Sciatica: Causes, Symptoms, and Treatment Options

Sciatic nerve

Hello doctor, recently my mother has been frequently complaining about lower back pain.
When she lies down, she feels numbness and soreness that radiates from her hips to her spine.
I would like to know if this requires treatment.
She works in the food service industry and stands for 8 hours a day; could standing for too long be the cause of these symptoms?

li, 10~19 year old female. Ask Date: 2013/08/13

Dr. Yan Sumei reply Traditional Chinese Medicine

Hello! I am glad to receive your message.
"When my mother lies down, she feels numbness and pain starting from her lower back to her spine." This sounds like a troubling issue.
The sensation of soreness and numbness is quite different; numbness is generally more severe than soreness.
Numbness can occur when blood flow is restricted, preventing nerves from receiving adequate nutrients (for example, when one naps on their arm).
Additionally, numbness can arise from nerve compression (such as with bone spurs in the lumbar spine).
If resting alleviates the symptoms, it indicates that the condition may not be severe.
However, if resting does not provide relief, I recommend taking your mother to a rehabilitation physician for an X-ray to check for any issues with her lumbar spine.
This is my response to you.
Wishing you health and happiness! Sincerely, Yen Su-Mei, Department of Traditional Chinese Medicine, Nantou Hospital.

Reply Date: 2013/08/13

More Info

Sciatica is a condition characterized by pain that radiates along the path of the sciatic nerve, which branches from the lower back through the hips and buttocks and down each leg. It typically occurs when the sciatic nerve is compressed, often due to a herniated disk, bone spur on the spine, or narrowing of the spine (spinal stenosis). Understanding the causes, symptoms, and treatment options for sciatica can help in managing this condition effectively.

Causes of Sciatica
1. Herniated Disks: The most common cause of sciatica is a herniated or slipped disk in the spine. When the soft material inside a disk pushes out, it can press on the sciatic nerve.

2. Bone Spurs: Over time, wear and tear on the spine can lead to bone spurs, which can also compress the sciatic nerve.

3. Spinal Stenosis: This condition involves the narrowing of the spinal canal, which can put pressure on the sciatic nerve.

4. Injuries: Trauma to the lower back or spine can lead to sciatica.

5. Lifestyle Factors: Prolonged sitting, standing, or poor posture can contribute to the development of sciatica. In your mother's case, standing for long hours while working in a restaurant may indeed be a contributing factor.

Symptoms of Sciatica
The symptoms of sciatica can vary but typically include:
- Pain: This can range from a mild ache to a sharp, burning sensation that may be felt in the lower back, buttocks, and down the leg.

- Numbness or Tingling: Many individuals report a tingling sensation or numbness in the leg or foot.

- Muscle Weakness: The affected leg may feel weak, making it difficult to move or control.

- Worsening Symptoms: Symptoms may worsen with prolonged sitting, standing, or certain movements.

Treatment Options
1. Conservative Treatments:
- Physical Therapy: A physical therapist can design a program to strengthen the muscles supporting the back and improve flexibility.

- Medications: Over-the-counter pain relievers such as ibuprofen or naproxen can help reduce inflammation and relieve pain. In some cases, prescription medications may be necessary.

- Heat and Ice Therapy: Applying heat or ice to the affected area can provide relief from pain and inflammation.

2. Lifestyle Modifications:
- Posture Correction: Encouraging your mother to maintain good posture while standing and sitting can help alleviate pressure on the sciatic nerve.

- Frequent Breaks: If she stands for long periods, taking breaks to sit or walk around can reduce strain on her back.

3. Invasive Treatments:
- Epidural Steroid Injections: In some cases, corticosteroid injections can help reduce inflammation around the sciatic nerve.

- Surgery: If conservative treatments fail and the pain is severe or debilitating, surgical options may be considered to relieve pressure on the sciatic nerve.

Conclusion
Given your mother's symptoms of pain radiating from her lower back to her legs, it is advisable to seek medical attention. A healthcare professional can perform a thorough evaluation, which may include imaging studies like an MRI or CT scan, to determine the underlying cause of her sciatica. Early intervention can lead to better outcomes and help prevent the condition from worsening. Additionally, addressing her work environment and habits may also play a crucial role in her recovery. Encouraging her to take breaks and practice good posture while standing can significantly alleviate her symptoms.

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