Separate the misconceptions about sciatica from the truth with this article. Sciatica is pain or numbness anywhere along the sciatic nerve, which runs from the bottom of the spine through the buttocks and down the back of the legs, caused by compression of the nerve. Sciatica pain can range from mild to unbearable, but in most cases it is self-limiting, meaning it goes away on its own. Of course, as long as you suffer from it, you feel like it will never go away.
What are the common myths about sciatica? And what is the truth?
Myth 1: Sciatica is a condition or a diagnosis
Fact: People commonly call sciatica a condition or diagnosis, but it’s actually a symptom, indicating that something is irritating a nerve root in the lower back.
The important thing is to decipher what is causing the pressure on the nerve.
Myth 2: All leg pain can be classified as sciatica.
Sufferers often think that any pain in the leg can be considered sciatica, but that’s not true. Leg pain can be induced by vascular problems, muscle strains, cellulitis, or irritation of another nerve, such as the femoral nerve, which would cause pain in the front of the leg. A true sciatic symptom runs from the middle of the buttock down the back of the leg, usually past the knee and up the calf.
Myth 3: We don’t know what causes sciatica
Fact: Sciatica occurs when the sciatic nerve becomes pinched or compressed, which is usually caused by a bulging or herniated disc between the vertebrae at the bottom of the spine. It can also be caused by a bone spur, or bony growth, on the spine itself or by spinal stenosis, a narrowing of the spinal canal. In rare cases, a spinal tumor can compress the nerve, causing sciatic pain.
Myth 4: A specific event causes sciatica
Fact: People often think that if they don’t lift that suitcase, sit down on a long flight, or help a friend move around, they won’t have pain. Most of the time, the intervertebral disc has a small defect and is ready to rupture, and sciatica is not necessarily caused by this specific event. Most people have single or occasionally repeated episodes of sciatica. It’s important when it happens, but overall it’s a minor part of their lives. While a specific event doesn’t necessarily lead to sciatica, some jobs can. A study found that physically demanding work is a significant risk factor for sciatica. Among men, jobs associated with higher risk included metal, machine, and other industrial work. Among women, the risk was higher among nurses, shop assistants and industrial workers.
Myth 5: If you have sciatica, you need to stay in bed and rest.
Fact: Most patients do better if they stay active and avoid excessive rest. Numerous studies have shown that people with sciatica have little or no benefit from staying in bed compared to staying active.
Myth 6: Medication is the best way to relieve sciatica.
Fact: You might think that taking a painkiller or anti-inflammatory might ease sciatica pain, but in fact, a systematic review and meta-analysis found a lack of evidence for the effectiveness of medications such as NSAIDs, corticosteroids, antidepressants, and opioid painkillers. There is at best low quality evidence to judge the effectiveness and safety of drugs commonly prescribed for the management of sciatica in primary care.
However, short-term treatment with an anti-inflammatory may be helpful for some people. For people whose severe and persistent symptoms do not respond to pain medication or do not improve with modification of activities, another treatment option is to receive epidural steroid injections, that is, injections into the body. epidural space around the spinal cord. But epidural steroid injections are usually indicated for acute radiculopathy [racine nerveuse pincée]. They are generally not useful in cases of chronic sciatica.
Myth 7: Surgery is the only way to really cure sciatica
Fact: Most cases of sciatica go away in about six weeks and don’t require surgery. Other treatments, including physical therapy and epidural injections, may be helpful. But if these treatments fail or, in rare cases, if you experience severe weakness, numbness, or pain, surgery can significantly and permanently improve sciatic pain.
Myth 8: Sometimes nothing helps sciatica
Sometimes patients worry that there is no cure or that nothing can be done to improve their symptoms. Fortunately, very high quality scientific studies have repeatedly shown that most symptoms improve and that, if necessary, surgery is very effective.
Myth 9: Sciatica cannot be avoided
Fact: It’s not possible to prevent all cases of sciatica, but staying active, and using proper form during activities, can go a long way in reducing the incidence and recurrence of lower back pain. In addition, maintaining a strong core, ie strengthening the muscles of the abdomen and back, can also help prevent recurrences of sciatica. Pilates is great for strengthening the core and can be adapted for many health issues, including sciatica. Finally, sciatica can be prevented by practicing good posture, minimizing sitting, managing weight, maintaining hamstring flexibility, and maintaining proper spinal alignment.
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