What is Sciatica?
Sciatica describes the pain that spread from the lower back to the hips and buttocks then down to the leg. This pain is associated with the sciatic nerve and it normally involves one side of the body.
Sciatica usually happens when the part of the nerve is press by a herniated disk or a bone spur, thus causes inflammation, pain and numbness on the affected leg.
What are the Symptoms of Sciatica?
Most patients with Sciatica condition describe the symptoms includes:
- Pain on one side of the buttock or in one leg that is worse when sitting
- Burning or tingling down the leg
- Weakness, numbness or difficulty moving the leg or foot
- A constant pain on one side of the rear
- A sharp pain that may make it difficult to stand up or to walk
At times, the pain could get more severe when cough, sneeze or sitting for a long period of time.
What are the causes for Sciatica?
- Herniated disk
- Bone spurs on spine
Sciatica occurs when the sciatic nerve becomes pinched, usually by a herniated disk in your spine or by an overgrowth of bone (bone spur) on your vertebrae. More rarely, the nerve can be compressed by a tumor or damaged by a disease such as diabetes.
What are the Risk factors for Sciatica Condition?
Risk factors for sciatica include:
- Age. Age-related changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica.
- Obesity. The excessive body mass increase the amount of pressure on the spine which may trigger sciatica
- Occupation. It is said that jobs that involves twisting of back, carrying heavy loads or driving long hours may cause sciatica, yet there are still no studies result to this factor.
- Prolonged sitting. People who are deskbound have the higher chances of getting sciatica than people who have an active lifestyle. people
- Diabetes. It interfere with the how the body function using the blood glucose, and thus amplifying the risk of nerve damage.
What are the Complications of Sciatica?
Even though many people get better from sciatica without any form of treatment, it can still inflict permanent nerve damage. It is recommended that you seek immediate medical assistance if you encounter:
- Loss of feeling in the affected leg
- Weakness in the affected leg
- Loss of bowel or bladder function
What are the Tests and diagnosis for Sciatica?
The doctor will examine the strength and reflexes of your muscle by asking you to do some movement or static exercise. At the same time checking if the pain gets worse during the activities.
The doctor may also take some image test to examine the trigger point of sciatica. Imaging test such as:
Magnetic resonance imaging (MRI)
Computerized tomography (CT) scan
Treatments and drugs
If the pain persist or gets worse even after self-care measures, the doctor may suggest other treatment methods such as:
The types of drugs that might be prescribed for sciatica pain include:
- Muscle relaxants
- Tricyclic antidepressants
- Anti-seizure medications
When the pain improves, the doctor or physical therapist will recommend a series of physiotherapy session to help improve strength, flexibility, posture and also preventing injuries from reoccurring.
Injection of corticosteroid medication can be injected into the area where the damaged nerve root is. Corticosteroid can ease the pain by stopping or slowing down the inflammation near the nerve. The pain relief effects will subside with a few months. Due to increasing risk of serious side effects for every steroid injection given, thus there will be a limit to the number of dose each person can receive.
If the Sciatica pain becomes worse within 6 to 12 weeks, patient should consider getting a lower back surgery.
- A microdiscectomy (or small open surgery)
- A lumbar laminectomy (an open decompression)
Microdiscectomy for Sciatica
If the sciatica pain is caused by a lumbar disc herniation, a microdiscectomy or small open surgery can be done. This surgery will remove a portion of the herniated disc which is putting pressure on the nerve.
Microdiscectomy should be considered if the pain is not ease after 4 to 6 weeks of non-surgical treatment. If the pain deteriorate and become worse, patient may seek for surgical treatment even before 4 to 6 weeks.
Lumbar Laminectomy for Sciatica
If the sciatica pain is caused by lumbar spinal stenosis, a lumbar laminectomy can be done. This surgery will remove a small part of the bone and/or disc material which is putting pressure on the nerve.
Laminectomy should be considered if the pain increases to an unbearable level, however the patient’s general health plays a part on whether to have the surgery or not to.
According to surgical history for lumbar laminectomy, about 70 to 80 percent of patients get relief from their sciatic nerve pain.