Common Causes of Sciatica

From Medical News Today

Sciatica is a type of nerve pain that radiates down the back into the hip and leg. It often goes away in a few weeks, but for some people, the condition is chronic.

The pain can feel like an intense cramp or burning electrical sensations.

Sciatica that lasts more than 3 months or that goes away and comes back may be chronic sciatica.

Chronic sciatica is a long-term condition that can cause ongoing pain. It is more difficult to treat than acute (short-term) sciatica, but several remedies can offer relief.

This article reviews what sciatica is, what causes it, and how to treat it.

Why is my sciatica not going away?

Sciatica happens when something presses on or traps the sciatic nerve.

The most common cause is a herniated disk in the lower spine.

Another risk factor is spinal stenosis, a condition that causes the spinal column to narrow.

Herniated disk

Doctors do not know why some cases of sciatica become chronic.

Many acute and chronic cases happen because of a herniated disk. In most cases, herniated disks improve on their own within a few weeks. When they do not, this may cause chronic pain.

Injury

People with herniated disks often remember a specific injury that triggered the pain.

An injury does not mean that the pain will be chronic.

However, people who have a herniated disk from an injury may develop the same injury again, especially if they continue repeating the movements that led to it.

Inflammation

Inflammatory conditions can trap spinal nerves, causing sciatic pain.

People with chronic inflammatory conditions, such as rheumatoid arthritis, may notice that their sciatica flares when their condition gets worse.

Treating the underlying condition may help treat the sciatica.

Infection

An infection in or around the spine can cause an abscess, which is a swollen and infected mass. This abscess can trap spinal nerves, causing sciatica and, sometimes, other symptoms.

A person with an abscess may develop a fever, have pain in other areas of the body, or find that sciatica begins after they have another infection.

Spinal mass or cancer

Any type of mass in or near the spine may trap spinal nerves, causing sciatic pain.

Some masses are cancerous. In other cases, an epidural hematoma, which is a swollen blood spot near the spine, can cause the pain.

It is important that people with sciatica see a doctor to rule out potentially dangerous conditions such as cancer, especially when sciatica does not go away.

Wear and tear

As a person ages, the normal wear and tear on their spine can cause the spinal column to narrow, resulting in spinal stenosis.

For some people, spinal stenosis causes chronic or worsening pain.

Lifestyle issues

Several lifestyle factors may increase the risk of sciatic pain or extend the healing time.

People with these risk factors may find that sciatica becomes chronic or recurs. Risk factors for sciatica include:

  • little physical activity and prolonged sitting
  • having overweight or obesity
  • smoking

As sciatica often follows an injury, people may also find that the symptoms do not improve if they continue the activity that caused the original injury.

Spinal misalignment

When the spine is not properly aligned, such as when a person has scoliosis or another chronic condition, it can put pressure on the space between the vertebrae.

This pressure may cause herniated disks. It can also compress the sciatic nerve, causing nerve pain. Depending on the cause, a person may need surgery, physical therapy, or other treatments.

Will my sciatica come back?

Sciatica can and does come back, especially when a person has a chronic medical condition.

People who do not make lifestyle changes to prevent more sciatic pain may also redevelop symptoms. However, for most people, sciatica heals on its own within a month or two.

 


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What to Know About Lower Back Pain When Sitting

Medically reviewed by Emelia Arquilla, DO— Written by Hana Ames on October 14, 2020. | From Medical News Today

The cause of pain in the lower back while sitting may involve posture, an injury, or a health condition.

Back pain is one of the most common medical problems in the United States. About 1 in 4 adults in the country have at least 1 day of back pain in any 3-month period.

Here, we describe the causes, treatments, and prevention of lower back pain while sitting.

What does it feel like?

Back pain may be acute, in which case it comes on suddenly and usually lasts a few days or weeks. Or, the pain may be chronic, lasting longer than 12 weeks.

Pain in the lower back may be sudden and sharp or a dull, constant ache.

Causes

A variety of factors can cause pain in the lower back while sitting, and the best approach to treatment depends on the cause.

The treatment plan might include over-the-counter pain relief medication, physical therapy, a new exercise routine, surgery, or a combination.

Posture

Poor posture can cause or worsen lower back pain. Improving posture involves changing a person’s position as they sit or stand. It can often ease or relieve the pain.

Injury

A person might injure their lower back while lifting something incorrectly, leading to a strain or sprain in the area.

