Compliments of FEOAA Newsletter 2007, Knopf

OH, MY ACHING BACK!

By Mary Ann Wilson, RN

The largest and longest nerve in the body that causes back pain when irritated

is the sciatic nerve. The sciatic nerve is as wide as your thumb and runs from the

lower back, down the buttocks, legs, and to the feet. It is responsible for the painful condition referred to as sciatica.

When this nerve is compressed or strained, the resulting irritation can play havoc with everyday life. For example:

• ?Next to the common cold, it is the second most common reasonfor lost days of work.
• ?Treating it can run into billions of healthcare dollars.
• ?It can interfere with being able to complete the simplest everydayduties without pain. The symptoms help to diagnose this condition easily because the pain has several distinctive characteristics: It typically occurs on one side of the body. The pain is often described as tingling, burning, pins and needles sensations, feelings of electric shock, hot and cold sensations, numbness and weakness in the leg or foot. The classic symptom starts with lower back pain that runs throughthe buttocks, back of the thighs, and divides into two branches just above the knees. It continues to branch out into the calf muscle and all the way down to the feet.Possible CausesThe sciatic nerve is designed to transmit messages from the spinal cord to the legs, directing them to move. But when the sciatic nerve becomes compressed, irritated, or inflamed, the only message it trans- mits is pain. A herniated disc, arthritis, a tumor, an injury or spinal infection are a few of the various causes of sciatica.

Researchers in Finland have also discov- ered a genetic component that con- tributes to a predisposition for devel- oping sciatica. So don’t be surprised it you find that it runs in the family!

One of the most common causes of sciatic pain involves a small, deep mus- cle called the piriformis. It is located beneath the gluteus maximus and in a fraction of cases the sciatic nerve actu- ally runs through the piriformis muscle. When the muscle contracts it compresses the nerve, causing irritation and pain.

There are other things that will cause the piriformis muscle to act up. For example, repetitive activity involving the hip, back, and buttocks can be intense enough to cause the piriformis muscle to swell up, cre- ating pressure on the nerve.

Another common cause of sciatica is a herniated disc in the lower spine, which can pinch off or com- press the nerve.

Other circumstances that can create compression on the sciatic nerve include the bony, irregular projec-

reduce the inflammation. He may also recommend ten minutes of cold com- presses or ice followed by stretching

the hamstring group, piriformis muscle, and all the surrounding muscles.

Other treatment modalities might include physical therapy, biofeedback, extended bed rest,

epidural steroid injections, or nerve blocks.

Prevention

Engaging in a regular exercise program that focuses on strengthening the postural and abdominal muscles and stretching the hamstring group, piriformis muscle and the other external rotators is a great first step.

Here are a few suggestions that will help prevent sciati- ca if it is caused by prolonged sitting:

• ?Take a break from sitting by getting up and walkingaround once every hour.
• ?When sitting, keep your feel flat on the floor anddon’t cross your legs.
• ?When sitting in a car, use a lumbar support, arolled up towel, or a jacket for lower back support.
• ?Men, don’t carry your wallets in your back pocketsto avoid putting pressure on the sciatic nerve when you sit down.A Final WordAlong with using proper body mechanics, correcting your posture throughout the day, and avoiding pro- longed sitting, there is one other important fact to keep in mind. It has been shown that individuals who are consistently improving their general fitness level are less prone to suffer back problems and most likely will never utter those dreadful words, “Oh, my aching back!”Reprinted from the Sit and Be FitTM newsletter, Focus on Fitness, Vol. 10, No. 1.

“I’m at an age where my back goes out more than I do.”

—Phyllis Diller

tions due to osteoarthritis or swelling that develops as a result of an injured ligament.

Even something as simple as a man sit- ting on a wallet in his

back pocket can put enough pressure on the piriformis muscle to cause problems.

Last but not least, weak hip and gluteal muscles will cause the piriformis muscle to become tight, compress- ing the nerve.

Available Treatments

Good news! Dr. James Wheeler, III, an orthopedic sur- geon in Marion, NC, reports that “Ninety percent or more of sciatica problems resolve themselves.” Surgery is considered only when a person becomes functionally disabled.

It is imperative to begin with professional help. A neurological exam is a must and a peripheral vascular exam is most likely needed to rule out any circulatory problems. Your doctor may prescribe an anti-inflamma- tory medication to relieve the pain temporarily and to