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Sciatica pain — causes, symptoms, diagnosis, treatment and complications

Sciatica-painMany people who complain about lower back pain that travels down the legs suffer from a condition called sciatica pain. While acute sciatica pain can be relieved within 1-2 months, ignoring the condition for a long time may result in flare-ups that worsen with time, interfering with simple daily activities like walking, standing and sleeping. Therefore, a better understanding about the condition is needed.

What is sciatica? 

Sciatica is a condition resulting in back pain due to irritation or compression of the sciatic nerve. The sciatic nerve is the longest nerve in your body running from the back of your pelvis, through your buttocks, and all the way down both legs, ending at your feet. Compression of the sciatic nerve can cause pain that radiates out from your lower back and travels down your leg to your calf. Sciatic pain can range from being mild to very painful.

What are the common symptoms of the condition?

Sciatica is different from general back pain. Sciatica pain hardly affects the entire back. It radiates from the lower back, down to the buttocks and into one or both of the legs, right down to the calf. Some patients even complain about shooting pain while sneezing, coughing or laughing, standing or sitting for a long period of time and while bending backwards. Patients who have long period of numbness in their bottom, lower back and leg or those who experience loss of bladder or bowel control and often feel weakness in their leg and foot must visit a doctor immediately.

If a person is susceptible to suffer from the condition, what precautions should they take?

Although it is not always possible to prevent sciatica, there are several things you can do to prevent a slipped disc or other back injuries that could lead to sciatica. Here are some general precautions that you should take:

  • Maintain a better posture at work
  • Avoid sustained periods of sitting
  • Be careful while lifting anything
  • Maintain correct posture while lifting
  • Always stretch before and after exercise
  • Exercise regularly to improve your strength and flexibility.

Who is most likely to suffer from this condition?

Sedentary lifestyle is one of the major reasons people suffer from sciatica pain. People who have to perform work involving frequent bending and twisting, lifting heavy weights are more likely to suffer from the condition. Being overweight is also a risk factor. It can put extra strain and pressure on your back, leading to sciatica.

What are the various ways to diagnose the condition?

Leading causes of chronic sciatica include disc prolapse, disc herniation, piriformis syndrome and muscle weakness. Primary diagnosis is usually done by a general practitioner based on physical examination. Depending on your symptoms, your GP may find it necessary for you to undergo further tests, which may include a blood test to rule out infections, imaging tests such as X-ray or CT scan or MRI scan.

In India, patients can now benefit from Digital Spine Analysis Test. It is a non-invasive functional test of back musculature and helps to measure strength, mobility and alignment. 21 different parameters can be plotted using the test which helps spine consultants to accurately understand the root cause of the condition.

How is it treated?

In the early stages, doctors advise the patients to be physically active as much possible. While bed rest may provide some temporary pain relief, prolonged bed rest may be unnecessary. Walking and gentle stretching exercises may also be advised as part of treatment. Many people find that using either hot or cold compression packs helps to reduce pain.

Treating persistent or advance stage sciatica usually requires a combination of self-help techniques and medical treatment. Treatment options include painkillers in injectable format or epidural steroid injection and physiotherapy.

Medication: For early stage chronic sciatica doctors prescribe painkillers, either paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs).

Exercise: Regular exercise will help to strengthen the muscles that support your back. Exercise also stimulates the production of endorphins, which are natural painkilling chemicals.

Surgery: Surgery may be an option to treat cases of chronic sciatica when, there is an identifiable cause, such as a slipped or herniated disc or if the symptoms are getting progressively worse. Surgical options may range from discectomy or fusion surgery or laminectomy or a combination of these. Before opting for spinal surgery, the orthopedic surgeon will discuss the relative risks and benefits with the patients.

Advances in treatment: A modern approach to treatment is using a combination of Digital Spine Analysis (DSA) test and treatment program practiced at Qi Spine Clinic. The treatment involves effective usage of evidence based techniques combined with the DSA treatment protocols to strengthen effected musculature, thereby delivering faster and lasting treatment.

What are the complications if the condition is left untreated? 

Complications of sciatica could lead to partial immobility of the leg and partial or complete loss of feeling (sensation) in the effected leg. It could lead to severe functional disabilities like limitation in sitting, standing, walking and sleeping.

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