NCTV Episode 31

Continuing with the series of bitesize health tip videos which can be found here on my YouTube Channel, this episode, includes:-

  • A crash course to help you understand it
  • What you can do to help it
  • The main do’s and don’ts
  • How to know when you may need A&E
  • Preventative measures you can take to avoid reoccurrence

Transcript

If you’d prefer to read the content within, rather than watch the video, then feel free to read the transcript, as follows:-

Hello and welcome to NCTV Episode 31 and this one is all about Sciatica.

So what is sciatica? First of all it’s actually a set of symptoms stemming from another problem causing compression of the sciatic nerve as opposed to being the main issue itself.

It can also be referred to as Neuritis, Lumbar radiculopathy or Neuralgia.

Those with sciatica may experience pain, numbness, pins & needles and weakness in the lower back and/or buttocks, legs and feet. Occasionally people may also report a burning pain or spider like tickle in the leg and generally speaking it tends to only occur on one side.

To give you an idea of why this can be so painful – the sciatic nerve is the longest and largest nerve in the body and at its thickest point, it’s as wide as your thumb. It’s roots stem from the spinal cord and pass through the last few vertebrae in your lower back and it extends the entire length of your leg into your foot.

Here are some of the causes of sciatica, firstly the most common one, which is a disc prolapse or “Slipped disc” as some call it and that’s where the disc bulges and touches the sciatic nerve, sending pain down the back of the leg.

Next, Spondylolisthesis – almost as hard to say as it is to spell. This is where an actual vertebrae slips forward, usually after a fracture and pinches the sciatic nerve or narrows the spinal canal

Piriformis Syndrome is another cause which is where the piriformis muscle, deep in the buttock, compresses and impinges the sciatic nerve.

Another cause, albeit less common is something called a space occupying lesion which means anything occupying the space around the nerve such as a tumour or cyst, compressing it, leading to sciatica.

So now you know what it is, how and why it happens, here are some of the things you can do about it:-

It usually gets better in 4-6 weeks but can last longer and in the short-term anti-inflammatories like ibuprofen or aspirin can be helpful, ice and heat may also provide relief.

For more natural ways to reduce inflammation in the longer term, this can be done through nutrition with a diet rich in wholegrains, fruits, vegetables, nuts, fatty fish such as salmon and also turmeric, ginger, green and black tea.

Whilst experiencing sciatica, it’s good to reduce your activity levels for a few days then slowly work your way back up to the usual level and avoid forward bending as much as possible.

Depending on the severity, it may need to be around 12 weeks until you can resume exercising and when doing so, pay particular attention to strengthening your abdomen and increasing the flexibility of the spine.

I realise this may come across as being biased but physical therapy, such as osteopathy is also highly recommended, not only by myself but across the many health advisory boards in existence, so don’t just take my word for it.

If physical therapy is unsuccessful, it may be that the nerve is too severely pinched and the next step is usually an MRI scan to determine the severity of it. Following an MRI, a consultant may wish to do an injection or epidural into the spine to reduce inflammation on the sciatic nerve roots.

A few other top tips to mention and this is mostly comprised of do’s and don’ts but before those, it can be helpful to put a pillow or cushion between the knees when sleeping on your sides or under your knees when lying on your back.

This leads nicely into the next tip being – get more restorative sleep.

Some people also find mind-body techniques helpful such as deep breathing, meditation, visualisation and cognitive behavioural therapy.

Some exercises to do that can be helpful, although not in every case as these depend on the cause, may be knee hugs, back extensions, hamstring stretches and buttock stretches.

Starting with the don’ts, if you have sciatica, don’t sit for more than 20 minutes without getting up and moving around for a few minutes.

I said it before but I’ll say it again, don’t bend forward if you can help it and I realise this isn’t easy but that includes leaning over a sink to wash your face, bending to pick up objects from the floor, reaching across a table or making the bed. And definitely don’t bend and twist at the same time or lift anything heavy.

And now onto some of the things that you can do and that is move, gentle movement or exercise usually helps.

Do go to work. Resuming normal day-to-day activities and a normal routine can help after the acute stage.

Do cycle and swim as part of your rehabilitation and under guidance from your doctor or therapist.

And finally, this is neither a do, or a don’t, more of a be careful running – it can cause compression through the spine and might make the problem worse.

It should be said that there are some instances to be aware of where you may need to go to A&E or call 999, if you’re in the UK that is, and that’s if you have sciatica on both sides, have weakness and numbness in both legs that’s getting worse, numbness around your genitals or anus, or have a loss of bowel or bladder function.

Once over the issue some things you can do to prevent it coming back are keeping active with regular exercise, improving your posture when lifting, sitting, standing or at a computer, losing weight and quitting smoking, if you do smoke that is.

And that concludes this week bitesize bit to help your health flourish, until next time, bye bye.