Sciatica is a symptom instead of a medical diagnosis. It refers to sciatic nerve pain travelling from your lower back through your hips and buttocks, and down the large sciatic nerve in the back of the leg. You will experience tingling, numbness or weakness along the “path”.
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Causes of sciatica
There are a number of underlying causes of sciatica include:
- Degenerative disc disease
Disc degeneration is very common when people age. If you experience one or more degenerated discs in the lower back, a nerve root will be irritated and sciatica will be caused.
- Lumbar spinal stenosis
Spine will age when you are over the age of 60, lumbar spinal stenosis will be caused. Stenosis in this area will cause narrowing of the spinal canal, leading to overgrowth of soft tissue, and a bulging disc placing pressure on the nerve roots. Sciatica pain will be the result.
Weight gain during pregnancy will shift one’s centre of gravity, making the pregnancy woman easier to sustain sciatica.
- Muscle strain
Inflammation resulted from a muscle strain can put pressure on a nerve root and cause sciatica.
Though the situation is rare, infection occurs in the lower back can affect the nerve root and cause sciatica.
- Spinal tumor
A spinal tumor can impinge on a nerve root in the lower back and cause sciatica.
Symptoms of sciatica
Sciatica is often characterized by one or more symptoms include:
- Constant pain along one side of the buttock or leg (rarely occur in both legs)
- Pain varies widely from a mild ache to a sharp and burning sensation, or tingling down the leg
- Coughing or sneezing, and prolonged sitting will aggravate the symptoms
- Weakness, numbness or difficulty moving the leg or foot
- A sharp pain that may make it difficult to stand up or walk
Sciatic pain can vary from infrequent to constant pattern. Though debilitating it will be, it is rare that permanent sciatic nerve damage will result. Most cases can be resolved with just conservative treatments in a few weeks. Severe cases will need surgery to relieve pressure on the nerve.
Diagnosis of sciatica
- Physical examination
Your doctor will check your muscle strength and reflexes by doing the following actions: If you get sciatica, you will experience pain.
- Walk on your toes or heels
- Rise from a squatting position
- Lie on your back and lift your legs one at a time straight in the air
- Imaging tests
Imaging tests will be ordered by your doctor if your pain is very severe or does not improve within a few weeks. They will be used to examine whether you have herniated disks or bone spurs that normally produce no symptoms, but may show up on X-rays and other imaging tests.
X-ray will be a good way to reflect whether you have overgrowth of bone (bone spur) that presses on a nerve.
- Magnetic resonance imaging (MRI)
MRI uses magnetic field and radio waves to produce cross-sectional images of your back, which clearly shows any problems of your bones and soft tissues, such as herniated disks.
- Computerized tomography (CT) scan
You may need to inject a contrast dye into your spinal canal before taking CT scan, the dye which circulates around your spinal cord and spinal nerves will show clearly on screen.
Treatments of sciatica
Though non-surgical treatments and exercise sessions are available to treat sciatica, it goes a long way to relieve your pain. Here are some treatments options for your reference:
One or more combinations will be used for better results:
A number of medicines can be used to treat the pain of sciatica. For example, non-steroidal anti-inflammatory drugs, or oral steroids can reduce the inflammation. Muscle relaxants, narcotics, tricyclic antidepressants or anti-seizure medications are other options that your doctor will consider based on your situation.
- Pain relieving injections
Injections into or near your spine help deliver pain-reducing medicines directly to the source of pain and can ease sciatica. Right before the injection, you will receive a local anaesthetic to block pain from the injected area. A sedative will be offered to make you relax and ease your anxiety. The two main types of injections include:
- Epidural steroid injection: Steroid is injected directly to the painful area around the sciatic nerve to help reduce the inflammation.
- Nerve root block injection: Targets individual nerves in your spine.
During the treatment, you will be asked to lie on your abdomen or on your side with your knees drawn up and chin tucked in. This position helps to open up the space between the bones in your back. A machine called a fluoroscope is usually positioned close to the area being injected. This shows real-time X-ray images during the procedure and your doctor will use this to guide the needle into the correct place.
The steroid injections are believed to have a relieving effect on your sciatic pain, which allows you to go for physiotherapy training and other rehabilitation programs.
You should be able to start physical therapy within a week of your injection. Injections are not a cure for back pain. It is the physical therapy that will help improve your medical condition in the long run. Remember to schedule physiotherapy sessions for your better recovery.
In addition to standard medical treatments, several alternative treatments including manual manipulation, acupuncture and massage therapy have shown some effects on pain relief.
- Manual manipulation
Manual manipulation is provided by trained health professionals such as chiropractors, physiotherapists, etc. It offers better spinal column alignment that may address potential causes of sciatica.
Acupuncture aims to use hair-thin needles to insert into the skin near the area of pain, achieving wellbeing through specific pathways of the body.
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