Sciatica

An Overview

Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body. Sciatica is a common type of pain affecting the sciatic nerve, a large nerve extending from the lower back down the back of each leg. Sciatica most commonly occurs when a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses part of the nerve. However, sciatica is not just limited to the back.

The sciatic nerve is the longest and widest nerve in the human body. It runs from the lower back, through the buttocks, and down the legs, ending just below the knee. The sciatic nerve is the longest nerve in the human body. The most common cause of sciatica is a slipped (herniated) disk. The sciatic nerve is the largest and longest nerve in the human body and begins with contributions from the lower lumbar and upper sacral nerve roots. It runs from the spine, through the pelvis, down the thigh and to the back of the knee where it branches into the tibial and peroneal nerves.

Symptoms of Sciatica

The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating pain. Sometimes it can feel like a jolt or electric shock. It can be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms. Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg is the hallmark of sciatica. Common symptoms of sciatica include:

  • Lower back pain.
  • You might feel the discomfort almost anywhere along the nerve pathway.
  • Pain in the rear or leg that is worse when sitting.
  • The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating pain.
  • Hip pain Burning or tingling down the leg.
  • Numbness in the leg along the nerve.
  • Weakness numbness or difficulty moving the leg or foot.
  • Tingling sensation (pins and needles) in the feet and toes.
  • A constant pain on one side of the rear.
  • A shooting pain that makes it difficult to stand up.

What Causes Sciatica?

Sciatica occurs when the sciatic nerve becomes pinched,. More rarely, the
Additional common causes of sciatica include:

  • Lumbar spinal stenosis (narrowing of the spinal canal in the lower back)
  • Usually by a herniated disk in your spine or by an overgrowth of bone (bone spur) on your vertebrae.
  • Cauda equina syndrome – a rare but serious condition that affects the nerves in the lower part of the spinal cord; it requires immediate medical attention.
  • Degenerative disc disease (breakdown of discs, which act as cushions between the vertebrae).
  • Spondylolisthesis (a condition in which one vertebra slips forward over another one).
  • Sciatica is caused by irritation of the root(s) of the lower lumbar and lumbosacral spine.
  • Pregnancy.
  • Muscle Spasm in the back or buttocks.
  • Tumors within the spine – these may compress the root of the sciatic nerve.
  • Nerve can be compressed by a tumor or damaged by a disease such as diabetes.
  • Other things that may make your back pain worse include being overweight not exercising regularly, wearing high heels or sleeping on a mattress that is too hard or too soft.

Diagnosis

During the physical exam, your doctor may check your muscle strength and reflexes. For example, you may be asked to walk on your toes or heels, rise from a squatting position and, while lying on your back, lift your legs one at a time. Pain that results from sciatica will usually worsen during these activities. The role of electromyography tests (EMG) and nerve conduction velocity tests (NCV) are not well defined and are not routinely used in the diagnosis of sciatica. An EMG or NCV may be ordered in the rare cases where a patient has persistent sciatica despite a normal spine MRI.

  • X-ray. An X-ray of your spine may reveal an overgrowth of bone (bone spur) that may be pressing on a nerve.
  • MRI. This procedure uses a powerful magnet and radio waves to produce cross-sectional images of your back. An MRI produces detailed images of bone and soft tissues such as herniated disks.
  • CT scan. When a CT is used to image the spine, you may have a contrast dye injected into your spinal canal before the X-rays are taken — a procedure called a CT myelogram.

Electromyography (EMG). This test measures the electrical impulses produced by the nerves and the responses of your muscles

Treatment

  • If your pain doesn’t improve with self-care measures, your doctor might suggest some of the following treatments.
  • Physical Therapy. Once your acute pain improves, your doctor or a physical therapist can design a rehabilitation program to help you prevent future injuries.
  • The mainstay of treatment includes nonsteroidal anti-inflammatories, alternating heat and ice, and staying active.
  • Steroid injections In some cases, your doctor might recommend injection of a corticosteroid medication into the area around the involved nerve root. Corticosteroids help reduce pain by suppressing inflammation around the irritated nerve.
  • Opioid pain medication and extensive bed rest should be avoided. This option is usually reserved for when the compressed nerve causes significant weakness, loss of bowel or bladder control or when you have pain that progressively worsens or doesn’t improve with other therapies.

Prevention

Some sources of sciatica may not be preventable, such as degenerative disk disease, sciatica due to pregnancy or accidental falls.

  • Exercise regularly. To keep your back strong, pay special attention to your core muscles the muscles in your abdomen and lower back that are essential for proper posture and align. Exercise includes stretching to keep your joints flexible and exercises to strengthen your core the muscles of your lower back and abdomen.
  • Maintain a healthy weight: Extra weight and a poor diet are associated with inflammation and pain throughout your body. To lose weight or learn healthier eating habits, look into the Mediterranean diet. Ask your doctor to recommend specific activities.
  • Don’t smoke: Nicotine reduces the blood supply to bones. It weakens the spine and the vertebral disks, which puts more stress on the spine and disks and causes back and spine problems.

Hope this Symptoms and cure article will be helpful to all. Do not forget to share your valuable suggestions if any.

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