Sciatica is a term you may have heard associated with leg pain emanating from the back. It’s also a reason why more office workers temporarily opt to sit on a large exercise ball instead of a chair.
Sciatica is sometimes misunderstood. That’s mainly because the term refers to symptoms, not a diagnosis of the underlying issue. Sciatica is related to leg pain — and possibly tingling, numbness, or weakness — that starts in the lower back and radiates down through the buttock and along the large sciatic nerve in the back of the leg and usually into the foot. Symptoms are usually present on just one side of the body.
Most often, sciatica is caused by a disc problem, such as a herniation, that results in a pressing against a nerve root.
“Sciatica can be caused by a disc pushing on one of the spinal nerves, and sending electrical sensations down the leg, below the knee and into the calf and foot,” says Ronald Tolchin, D.O. [1], medical director of Baptist Health Center for Spine Care, part of Baptist Health Neuroscience Center [2]. “If you have sciatica, it could be more painful to sit because the disk protrudes more on the nerve in the sitting position.”
Standing is usually more tolerable, but not bending or sitting, he added.
How does sitting on a ball help those with sciatica? Sitting on the exercise ball forces a person to contract spinal and abdominal muscles to stabilize the body. By strengthening these “core” muscles, you can reduce sciatica pain by reducing the stress on the spine and utilizing the core muscles for support.
“Contracting those muscles really helps alleviate the pain,” says Dr. Tolchin. “The ball forces you to be more upright and that’s more tolerable for sciatica sufferers.”
Treating Sciatica
Exercises that strengthen core muscles make up a primary component of physical therapy prescribed for those with sciatica. Core exercises can improve balance and stability. These exercises build strength in the muscles of the pelvis, lower back, hips and abdomen. The routines required to build core strength should be supervised by a trainer during physical therapy sessions for sciatica sufferers.
Over-the-counter or prescription medications can reduce severe sciatica pain. Nonsteroidal anti-inflammatory drugs (such as ibuprofen or naproxen), or oral steroids can reduce the inflammation that is usually part of the cause of pain. However, regular exercises as part of prescribed therapy and heat/cold applications when flare-ups occur can result in significant improvement, often without the use of prescribed pain killers.
In cases of severe lumbar disc herniation, or prominent spinal stenosis, surgery may be the best option to relieve chronic sciatica pain after non-surgery options have been exhausted.
Sciatica Symptoms
Sciatica most often has one or more of the following symptoms:
- Constant pain mainly on one side of the buttock or leg (rarely in both legs except in cases of moderate to severe lumbar stenosis).
- Pain that is worse when sitting. Although spinal stenosis improves with sitting.
- Leg pain that sufferers describe as a burning or tingling sensation, versus a dull ache or pain.
- Weakness, numbness, or difficulty moving the leg, foot, and/or toes.
- A sharp pain that can make it difficult to stand up or walk.
- Pain that radiates down the leg and possibly into the foot and toes (the pain usually does not occur solely in the foot)
Dr. Tolchin says that sciatica which develops in older adults can be characterized by different symptoms. Age-related disk degeneration or spinal stenosis (the narrowing of the spinal canal) can create similar radiating pain.
“As you get older, sciatica can be caused by a bone spur pushing on the nerve,” says Dr. Tolchin. “Those individuals can’t stand or walk very well without intense radiating pain. Spurs can be the result of degeneration of the spine and may also result in spinal stenosis. This in turn may cause vague discomfort in the legs, heaviness in the legs when walking, and the need to sit down and rest after a short walking distance, such as a block or two.”