The injury might instead result from trauma, sustained during sports or from a car accident, for example.

Sciatica

Sciatica happens when something presses on the sciatic nerve, which travels through the buttocks and extends down the back of the leg, and the issue can cause pain throughout the area.

The pain may be intense and feel like an electric shock or be a dull ache.

Herniated disk

A herniated disk refers to a disk in the spine bulging outward and pressing on a spinal nerve. Any disk in the spine can be affected.

Treatment for this condition usually involves medication and physical therapy.

Lumbar disk disease

Lumbar disk disease, also known as degenerative disk disease, is not actually a disease. Usually, it results from aging.

It occurs when the disks between the vertebrae of the spinal column wear down.

Spondylolisthesis

Spondylolisthesis involves a vertebra of the lower spine slipping out of place and pinching nearby nerves.

Home care strategies

A person may not need professional treatment for lower back pain while sitting.

Often, a person can take steps at home to relieve the pain and keep it from returning. Some strategies include:

Staying active

It can be tempting to rest as much as possible, but the medical community recommend keeping active to ease lower back pain.

Try not to do too much at once, however. Instead, try coupling physical therapy or a recommended form of exercise below with other home treatments.

Using heat and cold

Alternating between heat and cold can often help ease lower back pain.

Taking a hot bath or using a hot water bottle may help alleviate the pain. Heat can also increase blood flow to the area and promote healing in the muscles and tissues of the back.

Applying ice packs or bags of frozen vegetables to the area can also ease pain, but ensure to wrap them in a cloth first.

Heating or cooling sprays are also available over the counter, and they can stimulate the nerves in the area.

Taking pain relief medication

Nonsteroidal anti-inflammatory drugs, or NSAIDs can help ease pain in the lower back. Many, such as ibuprofen, are available without a prescription.

People tend to take these medications orally, but they also come as creams, gels, patches, and sprays.

Stretching and exercising

Exercises and stretches can help strengthen the lower back and prevent the pain from occurring.

Routines that focus on working the core, or abdominal, muscles may also help speed recovery from chronic lower back pain.

Yoga, for example, can help relieve pain in the lower back and neck, and other forms of exercise that may help include:

  • swimming
  • walking
  • Pilates

Stretches that can help alleviate lower back pain include:

  • Deep lunge: Kneel on one knee, with the other foot in front. Facing forward, lift the back knee up. Hold the position for 5 seconds.
  • Back stretch: Lie on the stomach, using the arms to push the upper body off the floor. Hold the position for 30 seconds before allowing the back to relax.
  • Sagittal core strengthening: Standing 3 feet away from a wall with the feet should-width apart, tighten the abdominal muscles, then reach through the legs to touch the wall, keeping the hips and knees bent. Use the hips to push the body back to a standing position, then extend arms and reach over the head and slightly backward.

Prevention

Lower back pain is more common in people with obesity and people who smoke.

Also, people who are infrequently active are more likely to have lower back pain, as are people who tend to be inactive but occasionally engage in strenuous exercise.

The best sitting position

The Department of Health and Human Services warn against slouching and recommend sitting up straight, with the back against the back of the chair and the feet flat on the floor.

They also recommend keeping the knees slightly higher than the hips when sitting.

Diagnosis

To determine the cause of back pain, a healthcare provider will ask the person about their medical history and perform a physical examination.

If the pain is acute, further tests are usually not necessary, unless the pain results from an injury.

The treatment for chronic pain depends on the cause, and surgery may be an option.

When to see a doctor

Seek medical attention if lower back pain is severe, lasting, or does not improve with stretches, exercises, and other home care techniques.

Also, contact a doctor if the pain results from an injury.

 

 


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Risk Factors and Common Causes of Lower Back Pain

Article from City Hospital at White Rock

Eighty percent of adults will suffer from lower back pain during their lifetime according to an epidemiology study published by the National Institutes of Health. Lower back pain is the second-most common cause of job-related disability and time off of work. Most chronic sufferers turn to medications, heating pads, and massage to relieve their aches, but when is the right time to see an orthopedic surgeon?

Do you suffer from lower back pain? You’re not alone. In this guide, we will discuss the common causes of lower back pain and how an orthopedic surgeon can help you. Read more

Understanding Spinal Disk Problems — the Basics

Article Featured on WebMD

What Are Spinal Disk Problems?

