What is Sciatica?
Sciatica is a symptom which results in pain that radiates along the sciatic nerve. The sciatic nerve is a nerve that emerges as several nerve roots from the lower back.
The nerves join together to form the sciatic nerve, which passes through the hip and buttock on either side and down on each leg. Sciatic pain usually presents as a shooting pain that can become worse on prolonged sitting, sneezing or coughing.
Pressure on sciatic nerve or the nerve roots forming the sciatic nerve can lead to sciatica.
Sciatica causing conditions are:
- Slipped disc, where a disc between vertebrae moves out of its place
- Piriformis syndrome, where a small muscle called the piriformis presses over the sciatic nerve
- Spinal stenosis, where there is narrowing of the central cavity of the backbone that houses the spinal cord
- Spondylolisthesis, where a vertebra slips over the next
- Pelvic injury or fracture
- Tumors of or around the spine
- Other conditions like overweight, no regular exercise, wearing high heels, sleeping on soft mattress, etc.
Signs and symptoms of sciatica include the following:
- Constant pain in the back or leg, usually on one side, which gets worse on sitting and makes it difficult to stand or move.
- Burning or tingling sensations in the leg.
- Feeling of weakness or numbness on the affected side of the lower limb
Diagnosis of sciatica is based on:
- Complete medical history and physical exam
- Straight-leg-raise test: This test is done to diagnose a slipped disc. Raising of leg in a lying down position causes pain in the back in patients with a slipped disc.
Other diagnostic tests recommended or performed depending on the suspected cause of sciatica include:
- X-ray of the backbone
- Nerve conduction studies of the sciatic nerve
- Myelogram, where a dye is introduced in the spinal canal
- Magnetic resonance imaging (MRI) or computed tomography (CT) scan
Patients of sciatica are advised to rest on the floor or firm mattress. Treatments for sciatica include the following:
- Medications usually include painkiller drugs like aspirin, ibuprofen and naproxen. Muscle relaxants like cyclobenzaprine are used to relieve muscle spasms. Anti-inflammatory cortisone injection may be directly administered into the back.
- Physical therapy includes exercises to improve the muscle strength and flexibility of muscles of back, abdomen, and legs. Yoga and massage may also help
- Surgery is done if patients are not responding to conventional treatment, or experience severe pain. Surgery may also be considered in those who develop bowel and/or bladder problems or weakness of a leg. Surgery is performed to relieve the pressure on the nerve.
- Other therapies like acupuncture may help. Biofeedback may also be used which is a technique that improves the ability to cope with pain.
Sciatica may always not be prevented and condition may recur. However, some steps may help to avoid its occurrence:
- Regular exercise
- Practice correct techniques for lifting up loads
- Avoid cigarette smoking since it can damage the discs between vertebrae
- Maintain good posture for a healthy back
- Avoid sitting in one place for a long time.
Self-care treatments include:
- Use of cold or hot packs to relieve pain
- Stretching exercises under the guidance of a trained person
- Over-the-counter painkillers to relieve pain
- Sciatica - (http://my.clevelandclinic.org/health/diseases_conditions/hic_What_is_Sciatica)
- About Sciatica - (http://www.mayoclinic.org/diseases-conditions/sciatica/basics/definition/con-20026478)
- Pain Management and Sciatica - (http://www.webmd.com/back-pain/guide/sciatica-symptoms)
- More on Sciatica - (http://www.nlm.nih.gov/medlineplus/ency/article/000686.htm)
- Information About Sciatica - (https://en.wikipedia.org/wiki/Sciatica)
- What is Sciatica ? - (http://www.nhs.uk/Conditions/Sciatica/Pages/Introduction.aspx)
Latest Publications and Research on Sciatica
- A Prospective Long-term Follow-up Study of the Posterior Dynamic Stabilizing System to Treat Back Pain Associated With Degenerative Disc Disease. - Published by PubMed
- Anticonvulsants for the Treatment of Low Back Pain and Lumbar Radicular Pain. - Published by PubMed
- Pulsed radiofrequency for low-back pain and sciatica. - Published by PubMed
- Numbness and Weakness Recovered at a Less Extent in Patients with Lumbar Disc Herniation after Percutaneous Endoscopic Lumbar Discectomy. - Published by PubMed
- Changes in resting-state functional connectivity in nonacute sciatica with acupuncture modulation: A preliminary study. - Published by PubMed