Sciatica

Have you ever experienced pain starting in the buttock and radiating to the back of the thigh and down to the calf or foot? That pain could be sciatica. Lets us understand what is sciatica, its causes and how to get relieve from sciatica pain and what is the best treatment for sciatica in this article.

The sciatic nerve is the thickest nerve in the body. Sciatica is described as the pain developed due to irritation and compression of sciatic nerve. It radiates along the path from your lower back and buttocks down to each leg. The pain can vary from moderate to severe and weakness and numbness can be experienced in these areas. About 40 percent of people suffer from Sciatica at some point in their lives. It causes muscle weakness in the foot and hamstring muscles and tingling in leg, foot and toes.

Sciatica Diagnosis

Physical Examination : During the physical examination, the doctor might check for localized pain in the lower back, buttocks and legs.
Clinical Tests
Straight leg raise test : The patient is asked to lie on his back and lift one leg at a time with another bent at the knee. If the pain occurs and radiates along the course of the sciatica nerve, your pain is related to sciatica.
Medical history and test imaging : The doctor might order some medical imaging and learn about the patient’s acutal cause of sciatica.

Typically tests done are

Dynamic X-rays of the lumbar spine in AP, lateral flexion and lateral extension views: This helps to understand the alignment of the spine and to detect if there is any abnormal movement between the bones of the spine which can cause sciatica pain
MRI of the lumbar spine: This helps to understand the exact condition of the bones, discs, nerves, joints and the ligaments of the spine and form a sciatica diagnosis

Causes

Disc herniation or slip disc: It presses and irritates the lumbar nerve roots giving rise to sciatica pain
Spondylolisthesis (condition which occurs when one vertebra slips over another) leading to compression of the nerves in the spine which cause sciatica pain
Degenerative disk disease
Being overweight
Aging (aging spine compresses lower back nerves)
Lumbar spinal stenosis
Piriformis syndrome (inflammation can cause muscle and compress sciatic nerves)
Spinal tumors (tumor in the lumbar spinal can cause nerve compression)

Spine Infections: Spine infection can lead to abscess formation that creates pressure on the nerve roots and leads to sciatica pain

Risk factors

Diabetes increases the risk of nerve damage
Heavy lifting and prolonged sitting can cause strain on your back.
With age, the body parts tend to experience break downs and wear and tear.
Smoking can cause the outer layer of spinal discs to break down
Obese body increases stress on the spine which triggers sciatica.
Vitamin B 12 deficiency
Poor work ergonomics
Genetic susceptibility

Sciatica Treatments

It is advisable to treat sciatica at the initial stages only to avoid progression of symptoms.

A) Nonsurgical Sciatica Treatment

Acute sciatic nerve conditions are generally treated by non-surgical treatments. The non surgical sciatica treatment is a combination of physical therapy,medications, therapeutic injections and alternative therapies which provides a cure in about 4 to 6 weeks.

Trained health professionals and physical therapists formulate an effective non surgical sciatica treatment plan which includes certain exercise. These exercises provide relief from sciatic pain and increase core strength.

Medications are the second step which is used to relieve sciatic pain. Nonsteroidal anti-inflammatory drugs, oral steroids,anticonvulsant medications, antidepressants and opioid analgesics are generally prescribed by the doctor for a short duration.

Chiropractic and massage therapy are techniques used to address the underlying cause of sciatic nerve pain that can be herniated discs or spinal stenosis. Massaging improves the blood circulations and relaxes the tight muscles that can be a contributing factor for pain. Massage induces the release of endorphins which acts as natural pain relievers.

Some common injections such as Epidural steroid injections and selective nerve blocks are administered for controlling the inflammatory response around the sciatic nerve and reduce the production of inflammatory cells in the body. Selective nerve root blocks provide instant relief from the pain and inflammation in some cases.

B) Surgical Sciatica Treatment

Surgery for sciatica is needed if the pain persists for a long duration even after several non- surgical sciatica treatments.

Microdiscectomy

It is a common approach used for treating sciatica caused by a lumbar disc herniation. It is a minimally invasive technique done by making small incisions and causing minimal damage to the surrounding tissues.

Minimally invasive Lumbar decompression

It is usually done to treat the sciatica pain caused by lumbar spinal stenosis. In this, all part of the lamina is removed making more space for the spinal nerves. It provides relief from nerve root compressions and irritation.

There are several other surgical approaches such as foraminotomy, facetectomy, lamino-foraminotomy, laminectomy that are performed depending upon the cause of sciatic pain.

Prevention

Exercise regularly :
Strengthening of core muscles and back muscles is essential for maintaining a healthy spine and proper posture.
Keep a check on weight you lifting :
Lift heavy objects in a proper way by bending at your knees and keeping back straight
Change your positions :
Don’t stand or sit for too long ,rest one foot on a stool from time to time in case of constant sitting. Pain can be an early warning
that your body is not perfectly aligned. If you start to feel sore, change your posture.
Quit smoking :
Nicotine weakens the spine andvertebral discsasit reduces the blood supply to the bones. This puts more pressure on the spine
and discs and causes back problems.
Maintain bodyweight :
Avoid consumption of high calories and fats.Maintaining a healthy weight is essential as the increased body can put extra pressure on the spine.

We at Pune spine Institute are leading expert in treating spinal problems and injuries. We have the best sciatica pain specialists who will help you understand the causes and choices of sciatica treatment better. Register or walk-in today to experience the difference.

Frequently Asked Questions

Q. What causes sciatic pain during pregnancy?

A. During pregnancy, a bundle of nerves gets pressed between the growing baby and pelvic bones that causes sciatica.

Q. When to see a doctor?

A. If you experience severe pain in lower back and numbness in your leg or your symptoms have been present for more than 3 weeks or you haveanytrouble controlling the bowels or bladder than you should visit a doctor as these may the symptoms of worsening of sciatica and impending nerve damage.