The sciatic is the longest nerve in the body, beginning from nerve roots in the lumbar part of the spinal cord (lower part of the back) and extending through the buttock area to send nerve endings down to the legs. It connects the spinal cord and the leg/feet muscles.
Pain resulting from irritation of the sciatic nerve is called sciatica. It is a symptom rather than a disorder itself. It is important to understand this because it is the underlying diagnosis that needs to be addressed in order to relieve sciatic nerve pain.
The clinical diagnosis of sciatica is referred to as a radiculopathy. Radiculopathy means that a disc has protruded from its normal position in the vertebral column and is putting pressure on the radicular nerve (nerve root) in the lower back, which forms part of the sciatic nerve. This is most commonly a result of a disc herniation, which compresses the L5 or S1 nerve root found in the lower spine but any other irritation or inflammation of this nerve can lead to the symptoms of sciatica. A mechanical compression of the siatic nerve as a result of spondylolisthesis, arthritis or spinal stenosis may also cause the pain.
When the sciatic nerve is pressed, the pain that radiates along its path is typically felt at the back of the thigh and is usually difficult to ignore. Depending on where damage to the nerve occurred, the pain may be accompanied by symptoms such as numbness or tingling, a burning sensation or general weakness in the leg.
There is no danger of paralysis because the spinal cord is not present in the lower (lumbar) spine.
Over time, the nerve usually heals itself and pain gradually dissipates, given proper rest and care.
Depending on the severity of pain, aspirin or ibuprofen, muscle relaxants or cortisone injections may be prescribed, along with urging of regular exercise which helps ease inflammation. Relief for aching muscles can also be found in gentle cold or hot compresses.
There are a few sciatica symptoms that may represent a medical emergency. They are:
%26bull; Progressive weakness in the leg
%26bull; Bladder or bowel incontinence or dysfunction
Patients with either of the above symptoms are suspected of suffering from cauda equina syndrome and are advised to seek immediate medical attention.
In the so called risk group, who should contact their doctor if sciatica occurs, belong people who
have been diagnosed with cancer;
take steroid medication;
abuse drugs;
have unexplained, significant weight loss;
have HIV.
Before jumping to treatment, here are some useful tips when suffering from sciatic nerve pain:
- Sciatica will usually get better on its own, within a few days, or possibly a few weeks.
- If possible, stay at work and active
- If the pain forces you to rest, know that it is not a good treatment for sciatica. Try limiting time spent in bed
- Simple pain killers, including paracetamol or ibuprofen, may come in handy
- Do not necessarily put strain on your back.
- If the symptoms are present for more than a few days, consider seeing a physiotherapist, chiropractor or osteopath.
- An epidural injection into the spine may be helpful in cases of severe and disabling pain
- Complications arise in a minority of cases. Your doctor may suggest surgery if sciatica does not settle or complications occur.
- Most commonly, symptoms of sciatica pain decrease after a few weeks or months with non-surgical treatment.
Typical sciatica treatment
Depending on the nature of the diagnosed reason for sciatica, your doctor may recommend different treatment approaches. To cure sciatica symptom, the root cause needs to get eliminated.
Non-surgical treatment options
Cold packs are useful with minor irritations to the sciatic nerve. Cold packs reduce inflammation, muscle spasms and pain when placed on the affected area by slowing down the blood circulation. It can also be used in addition to the main therapy in more serious conditions.
Hot packs work by increasing blood flow to get more blood in the area of application in order to generate more oxygen and drive more nutrients in to affected area.
OTC medications like aspirin or ibuprofen belong to Non-Steroidal Anti-Inflammatory group of drugs. They act as pain killers and are help with reducing inflammation.
Prescription medications are stronger and prescribed in cases of chronic conditions or severe pain. These are muscle relaxants and anti depressants.
Regular exercises should be easy to be able to do them at home. All the exercises need to be adjusted to suit individuals needs. Your doctor may recommend swimming and walking and even yoga. A therapist will first train his patient to perform regular exercises, so they would be able to do them alone in their homes later on.
A doctor suggests stretching and strengthening exercises.
Stretching helps bring sustained pain relief. The type of exercises focus on increasing flexibility in the disc, muscles, ligaments, and tendons. It is important to stretch those muscles that are not directly involved with the injured area, such as the arms and legs.
Strengthening exercises are very important in the management of low back pain.
These exercises are designed to strengthen the %26ldquo;core%26rdquo; or trunk muscles. Two common forms of strengthening exercises to treat sciatica are McKenzie exercises and Dynamic Lumbar Stabilization exercises.
In order to be effective, these exercises must be done regularly (typically two times daily) and correctly. You need to make it your daily routine. The duration of these exercises are progressive starting from short periods and low reps at start.
Regular exercise is crucial for both current and recurrent episodes of sciatica and for overall back health. In addition to exercises, patients with sciatica should minimize everyday stress on the lower back by maintaining good posture, making sure the lower back is supported while sitting, and avoiding standing for long periods of time.
A patient is also likely to receive a complementary diet program during the therapy sessions to help them accelerate the body%26rsquo;s recovery.
Alternative treatments
Acupuncture bases its practice on the philosophy of achieving or maintaining well being through the open flow of energy via specific pathways in the body. The practitioner uses hair-thin needles and inserts them into the skin near the area of pain. This kind of practice has been approved by the U.S. FDA as a treatment for back pain, and the National Institutes of Health as effective in relieving back pain, including sciatica.
Massage - some forms of massage have been shown to have numerous benefits for back pain, including increased blood circulation, muscle relaxation, and release of endorphins - the body%26rsquo;s natural pain relievers.
Surgery
Surgery should be the last solution. There are different types of surgeries depending on the diagnosed root cause for sciatica.
Microdiscectomy is a microscopic surgery performed through a very small incision with very small instruments to remove either the whole or parts of a herniated disc.
Endoscopic Discectomy invloves a tube-like structure is inserted in the body and the operation is performed within. Recovery from endoscopic surgery takes longer than microscopic.
Percutaneous Discectomy is a way to remove a herniated disc from the back bone. A surgeon may decide to completely remove the disc or only a part of it.
Laser Discectomy, just like the name says, involves lasers to remove the herniated disk. This is the most recent development in surgical treatments that are available for sciatica.
Lumbar laminectomy (open decompression) is offered to those patients who suffer from lumbar spinal stenosis that causes sciatica pain that waxes and wanes over many years. After this procedure, around 70% to 80% of patients typically experience relief from their sciatic nerve pain.
Posts
