DefinitionSciatica refers to pain, weakness, numbness, or tingling in the leg. It is caused by injury to or pressure on the sciatic nerve. Sciatica is a symptom of another medical problem, not a medical condition on its own.Alternative NamesNeuropathy – sciatic nerve; Sciatic nerve dysfunction; Low back pain – sciaticaCausesSciatica occurs when there is pressure or damage to the sciatic nerve. This nerve starts in the lower spine and runs down the back of each leg. This nerve controls the muscles of the back of the knee and lower leg. It also provides sensation to the back of the thigh, part of the lower leg, and the sole of the foot.Common causes of sciatica include:Slipped diskSpinal stenosisPiriformis syndrome (a pain disorder involving the narrow muscle in the buttocks)Pelvic injury or fractureTumorsSymptomsSciatica pain can vary widely. It may feel like a mild tingling, dull ache, or burning sensation. In some cases, the pain is severe enough to make a person unable to move.The pain most often occurs on one side. Some people have sharp pain in one part of the leg or hip and numbness in other parts. The pain or numbness may also be felt on the back of the calf or on the sole of the foot. The affected leg may feel weak.The pain often starts slowly. It may get worse:After standing or sittingAt nightWhen sneezing, coughing, or laughingWhen bending backward or walking more than a few yards, especially if caused by spinal stenosisExams and TestsadvertisementThe health care provider will perform a physical exam. This may show:Weakness when bending the kneeDifficulty bending the foot inward or downDifficulty bending forward or backwardAbnormal or weak reflexesLoss of sensation or numbnessPain when lifting the leg straight up off the examining tableTests are often not needed unless pain is severe or long-lasting. If tests are ordered, they may include:Blood testsX-raysMRIs or other imaging testsTreatmentBecause sciatica is a symptom of another medical condition, the underlying cause should be identified and treated.In some cases, no treatment is required and recovery occurs on its own.Conservative treatment is best in many cases. Your doctor may recommend the following steps to calm your symptoms and reduce inflammation.Apply heat or ice to the painful area. Try ice for the first 48to 72 hours, then use heat.Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol).Measures to take care of your back at home:Bed rest is not recommended.Reduce your activity for the first couple of days. Then, slowly start your usual activities.Do not do anyheavy lifting or twisting of your back for the first 6 weeks after the pain begins.Start exercising again after 2 to 3 weeks. Include exercises to strengthen your abdomen and improve flexibility of your spine.If these measures do not help, your doctor may recommend injections to reduce inflammation around the nerve. Other medicines may be prescribed to help reduce the stabbing painsof sciatica.Physical therapy may also be recommended. Additional treatments depend on the condition that is causing the sciatica.Nerve pain is very difficult to treat. If you have ongoing problems with pain, you may want to see a neurologist or a pain specialist to ensure that you have access to the widest range of treatment options.Outlook (Prognosis)Often, sciatica gets better on its own. But it is common for it to return.Possible ComplicationsMore serious complications depend on the cause of sciatica, such as slipped disc or spinal stenosis.When to Contact a Medical ProfessionalCall your doctor right away if you have:Unexplained fever with back painBack pain after a severe blow or fallRedness or swelling on the back or spinePain traveling down your legs below the kneeWeakness or numbness in your buttocks, thigh, leg, or pelvisBurning with urination or blood in your urinePain that is worse when you lie down, or awakens you at nightSevere pain and you cannot get comfortableLoss of control of urine or stool (incontinence)Also call if:You have been losing weight unintentionallyYou use steroids or intravenous drugsYou have had back pain before, but this episode is different and feels worseThis episode of back pain has lasted longer than 4 weeksPreventionPrevention varies, depending on the cause of the nerve damage. Avoid prolonged sitting or lying with pressure on the buttocks.ReferencesChou R, Qaseem A, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147:478-491.advertisementChou R, Qaseem A, Owens DK. Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians. Ann Intern Med. 2011;154:181-189.Chou R, Atlas SJ, Stanos SP, Rosenquist RW. Nonsurgical interventional therapies for low back pain: a review of the evidence for an American Pain Society clinical practice guideline. Spine. 2009;34:1078-93.Review Date:4/16/2013Reviewed By:C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
May 9, 2016A very special night in the Arcosanti cafe, celebrating Arizona Vivaldi Festival # 18.The Arizona Vivaldi Festival was founded by Michel Sarda at Arcosanti in October 1998 to honor Paolo Soleri. Sarda’s “Art Renaissance” was its producer again this year, and this time, the eighteenth time at Arcosanti, Vivaldi’s work was played by the terrific Phoenix String Quartet, and the emotion of the music was translated into Flamenco by the internationally acclaimed flamenco artists and musicians of Bernadette Gaxiola’s “Zona Flamenca.” [photos by Rob Jameson, text by Jeff Stein] This night was very special in another way, too: unlike all other dance forms, in which dancers move to the music, in Flamenco, the dancers lead and the musicians try to keep up. It all worked out wonderfully, and people in the packed house had the experience of their lives. A close-to-capacity audience arrived for a terrific Spanish-style dinner in the café and after dinner, 45 additional guests(!) filed in for the performance. With the startlingly beautiful flamenco was Spanish guitar, and voice, and Vivaldi with strings.Then: has it ever happened before that a wheelchair-bound person was featured in a dance performance? Yes, once or twice. Was it ever more beautifully done than in the Café at Arcosanti this past Saturday night? No, probably not ever. It was a transcendent moment, when a young girl in a wheelchair took part in the Flamenco, spinning among the dancers, her own flowing gown reminding everyone of how angels move.Congratulations to all involved in producing what everyone who was at Arcosanti will remember for a long, long time.
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