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Sciatica

 

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The sciatica nerve is derived from the fourth and fifth lumbar as well as the first and second sacral nerve roots. It provides nerve supply to the lower limbs. In the meantime, heat and cold applications, over-the-counter pain relievers, and exercise or physical therapy can help ease the discomfort of sciatica and speed recovery. Our aim is to promote understanding for healthcare professionals and for the general public by providing access to basic scientific and practice information which may help with diagnostic and treatment decisions involving sciatica.

This nerve is commonly injured in the fracture of the pelvis or femur, in knife stab wounds and gun shot wounds of the buttock and thigh. It may also be involved by pelvic tumors and in diabetes. A ruptured lumbar disk often stimulates sciatic neuropathy also known as sciatica. Although sciatica is a relatively common form of low back pain and leg pain, the true meaning of the term often is misunderstood. About one in every 50 people experience a herniated disk. Of these, 10-25 percent have symptoms lasting more than six weeks. About 80-90 percent of people with sciatica get better, over time, without surgery.

Sciatica is generally caused by the compression of a lumbar spine nerve root, and, far less commonly, by compression of the sciatic nerve itself. It is quite a common complaint. sciatica is caused by pressure on the sciatic nerve which runs down into the leg. The term "sciatica" refers to pain that radiates along the path of this nerve from your back into your buttock and leg. Sciatica is usually caused by pressure on the sciatic nerve from a herniated disc (also referred to as a ruptured disc, pinched nerve, slipped disk, etc.) in the lumbar spine. Sciatica pain is typically felt from the low back to behind the thigh and radiating down below the knee . Individuals who have sciatica are often crippled by it, and are driven to seek relief from conventional medical treatment, alternative therapies, and "miracle" cures. The most commonly associated muscles with trigger points triggering sciatic symptoms are: the quadratus lumborum, the gluteus medius, the gluteus minimus, and the deep hip rotators. Sciatica is pain arising in the sciatic nerve, most often from abnormal pressure on its roots at the spinal cord.

It is often assumed that there is sciatic nerve root entrapment, resulting in the compression of the nerve. Sciatica (lumbar radiculopathy) may feel like a bad leg cramp that lasts for weeks before it goes away. A herniated disc in the back, spinal stenosis and piriformis syndrome are medical disorders that can cause sciatica. Generally, the pain travels from the back of the thigh to the back of the calf, and also may extend upwards, to the hip , and downwards to the foot . Sciatica isn't a disorder in and of itself. Instead, it's a symptom of another problem involving the nerve, such as a herniated disk. This means one of the disks, which lie between each of the vertebra in the lower back (lumbar area), has cracked and allowed some of the inner disk material to protrude out, putting pressure on the adjacent nerve root, which in this case is the sciatic nerve. Sciatica is different from other forms of low back pain because there are 2 sciatic nerves, and the pain is usually on 1 side.

Causes of Sciatica

The common Causes of Sciatica :

  • These causes include irritation of the nerve from adjacent bone , tumors, muscle , internal bleeding, infections, injury , and other causes.
  • A car accident, fall or blow to the spine can injure the lumbar or sacral nerve roots.
  • Although this doesn't occur often, the sciatic nerve itself may be affected by a tumor or injury.
  • In some cases, your doctor may not be able to find a cause for your sciatica. A number of problems can affect the bones, joints and muscles, all of which could potentially result in sciatic pain.
  • If part of the fibrous outer ring of the disc is rather weaker than the rest, the softer centre (nucleus pulposus) may push its way through, bulging outwards if this bulge presses against a nerve which is running from the main, central nervous system to one of the legs, it causes symptoms in that leg.
  • Sciatica can also be caused by other effects of aging, such as osteoarthritis and osteoporosis .
  • Piriformis syndrome causes the sciatic nerve to become trapped deep in the buttock by the piriformis muscle. The symptoms are the same as those of sciatica.
  • The pressures within the discs can reach high levels when we bend or twist, even without carrying a heavy load. If we add to that a heavy load, especially held out at arms' length, the pressures rise even higher.

Symptoms of Sciatica

Some common Symptoms of Sciatica :

  • Numbness , decreased sensation
  • Weakness of the knee or foot
  • Of the back of the calf or the sole of the foot
  • A loss of bladder or bowel control.
  • Difficulty walking
  • Tingling , burning sensation
  • A loss of bladder or bowel control.
  • Foot or toe wounds that will not heal or heal very slowly
  • Numbness or muscle weakness along the nerve pathway in your leg or foot.

Treatment of Sciatica

Here is the list of the methods for treating Sciatica :

  • The pain may force you to rest, but this is a result of the pain, and not a good treatment for back pain and sciatica. If you have to take to your bed, limit it, if possible, to a week or two at the most
  • anti-inflammatory medication
  • Other conservative treatment options include anti-inflammatory medications (i.e. NSAIDs or oral steroids ), pain medications , and epidural steroid injections (however the latter carries the risk of possible side effects and complications from the needle puncture and medications used).
  • If the pain is severe and very disabling, and you cannot control it with simple pain killers and/or anti-inflammatory medication , your doctor may suggest you have an epidural injection, which is an injection into the spine, which soothes the nerves that are causing the pain.
  • physiotherapy, osteopathy or chiropractic
  • Alternative" and "complementary" treatments include chiropractic manipulation which may give short term relief.
  • Avoid activities likely to put unnecessary strain on your back.
  • painkillers
  • Initially, passive stretching exercises for your low back can help you feel better and may help relieve nerve root compression, but avoid jerking, bouncing or twisting.