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When sciatica is more persistent, the best plan of attack is a targeted exercise and education program.

"But for the most part, we know that the condition is one that usually clears up with non-surgical conservative care." If the problem persists after 12 weeks, imaging may be appropriate, he added. If there is pain or numbness in the groin or "saddle area," and particularly if there is dysfunction of urination or bowel control, you should go see a doctor right away, he said.

You expect to find the thing and get rid of it, and most often that's not the way it is." In fact, it probably sets up a lot of poor behaviours on the part of patients. "We know you don't need to image the hell out of these things. Many medications, such as opioids, show little evidence of effect.Įven the rush towards imaging such as X-rays and MRIs is not recommended, he said, because they often don't reveal the source of the problem. Pain medications should be resisted or only used for very short periods at very low doses. When severe sciatica does strike, he recommends starting with conservative care. "I couldn't even sit, and it was three months before I could put my shoes on," he said. Kawchuk had a bad case of sciatica last winter-so debilitating he was literally forced to his hands and knees. But typically it's a result of herniation from age-related changes in the spine." "Sometimes just sneezing or a good cough will bring it on. If the pain doesn't go away after about three months, and symptoms seem to mimic those of sciatica, you might have pain from other causes, said Lemieux, such as hip-joint arthritis or muscle-referral pain.ĭespite potentially aggravating pain, true sciatica doesn't have to result from severe trauma, he said.

(Video: Geoff McMaster)Ībout 85 per cent of the population will suffer from back pain at some point in their life, but only between two and 10 per cent will have true sciatica, said Edmonton chiropractor James Lemieux, who is pursuing a master's degree in rehabilitation medicine under Kawchuk. Most often these leg symptoms go down the back of the leg, past the knee and into the foot, although there are different flavours of this situation."Ĭhiropractor James Lemieux demonstrates some simple exercises to ease sciatic pain. "But in sciatica, there is typically pain, numbness or tingling down one leg, and these symptoms are typically worse than any back pain. "There are all sorts of other reasons you can have pain down the leg," he said. It's also possible to have sciatica without back pain, he said, just as it is possible to have symptoms of sciatica without involvement of the back. What's nice is that we know that in the majority of patients, it usually resolves and goes away over time-just not that quickly." "Sometimes the jelly comes out and it will either push on the nerve root or create inflammation that bothers the nerve. It usually results from compression of the nerve roots as they exit the spine, which is caused when jelly-like cushions between vertebrae herniate, said Kawchuk. Since the pain tends to radiate, it can be felt in a number of places, from the lower back to the buttocks, groin and down the back or front of the leg. It can come on suddenly in an acute, disabling way, resolving after a couple of months, or it can fluctuate over time, he said. That's because the condition-named for the sciatic nerve running down the spine and through the leg-is a general term for many different situations. While sciatica is one of the most common forms of back pain, people often assume they have it when they don't, says U of A physical therapy researcher Greg Kawchuk.