Sciatica is one of the most common musculoskeletal conditions in the United States and Western Europe and is a significant cause of pain and discomfort for a lot of people.

What is Sciatica?
Sciatic pain is caused by pressure placed on the sciatic nerve which in turn causes pain along the distributing nerve fibers. It is important to understand that the term sciatica does not describe a disorder or a medical diagnosis. Sciatica merely describes a set of signs and symptoms that may be caused by any disorder that places pressure on the sciatic nerve. There are many different disorders that may cause sciatic pain but some of the more common includes.

Piriformis Syndrome
The sciatic nerve travels through the gluteal region and passes right underneath the Piriformis muscle situated deep in the buttocks. Tightness or swelling (as a reult of injury) of the piriformis muscle may lead to compression of the sciatic nerve and cause sciatic symptoms.In about 15% of the population the sciatic nerve actually travels through the muscle belly of the piriformis and these individuals are more prone to sciatic symptoms originating here.

Lumbar Disc Herniation
A herniated lumbar disc may cause pressure on the sciatic nerve right where it exits the spinal canal and lead to sciatic symptoms. Herniation occurs when the "nucleus pulposus" (the liquid center of the spinal disc) protrudes through a weakened "annulus fibrosis" (the outer layers of the disc). Any action that involves compression of the spine,such as heavy lifting, may cause herniations. Compression of the spine during twisting or bending motions make matters even worse because these motions will act as a lever to push the central nucleous in a specific direction and often towards the weakest part of the annulus fibrosis. With age the water content of the discs will also decrease causing the disc to lose much of its cushioning effect and thus become more prone to herniation.

Spinal Stenosis
Spinal stenosis refers to a narrowing of the spinal canal due to bony outgrowths. These degenerative changes are usually age related or caused by excessive wear and tear. The outgrowths and bone spurs represents the body's attempt to repair the damage. This narrowing of the spinal canal can cause pressure on the sciatic nerve and lead to symptoms of sciatica

Spondylolisthesis
Spondylolisthesis describes forward slippage of a vertebra (usually lumbar.) This may cause pressure on the sciatic nerve where it exits the spine, or in severe cases spinal cord injury.

Symptoms
Symptoms of sciatica includes numbness, tingling and sharp shooting pain down the distribution of the sciatic nerve. Dull aching pain in the buttocks or in one of the lower limbs may also be present. The symptoms are usually unilateral (affecting one side of the body) and may increase with certain movements or activities.
In true sciatica pain travels down the leg below the knee and into the heal of the foot.

Treatment
If sciatica is caused by a herniated disc physical therapy is usually the way to go. Once the worst symptoms and the acute pain is gone, a physical therapist can administer a rehabilitation programme and exercises to help prevent future occurence. Rehabilitation for sciatica usually includes exercises to improve posture, correcting faulty movement patterns, strengthening muscles(usually core and abdominal muscles) and exercises to improve flexibility.

In the case of piriformis syndrome, streching exercises to increase the flexibilty of the piriformis muscle may be indicated. Trigger point treatment may also be effective in relieving tension in the pirifomis muscle.

Spinal Stenosis is a degenerative chronic disorder, treatment is therefore symptomatic although lumbar spinal traction may be effective for short term relief in some patients

Symptomatic Treatment
If your sciatica symptoms are severe,painful and disabling your doctor may prescribe medication for pain relief. He may also prescribe muscle relaxants or anti-inflammatory drugs

Surgical treatment
Surgical treatment is a last resort (surgery is always the last resort for nearly any condition because of the risks involved) and is only considered in cases when the compressed nerve causes significant weakness, bowel or bladder incontinence or progressively worsening pain that does not improve with other treatment modalities

Surgical options includes lumbar laminectomy and discectomy. In lumbar laminectomy with discectomy, surgeons remove a portion of the herniated disc that is compressing the nerve. Most of the disc is left intact to preserve as much of the normal anatomy and function as possible.

Alternative treatment methods that has shown good results for some people suffering from sciatica includes,acupuncture,chiropractic treatment and massage

If you think you might be suffering from sciatic symptoms do NOT hestitate to contact a medical professional about your problem. Early recognition of sciatica symptoms are one of the key factors to successful treatment. If you wait too long the condition may become progressively disabling and might turn into a significant economic burden if it disables you from going to work.

Hope this information on sciatica was helpful!