Millions of people across the world suffer from problems of the sciatic nerve—the longest nerve in the human body. It begins in the lower back and runs down to the foot, over the thigh and the calf.
When this nerve gets inflamed, it produces a cluster of symptoms referred to as sciatica. Here, we clear some common misconceptions around sciatica.
Myth 1: Sciatica is a disease
Sciatica is not a disease but a set of symptoms, pain being the most prominent among them. The pain is felt along the course of the nerve starting from the lower back to buttocks, calves and right down to the foot.
Other symptoms include tingling numbness and sensation of pins and needles along the course of the nerve. Hence, sciatica cannot be labelled as a diagnosis but only as a symptom of another disease. The treating physician has to find the cause underlying the symptoms of sciatica.
Myth 2: Sciatica is caused only due to slip disc
Although slip disc is the commonest cause of sciatica, it is not the only cause. In slipped disc or herniated disc, the intervertebral disc [disc between two vertebrae] comes out of its normal position and starts pressing on the nerve root, causing sciatica. Other possible causes include:
Lumbar degenerative disc disease: With ageing, the discs in the lower back weaken and this causes irritation of the nerve roots causing pain.
Lumbar spinal stenosis: In spinal stenosis, the canal width decreases and hence the nerve roots get compressed. The pain is usually positional, brought on by activities such as standing or walking and relieved by lying down.
Spondylolisthesis: In this, one vertebra slips forward over the adjacent vertebra. This too causes compression of the spinal nerves and results in pain.
Trauma: Direct impact on the spinal nerves by an external force such as an accident, injury or a fall on the back can trigger sciatica symptoms.
Piriformis syndrome: The sciatic nerve usually traverses beneath the piriformis muscle in the buttock. But in 15 per cent of the population, it runs through the muscle not under it. When this muscle shortens due to trauma or overuse, it compresses the sciatic nerve. Constantly carrying a thick wallet in the rear hip pocket can also cause sciatica. It is referred to as ‘Wallet Sciatica’.
Spinal tumours: When a spinal tumour develops in the lower back region, it compresses the nerves, causing sciatica. However, this is one of the less common causes.
Myth 3: Sciatica is hereditary
Sciatica doesn’t run in the family and can happen to anyone irrespective of his/her family health history. It is the result of a problem in the lower back that can develop from any number of reasons.
Myth 4: Leg pain without backache cannot be sciatica
It is rare for sciatica patients to experience pain only in the leg and not in the back or thigh as well. Even if you are one of them, don’t get fooled into believing that since the pain is in the leg, there’s something wrong with your leg. If it is sciatica, a clinical examination will reveal that the problem originates in the back. Since the sciatic nerve passes the lower back, legs and feet, a nerve compression in the lower back may not cause low back pain, but pain in the leg.
Myth 5: The treatment for all sciatica patients is the same
What works for one patient may not work for another, even if both have the same symptoms. The cause of pain may differ from one patient to another. Hence your treatment has to be based on the cause of your problem, your conditions and your response to medicines.
Myth 6: Surgery is the only way to treat sciatica
It’s advisable to try non-surgical methods before considering surgical intervention. However, some may need surgery to avoid further damage such as loss of muscle power. Usually, surgery is suggested in case of patients for whom conservative non-surgical treatments such as exercise, physical therapy, injections and complementary therapies have not helped. Those with severe pain or significant loss of function are also advised surgery.
Myth 7: Complete bed rest is treatment for sciatica
For the initial pain, it is OK to take bed rest for a day or two. However, excess inactivity too can worsen the pain; exercise and activity keep the back muscles healthy and strong. Exercise also helps exchange nutrients between the spinal discs and surrounding micro vessels, keeping the discs healthy and preventing further injury.
Myth 8: We must first try self-treatment for sciatica
Diagnosis of this condition requires a thorough evaluation of the spine in addition to other tests. It’s therefore important to rely on an expert and detect the exact cause of the pain before starting any treatment.
Myth 9: If I use traction to get my slipped disc into position, my sciatica will be cured
There is enough research and evidence to show that traction has no effect on slipped disc. A disc never gets pushed back using weights. Traction only helps relieve muscle spasm, create warmth, reduce pain and ensure that patients take bed rest.
Myth 10: Sciatica is incurable
Although finding the cause of sciatica is often tricky, but once the expert succeeds in pinpointing it, sciatica can be cured.