the severity of the symptoms and the cause of the problem, but always try the least invasive, most conservative treatment first. In the meantime, it is important to listen to the warning signals your body is giving you and stop doing whatever aggravates the pain.

It is also very important to consider the way you use your back. Back pain can recur and you should think about whether you need to modify your work environment or car or to if you need to correct your posture whilst sitting and standing, lifting and even sleeping.

Physiotherapy and the manipulative therapies of chiropractic and osteopathy are found to be beneficial by many people. Others find the Alexander Technique helpful and Acupuncture and the use of healing magnets can help with pain control.

Bear in mind however that with all treatments, each person's response will be different, because we are all different. It is difficult to say what will work for you and it is a matter of trial and error until you find which treatment works best for you.

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