SCIATICA

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Sciatica is the longest and widest nerve in your body, branches from your lower back to the back of each leg. This nerve provides sensual feelings to the skin of your foot and the lower leg and also controls several other functions of muscles in your lower legs. Typically, sciatica is not a disease; it’s a symptom of other problems where the sciatic nerve involved.

What Is Sciatic Pain?

Sciatica pain is a lower back pain caused due to the irritation or inflammation of the sciatic nerve. Usually, the pain radiates along the path of the nerve from the lower back down the leg through your hips and buttocks. Typically, sciatica pain occurs on only one side of the body, and the pain ranges from mild to severe.

Approximately 40% of people may experience this sciatic pain at a particular stage in their life. Many studies also state that sciatica is common among 25 to 45 years aged people. 

Causes Of Sciatica 

Sciatica is caused because of excess due to compression of the sciatic nerve by the surrounding tissues. The nerve might get affected anywhere in the spinal canal as it stretches to the foot. The common causes of sciatica include; 

  • A Herniated Or Slipped Disc: It is one of the most prevalent reasons for sciatic pain. Sciatica occurs when a disc in the spinal cord is relocated or damaged. The slipped disc creates excess pressure on the sciatic nerve and leads to pain. 
  • Piriformis Syndrome: Piriformis is a small muscle which lies deep in the buttocks. If the piriformis muscle becomes tight and spasms, it creates excess pressure and starts irritating the sciatic nerve, which ultimately leads to sciatica. 
  • Spondylolisthesis: This is a condition where the vertebra(bone) slips and falls on one another. In such cases, the opening, where the sciatic nerve exits are narrowed and lead to sciatica. 
  • Spinal Stenosis: Spinal stenosis and bone spurs is a condition where the spinal canal narrowed. As a result, it creates extra pressure on the Sciatic nerve causing intense pain. 
  • Degenerative Disk: In this condition, the intervertebral disc starts degenerating with age or due to some other pathological diseases. It alters the shape and function of the disc and results in disc bulging or herniated disc. 

Some other risk factors, along with the above causes include injuries to the spinal cord or trauma, obesity, pregnancy, wearing high heels, lack of physical activities, diabetes, age etc. 

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Signs & Symptoms Of Sciatica 

In the starting stage of sciatica, it exhibits the most common symptoms like lower back pain, sharp pain in the thighs radiating to foot and along with this some other symptoms which include: 

  • Pain in the leg which may worsen when sitting
  • Difficulties in walking or moving legs
  • Pain in the hip
  • Persistent pain in buttocks
  • Numbness and weakness in the legs
  • Burning or tingling (pins and needles) sensation in the legs 

Usually, sciatica affects one side of the lower body only and depends on where and how the sciatic nerve is affected.

How To Treat Sciatica? 

Most of the people with sciatic pain get better within days or a few weeks. Your first instinct may be taking rest when you have sciatica, but actually, it’s more important to move here and there. This movement will reduce the inflammation of the sciatic nerve. 

Medication  

If the condition doesn’t get better, the doctor might suggest placing cold packs or hot packs on your lower back for a few days and also recommend some OTC pain relievers like ibuprofen and naproxen sodium. If the pain worsens over time, some drugs are also prescribed under the guidance of a doctor, which include: 

  • NSAIDs like meloxicam and diclofenac
  • Acetaminophen and other muscle relaxants like cyclobenzaprine and tizanidine
  • Narcotics like codeine, Vicodin, morphine for severe pain
  • Tricyclic antidepressants
  • Anti-seizure medications 

Physical therapy  

Physical therapy decreases the sciatic pain by reducing pressure on the nerve. The program includes exercises to correct your posture, aerobic exercise, stretching exercises which improves the flexibility of muscles and to strengthen the muscles supporting your back. Some other exercises are also preferred by the therapist, which strengthen your back, abdomen, and legs muscles.

Spinal injections  

In some cases, anti-inflammatory medicine like corticosteroid injections, is given to reduce swelling and inflammation of the nerve roots to increase mobility.  However, these steroid injections are given limitedly because of the risk of severe side effects, if you take the doses too frequently. 

Surgery 

In worse conditions, when the compressed nerve causing loss of bladder control, or irregular bowel movements, significant weakness. Surgery is also an option when the pain doesn’t improve with medication or other therapies and worsen with time. The surgery involves removing the bone spur or part of the herniated disk that crushing the pinched nerve.

Surgical options include: 

Microdiscectomy: The procedure involves removing the fragments of a herniated disc. 

Laminectomy: The bone that curves around and covers the spinal cord (lamina), and the tissue that is causing pressure on the sciatic nerve will be removed.  

Many people think that yoga or acupuncture can fix sciatica. Massage might give relief from muscle spasms which occur along with the sciatic nerve. However, consulting a doctor is the best way for the best treatment options.

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