What is sciatica?
Sciatica is defined as pain in the lower limbs, resulting from irritation of the sciatic nerve. It is felt from ones lower back (lumbar area), buttocks, behind the thigh and radiating down, behind the knee up to the toes. It is in the distribution of sciatic nerve, which originates from four or six nerve roots, beginning from the spinal cord in the lumbar region.
What are the causes of Sciatica?
1) Disc herniation and bulge is the most commoncause which directly irritates or presses on one or more nerve roots.
2) Bony outgrowths called osteophytes.
3) Tumours.
4) Facet joint hypertrophy.
5) Internal bleeding within spinal canal.
6) Infections.
7) Trauma.
8) Pregnancy (in rare cases).
What are the symptoms of Sciatica?
Sciatica causes pain,burning sensation, numbness or tingling radiating from lower back and upperbuttock down the back of thigh to knee to calf and foot. The result is lumbaror low back pain, buttock pain, thigh pain, calf pain and foot pain. Sometimesleg pain is not accompanied by back pain. If the pain is severe, walkingbecomes difficult. Pain is worsened while bending forward, lifting weights andwalking. It is relieved by rest and lying down.
Diagnosis of Sciatica
1) History with above mentioned symptoms.
2) Physical examination in which the doctor findsthat the patient’s pain is present in the lower back and when the straight legraising test is positive.
3) X-rays will reveal that intervertebral spacemay be reduced.
4) MRI is a standard tool in diagnosing slip discsor any cause resulting in sciatica. It will show if there are disc relatedproblems like herniation, bulges which directly compresses the nerve root. Alsofacetal arthropathy, tumour, osteophytes, infections can be detected accuratelyon MRI.
Management of Sciatica
About 70-80% of patients,who have sciatica, improve and recover completely within 2-3 months, with orwithout treatment. It is those 20-30% patients who require treatment even after3 months of onset of pain.
1) Bed rest- Not more than few days of bed restis recommended.
2) Analgesics and muscle relaxants
a. Recommended for few days as there isinflammation and muscle spasm in the lower back.
3) Physiotherapy and exercises
Sciatica is acommon problem in general population causing chronic pain and loss of working hours. With advent ofnewer and safer interventional techniques patients can get rid of their painvery effectively and safely without compromising their work, family and social life .
