Sciatica ("Lumbar Radiculopathy") causes a pain that spreads from the lower back down into the buttock, hip and leg. Sometimes leg pain can occur without any back pain. Sciatica is due to irritation or pressure on a spinal nerve as it comes out of the spinal canal. This is most often due to a bulge or rupture of a nearby spinal disk (the cartilage cushion between each spinal bone), which presses on a nearby nerve. Other causes include spinal stenosis (narrowing of the spinal canal) and spasm of the piriformis muscle (a muscle in the buttocks that the sciatic nerve passes through).
Sciatica may begin after a sudden twisting/bending force (such as in a car accident), or sometimes after a simple awkward movement. In either case, muscle spasm is commonly present and contributes to the pain.
The diagnosis of sciatica is made from the symptoms and physical exam. Unless you had a physical injury (such as a car accident or fall), X-rays are usually not ordered for the initial evaluation of sciatica because the nerves and disks cannot be seen on an X-ray. Most sciatica (80-90%) gets better with time.
What can I do about my low back pain?
There are three main things you can do to ease low back pain and help it go away.
Use heat or cold packs.
Take medicine as directed.
Use positions, movements and exercises. Stay active! Too much rest can make your symptoms worse.
Using heat or cold packs
Try cold packs or gentle heat to ease your pain. Use whichever gives the most relief. Apply the cold pack or heat for 15 minutes at a time, as often as needed.
If taking over-the-counter medicine:
Take ibuprofen (Advil, Motrin) 600 mg. three times a day as needed for pain.
Take Aleve (naproxen sodium) 220 to 440 mg. two times a day as needed for pain
If your doctor prescribed a muscle relaxant (cyclobenzapine 10 mg.):
Take one half (½) to 1 tablet at bedtime
Do not drive when taking this medicine. This drug may make you sleepy.
Using positions, movements and exercises
Research tells us that moving your joints and muscles can help you recover from back pain. Such activity should be simple and gentle.
Use the positions below as well as walking to help relieve your discomfort. Try taking a short walk every 3 to 4 hours during the day. Walk for a few minutes inside your home or take longer walks outside, on a treadmill or at a mall. Slowly increase the amount of time you walk. Expect discomfort when you begin, but it should lessen as your back starts to recover.
Finding a position that is comfortable
When your back pain is new, you may find that certain positions will ease your pain. Gently try each of the following positions until you find one that eases your pain. Once you find a position of comfort, use it as often as you like while you recover. Return to your daily routine as soon as possible.
Lie on your back with your legs bent. You can do this by placing a pillow under your knees or lie on the floor and rest your lower legs on the seat of a chair.
Lie on your side with your knees bent and place a pillow between your knees.
Lie on your stomach over pillows.
When should I call my doctor?
Your back pain should improve over the first couple of weeks. As it improves, you should be able to return to your normal activities. But call your doctor if:
You have a sudden change in your ability to control your bladder or bowels.
You begin to feel tingling in your groin or legs.
The pain spreads down your leg and into your foot.
Your toes, feet or leg muscles begin to feel weak.
You feel generally unwell or sick.
Your pain gets worse.