Sciatica – Condition

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Overview

Sciatica is a kind of pain that spreads down each leg and down the course of the sciatic nerve, which runs from your lower back to your hips and buttocks. Sciatica is caused by a pinched nerve in your lower back or neck.

This condition is caused by compression of a portion of the nerve, which may be caused by a ruptured disk or constriction of the spine. Inflammation, discomfort, and numbness are all common symptoms on the side of the body that has been damaged by the injury. Despite the fact that sciatica may cause excruciating pain, the vast majority of cases resolve without the need for surgery within a few weeks of being diagnosed.

Injury to the sciatic nerve may cause sciatica. The sciatic nerve is the longest and thickest nerve in the body.

Despite the fact that genuine sciatic nerve injury is rare, the term “sciatica” is often used to describe any pain that begins in the lower back and travels down one or both of the legs. It is believed that nerve injury in your lower back is the source of the pain. Irritation, inflammation, pinching, or compression of a nerve are all possible causes.

Causes

When the sciatic nerve is pinched, it is referred to as sciatica. A herniated disk in the spine most often causes this disease, but it may also occur as a consequence of a herniated disk in the neck. In certain cases, a tumor may compress the nerve, and other conditions such as diabetes might cause it to be damaged.

A herniated disc in the lumbar region is responsible for most of the cases of sciatica. Typically, a herniated disc compresses one or more of the spinal nerve roots that are responsible for the formation of the sciatic nerve. A herniated lumbar disc in one of two ways causes sciatica:

1.      Direct compression: It is possible for a lumbar disc to bulge or for the soft inner material of the disc to seep out or herniate through the fibrous outer core and push on the sciatic nerve.

2.      Chemical inflammation: It is possible that an acidic chemical irritant from the disc will seep out and cause inflammation and irritation in the region around the sciatic nerve.

A herniated disc may compress the sciatic nerve on one side, resulting in symptoms in just one leg, or the disc may bulge or herniation from both sides, resulting in symptoms in both legs and lower back pain.

Another cause is degeneration. The sciatic nerve may be compressed or irritated because of the degeneration of tissues in the lumbar spine. It may cause the synovial tissue in the joint’s capsule to become inflamed and swollen, which can lead to further joint degeneration. Abnormal bone growths may result from the degeneration of vertebral bone. Inflammatory proteins may be secreted by degenerated intervertebral discs, resulting in irritation of the sciatic nerve in certain cases.

Symptoms

Sciatica is characterized by radiating pain that spreads from your lower (lumbar) spine to your buttocks and down the back of your legs. You may have pain nearly anywhere along the nerve route, but it is most likely to occur along a line that runs from your low back to your buttocks, as well as the back of your thigh and calf muscles.

There is a broad range of discomfort that may occur, from a little ache to a sharp, burning feeling or agonizing agony. The sensation may be similar to that of a jolt or electric shock at times. It may be made worse by coughing or sneezing, and sitting for extended periods of time can exacerbate symptoms. It is common for just one side of your body to be impacted.

Some individuals experience numbness, tingling, or muscular weakness in the leg or foot that is affected by the condition. You may be experiencing pain in one area of your leg while experiencing numbness in another.

Diagnosis

A correct diagnosis of sciatica is critical in developing an appropriate treatment strategy and in effectively managing sciatica symptoms. When a doctor suspects that a patient has sciatica, he or she will obtain a medical history and do a physical examination. It may be necessary in certain instances to perform medical imaging tests or provide diagnostic nerve blocks.

The doctor may check for the following symptoms during a physical examination:

·         Localized pain in the low back

·         The nerve’s response to leg movements that cause it to expand (straightening the leg)

·         It is possible to quantify and record the response to specific stimuli, such as lightly stroking the toes or calf region.

Furthermore, the doctor may do specialized clinical tests to establish whether the patient is experiencing sciatic nerve pain. These tests for sciatica include “Slump test and Straight leg raise (SLR) test.”

Imaging tests like MRI and CT-scans are also performed in order to establish sciatica diagnosis.

Treatment

Physical therapy, medicines, therapeutic injections, as well as alternative therapies are generally used as first-line treatments for sciatica. Nonsurgical therapy for acute sciatica typically takes 4 to 6 weeks.

Physical therapy is an important part of sciatica treatment strategy since it combines strengthening, flexibility, and aerobic fitness. It includes trap exercises. 

Sciatica pain may be treated with both prescription and OTC medicines. The following are some examples of medicines used to alleviate sciatica pain:

·         NSAIDS

·         oral steroids

·         anticonvulsant drugs

·         opioid analgesics

These medications are often used to relieve discomfort and enable patients to engage in physical therapy. To prevent addiction, drugs like opioid analgesics are usually given for brief periods.

When to see a doctor

Mild sciatica typically subsides on its own with time. If self-care methods fail to relieve your symptoms or if your pain persists for more than a week, is severe, or gets progressively worse, see your doctor immediately. If you’re having difficulty regulating your bowel or bladder, and experiencing any of the following symptoms, get medical attention right away: pain, numbness, or muscular weakness in your lower back or legs that comes suddenly, is severe, seek medical attention immediately.