Sciatica

Definition and Symptoms

Sciatica is a set of symptoms that point to a physical disease rather than being a separate condition. The term sciatica essentially refers to pain along the sciatic nerve, which is the largest nerve in the human body.
In particular, the sciatic nerve originates in the lower back and terminates in the back of the knee. The symptoms of sciatica occur when this nerve is compressed or damaged in some way.

Share:
  • Contralateral buttock or leg pain. Pain intensity and frequency vary among patients.
  • Pain that worsens when seated, or even when sneezing or coughing
  • Tingling or burning sensation in one leg
  • Numbness in one leg
  • Muscle weakness or muscle cramps in one leg
    The frequency of sciatica is increased in middle-aged people.

Symptoms

Causes of Sciatica

A herniated disc in the lumbar spine, which can irritate the sciatic nerve root, is the most frequent cause of sciatica.

Other reasons that cause pressure or inflammation on the sciatic nerve root and, therefore, sciatica are:

  • Degenerative disc disease: Degeneration of the spinal discs, usually age-related
  • Piriformis syndrome: A condition in which spasms occur in the piriformis muscle, affecting the sciatic nerve
  • Lumbar spinal stenosis A condition that causes pressure on the sciatic nerve where it exits the spinal canal
  • Spondylolisthesis

Treatment Options

Patients with sciatica have a variety of treatment options available to help treat their pain.

Conservative, non-surgical treatments

Most sciatica patients respond to such types of treatments, which usually include applying alternating heat and cold to the area for 20 minutes every two hours, taking OTC anti-inflammatory medications, and physiotherapy sessions.
Specific physiotherapy exercises for sciatica, i.e., stretching, muscle strengthening, and gentle aerobic exercise, are effective in both relieving pain and preventing future episodes of sciatica.
Muscle relaxants, steroids, antidepressants, opioids, or anticonvulsants may be administered when symptoms are more severe or persistent.
In addition, these patients may benefit from epidural steroid injections in the surrounding area, with the aim of reducing inflammation. Specifically, about 50% of patients receiving epidural steroid injections report some pain relief.

 

Invasive Treatments

Surgical treatments are indicated for patients who experience gradual deterioration of their sciatica symptoms, chronic pain, or more severe symptoms, e.g., urinary or fecal incontinence. Primary invasive treatments for sciatica include:

  • Microdiscectomy: A minimally invasive technique typically used to treat herniated discs, in which a portion of the injured disc is removed.
  • Lumbar laminectomy (decompression): The removal of the lamina (back part) of the vertebra which causes spinal narrowing, followed by decompression of the sciatic nerve.

 

Alternative Treatments

Alternative treatments are recommended to sciatica sufferers who wish to avoid prescription drugs, steroid infusions, or surgical procedures. Often, they are recommended as adjunct options to the above treatments.
Acupuncture, chiropractic (localized massage), and physiotherapy are some of the mainstream alternative treatments provided by specially trained experts.
Other alternative treatments include yoga, biofeedback, and transcutaneous electrical nerve stimulation (TENS).

Share: