Recently, I endured a ten hour marathon drive from the depths of LA traffic via highway 5 and finally back home. Highway 5 for some unknown reason was restricted to only one lane, adding to the misery of sitting in a car cruising along at a mere 5 mph. By the time I reached my destination, my back felt as if it had been pummeled by a 300lb+ defensive linebacker. I experienced exquisite discomfort in the form of sharp, shooting pains from my left buttock down the back of my left leg.
While it is true that with middle age, aches and pains do in fact increase in frequency, what I was enduring was not just aging, but also sciatica. Sciatica is a condition in which the sciatic nerve is compressed and voila! this nerve, which otherwise helps you move your leg now becomes your enemy. It is a very large nerve and as such can cause quite a bit of pain. I have seen otherwise stoic patients reduced to tears due to sciatica.
What can compress the sciatic nerve? Well, often it involves inflamed muscles, which press down on the hapless nerve. Sometimes it can be caused by arthritic bones which encroach upon this nerve. Other more unusual causes such as cancer, aneurysms and infection can also do the trick. Bottom line is whatever causes the nerve to be active will make your day miserable.
Treatment involves bed rest for no more than a day or so as otherwise stiffness occurs. Gentle stretching and walking on flat surfaces will also help. Medications such as Ibuprofen will help reduce the inflammation. Flexaril, Valium or Soma might help with the spasm although evidence for this is sparse. Narcotics such as Vicodin will help with the pain. Physical therapy may reduce the spasm. Although many will visit a chiropractor and find relief, there are to my knowledge no reliable studies which have shown any benefit over just placebo from chiropractic manipulation.
On the average most cases of sciatica are resolved within a few weeks. If the pain persists longer than you should see your doctor as other more serious causes mentioned above might be present. Other warning signs include inability to urinate or have a BM, fever, weight loss or being over 55 (hurray for middle age!)
By the way, sitting in a car for hours on end is not the only way to get sciatica. You could just as easily suffer sciatica from any one of a number of things including your first trip in years to a fitness center; showing your son how to “dunk” a basketball; bending over just a little bit too far to tie those shoelaces or you name it. Most of us by the time we have reached a certain age will at some point become victims of sciatica!