Anybody who has experienced a damaged spinal disk understands how painful it is. Every movement seems to make it worse. This pain is a warning signal that you should heed. If you take appropriate action, the discomfort usually stops, and the problem can be corrected.

Read more

About Back/Spine, Neck, and Shoulder Pain – The Statistics

Article Featured on PPP

Low back pain and neck pain are among the top contributors to chronic pain among adults.

Read more

Spine Pain: 3 Rare but Severe Conditions that Might Affect You

By Christine Rhodes, MS | Reviewed By Forest Tennant, MD, DrPH | Article Featured on Practical Pain Management

Injuries, abnormalities, and gradual wear and tear can lead to the development of severe spine pain. With straining, twisting, and spraining, soft tissues around the spine can become inflamed, causing pain and muscle spasms over time. This pain can be very debilitating and cause a patient to significantly reduce their day-to-day activities.

The severe pain that accompanies the following rare spine conditions detailed below can affect you or a loved one. Being knowledgeable about these conditions can help you to speak to your doctor if you feel you may have similar symptoms.

Read more

Sleep Hygiene and Back Pain

Article Featured on Spine Health Institute

Give Your Spine a Good Night’s Rest

Sleep. It’s one of the most natural and nurturing human activities, and it’s something we all require to keep our minds and bodies functioning properly. But did you know you can actually sleep the WRONG way? Think about the last time you awoke with a stiff neck after lying in an awkward position. Or maybe your back started hurting the second you got up for work. Whether you aggravated an old injury or created a new one, it happened when you weren’t even conscious!

The truth is, each of us can benefit by following certain “sleep strategies” that minimize the pressure on our spinal column while we’re at rest. This starts with learning the proper way to get into and out of bed so as to reduce unnecessary twisting of the spine.

Getting Into Bed
Obviously, if you’re prone to chronic back or neck pain, or if you’re trying to recover from a recent back injury, having a good mattress is a key to your comfort. While mattress shopping isn’t fun – or cheap! – it’s worth knowing what to look for when the time comes. Our Spine U library has a quick video that demonstrates how to choose the best mattress for your back.

That said, even the best mattress can’t keep you from straining a muscle when you’re getting into or out of bed. That’s why we recommend the “log roll” sequence, especially for those just recovering from a back injury. Here’s how it’s done:

  1. First, sit on the edge of the bed and use your arms to slowly lower your body down onto your side while bringing your legs and feet onto the bed.
  2. Roll onto your back while keeping your back and hips in line. Avoid twisting your back by tightening your abdominal muscles.
  3. To get up, slowly roll onto your side and slide your legs off the side of the bed. Be sure to keep your abdominal muscles tight.
  4. With your elbow and hand, push into the mattress and lift up into a sitting position.

This quick video demonstrates the log roll.

Lying on Your Back
If you typically sleep on your back, learn the correct “supine” position to avoid putting undue stress on parts of your spine.

  1. Start by completing the log roll sequence to lie down.
  2. Use a medium-sized pillow under your head to ensure that your body and head are at equal height.
  3. If needed, place a small pillow in the curve of your lower back for support.
  4. Place one or two pillows under your knees to keep your spine in a neutral position.

This video demonstrates the proper supine position.

Sleeping on Your Side
If you prefer lying on your side, it’s important to keep your hips and neck in alignment. Here’s how.

  1. Use the log roll sequence to get into bed.
  2. Place a medium-sized pillow under your head so your head and body are raised by the same amount.
  3. If needed, place a small towel roll in the curve of your neck.
  4. Place a thin- to medium-sized pillow between your knees to help support your lower back.

This video demonstrates the proper side-sleeping technique.

For Stomach Sleepers
In general, it’s not very wise to sleep on your stomach because of the strain that this position puts on your back and neck. But if this is the only way you’re able to sleep, you can reduce the pressure on your spinal column this way.

  1. Start the logroll sequence and use your arms to lower your body down on your stomach while lifting your legs onto the bed.
  2. Use a very thin pillow or no pillow under your head to keep your neck in line with your body.
  3. Place a thin or medium-size pillow under your stomach and pelvic region to help keep your spine in a neutral position.
  4. Bring one leg to your side and slightly bend it. Place a medium pillow underneath your knee to relieve pressure on your lower back.

Here’s a video that shows the best possible way to sleep on your stomach.


Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

How to Keep Your Spine Healthy As You Age

Article Featured on Spine Health Institute

As we get older, it’s not uncommon to experience increased aches, pains and joint stiffness. Many of us assume this discomfort just goes with the territory – and in fact, when it comes to the spine, some decline in function and flexibility may be expected as the bones and intervertebral disks begin to deteriorate over time.

But there are several things you can do right now to help maintain your spine’s flexibility and comfort well into your golden years.

Here’s what you should know about what happens to your spine as you age, common spinal conditions in older adults, and ways to help prevent back pain and injuries in the future.

Read more

Back Pain: Common Spine Problems & Causes of Back Pain

Reviewed By: Tyler Wheeler, MD | Article Featured on Medicinenet.com

Are you glad you can stand or sit upright? Thank your spine, a stack of little bones called vertebrae along the center of your back, from your seat to your neck. It supports your head, shoulders, and upper body. Your spine plays another key role: The vertebrae make a tunnel for your spinal cord. That’s the set of nerves that connect your brain to most of your body.

Read more

Lumbar Spine Surgery

Article Featured on Spine Health

Lumbar surgery refers to any type of surgery in the lumbar spine, or lower back, between one or more of the L1-S1 levels. There are two general types of lumbar spine surgery that comprise the most common surgical procedures for the lower back:

Lumbar Decompression

The goal of a decompression surgery is usually to relieve pain caused by nerve root pinching. There are two common causes of lumbar nerve root pressure: from a lumbar herniated disc or lumbar spinal stenosis.

This type of pain is usually referred to as a radiculopathy, or sciatica.

A decompression surgery involves removing a small portion of the bone over the nerve root and/or disc material from under the nerve root to relieve pinching of the nerve and provide more room for the nerve to heal. The most common types of decompression surgery are microdiscectomy and laminectomy.

There are also a few alternatives available to the above two standard procedures, such as an X-STOP which is a possible option instead of a laminectomy for lumbar spinal stenosis.

Lumbar Fusion

The goal of a lumbar fusion is to stop the pain at a painful motion segment in the lower back. Most commonly, this type of surgery is performed for pain and disability caused by lumbar degenerative disc disease or a spondylolisthesis.

A spinal fusion surgery involves using a bone graft to stop the motion at a painful vertebral segment, which in turn should decrease pain generated from the joint. Spine surgery instrumentation (medical devices), bone graft procedures, and a bone stimulator are sometimes used along with spinal fusion.

There are also many surgical approaches to performing spinal fusion, such as ALIF, PLIF, XLIF, TLIF, posterolateral gutter fusion, anterior/posterior fusion, and certain minimally invasive approaches.

In addition to the above conditions, decompression and/or spinal fusion may be performed to address other types of lumbar spine pathologies, such as infection or tumors.

Lumbar Spine Surgery Alternatives

In addition to the traditional one-level fusion or decompression surgery that is done for lumbar degenerative disc disease or spinal stenosis, respectively, there are a number of surgical alternatives available. Several of the most common ones include:

Artificial Disc Replacement

Artificial disc technology can be used in specific cases of lumbar degenerative disc disease.

Motion Preservation Technologies

It should be known that while spinal fusion has been a classical treatment for ongoing pain and disability from the lumbar spine, alternatives to fusion do exist for posterior conditions (problems in the back of the lumbar spine) such as spinal stenosis. Inserting an interspinous process spacer, such as the X-STOP device, can actually preserve motion as opposed to stopping it via fusion.

Vertebral Augmentation

A surgery called vertebral augmentation may be done to treat pathological fractures from tumors or osteoporosis.

Multilevel Lumbar Fusion

Lumbar spine fusion surgery for symptomatic degenerative disc disease is typically done on one level of the spine (most commonly toward the bottom of the spine, at L5-S1 or L4-L5). In certain cases it may be done on two levels, and only very rarely would it be considered on 3 or more levels. Multilevel spine fusion may be indicated in cases of scoliosis.

There are only two things that surgery can do. Surgery can decompress a nerve root or it can stabilize a painful motion segment. So we have to identify a nerve root that’s pinched or we have to identify a painful motion segment. And if we can do that, that would make you a candidate for surgery. Just having pain and having failed conservative treatment is not an indication for surgery if there is no pathological cause of the pain – it doesn’t mean there’s not pain, but we have to identify the cause of pain in order to be able to correct it. The only thing surgery can do is actually correct an anatomical defect, so we have to be able to identify it.


Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm