A: Absolutely nothing!
Picture this. You wake up in the morning, turn on the light, go to bend over and open your bottom drawer... And Boom! You hit the floor like a sack of potatoes. No, you didn't get struck by lightning, but you may have Sciatica. Sciatica is the name for the symptoms of leg pain that people sometimes experience. You may feel tingling, burning or even an extremely hard pinching sensation throughout your buttocks and leg.
So where did this lovely pain come from? Well, many of the nerves sprouting from your lower back connect to your sciatic nerve (the thickest, longest nerve in your body), and if any of these nerves become irritated your sciatic nerve will as well. Here are the three most common ways to irritate the nerves in your lower back:
Herniated Disc: A herniated disc occurs when the inner core of the disc gets crushed and leaks through the outer core of the disc. Picture squeezing a jelly doughnut between your palms. As that disc protrudes, it brushes upon one of the many nerve roots that flow from your spine. The nerve root in turn sends the signal to your sciatic nerve... and Voila! Instant sciatica ?
Spinal Stenosis: Spinal Stenosis is commonly found in adults over sixty years old. As you age, your spinal canal may tend to narrow. As it narrows, those nerve roots will become irritated. Spinal Stenosis is one of those disorders you cannot do much about. It is caused by enlarged facet joints or overgrowth of the spines soft tissue.
Degenerative Disc Disease: Now don't get nervous, it's not really a disease, it's more of a disorder. As you age your discs will go through a natural break down process. They sort of deteriorate in the lumbar and cervical regions due to excessive use over the years. In turn, this breakdown of the disc can easily irritate a nerve in your spine and cause sciatica.
So, how do we take care of our sciatica problem? Reports show the majority of people who suffer from sciatica recover on their own. The pain may persist anywhere from two to four months. Others are not that lucky and may remain under a physicians care for up to a year trying to correct the problem. Most important to a doctor is actually identifying where this pain is originating from. The sooner your doctor finds out what is causing your sciatica, the sooner the pain will cease. Hear are some solutions for the above stated problems:
Physical Therapy/Lumbar Traction- A doctor's first step in treating a herniated (crushed, ruptured, slipped or bulging) disc is usually Physical Therapy. Physical therapy may consist of one or many exercises and stretches. Aside from the various stretches that may be prescribed, there is also a device known as a Lumbar Traction Device. The theory behind this treatment is to stretch your vertebral column giving your disc enough room to travel back to it's original position, in turn releasing the pressure from whichever nerve root it was touching. Lumbar traction begins with the patient lying on an adjustable table in the "supine bicycle" position (on one's back, legs bent to a chair position, feet resting on a stool). The physical therapy specialist will then provide hip, thorax, and shoulder straps to keep the patient in place. Once in place, a pre-designated weight (usually between 50 and 75 percent of the patient's body weight) will begin separating the table's two pieces, which in turn will stretch the patients vertebral column. Think of a 16th Century torture rack. For approximately fifteen to thirty minutes, the machine will alternate between a full stretch (75 percent) and a relaxed state (about 10 percent). If after two to four weeks, lumbar traction and other physical therapy exercises fail to provide relief, a doctor may take the next step.
Cortisone Injection- A doctor may recommend cortisone injections for a patient with inflammation in the lumbar area. The injection acts differently than lumbar traction, yet has a similar effect. Cortisone is a steroid produced by the human body and runs through a person's blood stream, but it may only act for a few minutes. When synthetically produced and injected directly to the point of inflammation, it may stay active for a few days. As the steroid reduces the inflammation of the effected site, the nerve will become less and less irritated. Thus taking pressure away from the sciatic nerve. This process can be repeated as many times as needed. The inflammation may stay down for several weeks, as it reoccurs your doctor may recommend another cortisone injection. If the steroid fails to relieve pressure from your sciatic nerve, your doctor may be forced to take more extreme measures.
Discectomy- Of course surgery is a last resort, especially in younger patients. Nonetheless, this procedure has held a success rate of 90% when certain factors permit. In cases with a severely broad based disc bulge and narrow disc space, the procedure has seen rates of 65%. When undergoing the operation, the patient will be placed under general anaesthetic (basically in a coma). The surgeon will make a small incision in your back right above the problem disc. When he enters the site, your vertebrae will be blocking the disc. So he will perform a procedure known as a lamenectomy. In short, he will remove the portion of the bone that is blocking his view of the disc. Once removed, the surgeon will find his way past your spinal cord and problem nerve and he will remove the portion of the disc that is touching the nerve. It is a highly routine procedure that is done in the US on a daily basis. Upon completion of the surgery your sciatic nerve pain should be extinguished.
Now that you have rid yourself of that deplorable pain, you must ensure it never returns. Here are a few tips to help heal a recently operated on back: For the first few weeks you should keep pressure off of your back. For example, limit the amount of driving you do for the first four weeks; avoid sitting with an unsupported back; and keep away from any bending or lifting. Now that you have passed your four week mark and you have not had a recurring disc, you can slowly get back into your daily routine. You may return to work, but ensure your duties are limited. Keep the impact level very low, and do not lift greater than fifteen pounds. If your job requires you to be more physically active, you may want to think about waiting until the eight week mark to return. Overall, it's good to see "your back" in the swing of things.
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