As might be expected, firefighters are at increased risk of back injury compared to other professions due to the rigorous physical requirements of the occupation. You can experience back pain when lifting a tool, a patient, or dragging a hose line. The IAFF’s annual Death and Injury Survey reveals that back injuries often result in significant lost time and medical expense, and account for approximately 50% of all line-of-duty injury retirements each year.
Sciatica is often a symptom of a back injury and there are several reasons a patient may experience sciatica. A herniated or “slipped” disc, is the most common cause and occurs when a disc in the lower spine shifts out of alignment and pinches or damages the sciatic nerve. Sciatica can result from weakening of the discs. A ruptured disc occurs when the tough fibrous ring of the disc breaks down or cracks and the gel-like substance within the disc leaks out and irritates the nerve. Spondylolisthesis is the medical term for one or more vertebra shifting out of normal alignment in the spine. If this occurs, the disc can also be involved and pressure or damage to the nerve can result. Chronic bending, twisting and heavy lifting as well as prolonged sitting, obesity, poor posture, and pregnancy can cause sciatica.
The sciatic nerve is formed from a network of nerves that exit the spinal cord and form in the lower back extending through the buttock and runs down the length of the posterior leg bilaterally to the ankle and foot. At its largest diameter, the sciatic nerve is about an inch; which is about the width of your thumb.
Sciatica refers to symptoms that result from a pinched or damaged sciatic nerve. One important fact to remember: sciatica refers to symptoms; it is not a diagnosis. The pain of sciatica can be described as burning, searing, aching, tingling, and/or dull or sharp shooting pain. Other symptoms can include numbness and weakness. Symptoms can be felt anywhere along the path of the nerve and range from mild to severe intensity. The pain can be chronic or intermittent and usually involves pain radiating down only one leg.
If you present with sciatica, your healthcare provider will perform a history and physical and muscle testing to identify the potential source of your symptoms. If necessary, imaging studies such as X-rays and MRI or CT scan may be ordered to identify the exact location of the problem. A nerve conduction velocity/electromyography may also be ordered to further evaluate your symptoms.
The new and sudden onset (acute) of sciatica typically responds to conservative therapy. Initially, rest may be prescribed to reduce inflammation of the nerve —but don’t stay in bed too long (no longer than two days). Prolonged bed rest has been shown to actually worsen sciatica. Ice or heat, over the counter analgesics and the “tincture of time” are usually sufficient to help reduce or alleviate sciatica which usually resolves in a few days or weeks. It’s important to get moving as soon as possible. Stretching, walking, gentle exercise, and patience are important. Chiropractic manipulation may also help. Chiropractic spinal adjustments involve specific manual maneuvers aimed at restoring the proper biomechanics of the spine and removing nerve impingement. Severe sciatica may call for epidural injections into the spinal canal or surgery to remove the disc causing the pain.
Taking care of your lower back may help prevent sciatica. If you’re overweight, losing weight will help. The more overweight a person is, the greater strain is placed on the lower back muscles. Exercise, such as brisk walking, yoga, and core strengthening exercises will also help. Maintaining proper posture and avoiding sitting for prolonged periods of time is also advised. Also use proper body mechanics when lifting—lift with your legs, not your back.
Anyone who’s ever had sciatica knows how painful it can be—so an ounce of prevention is definitely the best way to go. So stay healthy and watch your back!
Provided by Dr. Alan Rosenthal, www.wholehealthmedicalsolutions.com