Nervous System

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Sciatica

What is sciatica?

Sciatica is a general term that refers to any type of pain caused by pressure on or inflammation of the sciatic nerve.

The sciatic nerve is the longest nerve in the body. It starts at the back of the pelvis and runs under the buttocks and down through the legs until it ends down in the bottom of the feet

Pain often occurs in the buttocks and legs and usually lasts for several weeks to then resolve spontaneously, except in some cases where it may persist for a year or more.

Cause:

In most cases, sciatica is caused by a herniated disc at one of the vertebrae, which often occurs with age.

The less common causes include:

Spinal stenosis
Spondylolisthesis
Inflammation or injury of the spine
Spinal tumors
Cauda equina syndrome

Symptoms:

If the sciatic nerve becomes compressed or inflamed, this may cause:

Pain
Numbness
Tingling sensation extending from the lower back down to the toes
Weakness of leg muscles or the muscles that move the foot and the ankle

The severity of pain varies from mild to very severe and it intensifies when sneezing or coughing or after prolonged sitting.

Although many people with sciatica suffer from back pain, pain associated with this condition is usually confined to the buttocks and legs.

Diagnosis:

It can be diagnosed by:

Spinal CT scan
Spinal MRI scan

Risk factors:

Age
Bodyweight
Nature of work
Prolonged sitting
Diabetes

Complications:

Although most people recover completely from sciatica and often without treatment, it can cause permanent nerve damage. Therefore, a doctor should be consulted in case of any of the following symptoms:

Loss of sensation in the affected leg
Weakness of the affected leg
Loss of bowel or bladder function

Treatment:

If the pain does not improve spontaneously with self-care, a doctor may recommend some of the following treatments:

Medications:

There are some medications that can be prescribed for sciatica pain, including:

Anti-inflammatory medicines
Muscle relaxants
Narcotics
Antidepressants

Physiotherapy:

Once the acute pain improves, the physiotherapist or doctor would set a plan or program to rehabilitate the patient in order to avoid future injuries. The program usually includes special exercises to correct the posture, strengthen the muscles of the back and improve flexibility.

Steroid Injection:

In some cases, your doctor may recommend injecting a corticosteroid drug into the area around the root of the nerve to help reduce the pain by eliminating the inflammation around the inflamed nerve. Its effect lasts only for several months.

It should be noted that steroid injections are attempted only on a limited basis because the risk of side effects increases with frequent use.

Surgery may be considered as the last resort.

Prevention:

Sciatica is not thought to be preventable and it may recur. However, there are several measures that may contribute significantly to the protection of your back, including: