The sciatic nerve begins at the spinal cord, passes through the hips and buttocks, and then branches down each leg.
This nerve is the longest nerve in the body and one of the most important, as it has a direct effect on the ability to control and feel the legs. When this nerve becomes irritated or compressed, you will experience "sciatica".
Sciatica is a sensation that can manifest as moderate to excruciating pain in the back, the buttocks and the legs.
You can also feel weakness or numbness in these areas. Sciatica is a symptom caused by injury underlying the nerve or an area that affects the nerve, like vertebrae (the bones in the neck and back).
According to the American Academy of Orthopedic Surgeons, sciatica is more likely to occur among the 30 and 50 year old
Index
What causes sciatica?
Sciatica can be caused by a number of conditions that involve spinal column and that can affect the nerves along the back. Other times, the cause is an injury, such as falls or tumors of the spinal / sciatic nerves.
Common conditions that can cause sciatica are outlined below:
Herniated discs
Vertebrae, or spinal bones, are separated by cartilage. Cartilage is filled with a thick gel-like material, to ensure flexibility and cushioning, as the spine moves in natural directions. The herniated discs occur when the first layer of cartilage tears.
The inner substance can come out and compress the sciatic nerve, which results in limb pain and numbness. It is estimated that one of each 50 people will suffer a herniated disc in their lifetime.
Spinal stenosis
It is also called spinal stenosis lumbar, This condition is characterized by abnormal narrowing of the upper or lower spinal canal.
This narrowing puts pressure on the spinal cord and the roots of the sciatic nerve..
Listing o spondylolisthesis
This is one of the associated conditions of degenerative disc disorder.. When a vertebral bone (vertebrae) moves forward over the previous one, can pinch the sciatic nerve.
Piriformis syndrome
Piriformis syndrome is a rare neuromuscular disease in which the pyramidal muscle of the pelvis (the muscle that connects the lower spine to your femurs) involuntarily contracts or hardens, causing sciatica.
Sciatica occurs due to the pressure that squeeze exerts on the sciatic nerve. Piriformis syndrome can get worse as a result of events such as sitting for long periods of time, the fall, or being involved in a minor accident.
Symptoms of sciatica
Sciatica has a characteristic type of symptoms. If you are experiencing pain that flows from the lower back through the gluteal area and into the lower extremities, usually sciatica.
Sciatica is the result of damage or injury to the sciatic nerve, so other symptoms of nerve damage are usually present with pain. Other symptoms of sciatica can include:
Pain that worsens with movement.
Numbness / weakness: This symptom can occur in the legs or feet and is usually felt along the path of the sciatic nerve.. In severe cases, there may be a loss of sensation and / or movement.
Pin or needle prick sensation: This is a painful tingling in the toes or both.
Incontinence: This is the term for the inability to control the bladder or bowels.. This is a rare symptom., Part of cauda equina syndrome (which is explained later) and it is a sign of need for immediate attention.
When to get medical attention
Seek immediate medical attention in case of the following symptoms:
- Pain occurs after a serious injury or accident.
- You have sudden, excruciating pain in your leg or lower back that is accompanied by numbness or muscle weakness in that same leg.
- You are not able to control your bladder or bowels (symptom of cauda equina syndrome).
Horsetail or horsetail syndrome
This is a rare disorder that can cause paralysis problems., bladder and bowel and decreased sexual sensitivity, if it is not.
Because this disorder often develops slowly, as soon as symptoms appear, it's important to make an appointment with your doctor right away.
The symptoms of this disorder are:
- Inability to control the bladder or bowels (this also includes withholding)
- Pain, numbness or weakness in one or both legs, making it difficult to get up after sitting; the patient may be observed stumbling when trying to get up.
- There is a noticeable progression or sudden and severe loss of sensation in the lower body, including the area between the legs, buttocks, the thighs, the back of the legs and heels and the entire foot.
Diagnosis of sciatica
Since sciatica is, per se, a symptom that can vary from state to state and from person to person, the doctor will first want to obtain your complete medical history.
This includes if you have had any recent injuries, where do you feel the pain, and how does it feel. The next step is a physical exam that includes tests of your muscle strength and reflexes..
Your doctor may also ask you to do some stretching and movement exercises to determine which ones cause the most pain..
The next round of diagnosis is for people who have been dealing with sciatica for more than a month or who have a serious illness such as cancer..
The nerve exams allow your doctor to examine the way nerve impulses are carried out and check for any abnormalities.
The imaging tests allow a doctor to get a glimpse of the spine, which will help you determine the cause of sciatica. The most common imaging tests used to diagnose sciatica and find its cause are as follows:
X-ray of the spine: normal x-rays will not be able to offer a view of sciatic nerve damage, but an X-ray of the spine may reveal herniated discs and other nerve damage.
Magnetic resonance imaging (IRM): In an MRI scan, a magnet and radio waves will be used to create detailed images of your back..
Computed tomography (TC): A CT scan uses radiation to create detailed images of your body. Your doctor will be more likely to inject a special dye into your spine in a process called a myelogram. (CT) to help produce clearer images of the spinal cord and nerves.
Treatment of sciatica
At the first diagnosis of sciatica, your doctor will often give you advice to treat your sciatica pain.
One of the most important things to remember is to keep your daily activities moving as much as possible., as staying in bed or avoiding activity can create a worse situation.
Treatments at home
Some commonly suggested home treatments are outlined below:
Cold remedies
You can buy ice packs or even use a package of frozen vegetables.. Wrap the bag of ice or frozen vegetables in a towel and then apply to the affected area for 20 minutes, several times a day.
This will help reduce swelling and relieve pain..
Heat remedies
You can also buy hot compresses or heating pads. The use of ice is recommended for the first couple of days. After two or three days, change to heat.
If the pain persists, try alternating between ice and heat therapy.
Stretching
Gentle stretching of the lower back may also be helpful. A good way to do quality stretch is to get, personal physical therapy, or even yoga classes from a physiotherapist or instructor known and trained in treating your injury.
Over the counter drugs
The use of over-the-counter medications, like aspirin and ibuprofen, can also help with pain, inflammation and swelling.
Be careful about using aspirin excessively due to its possible complications, including stomach bleeding and ulcers.
Regular exercise
The more you stay active, your body releases more endorphins. Endorphins are pain relievers made by the body.
Keep activities low-impact at first, how to swim and stationary bike. As your pain decreases and your stamina improves, create an exercise regimen that includes aerobic exercises, stability of the abdomen, and strength training.
A regimen with these components can lower the risk of future back problems..
Additional measures
If home treatments fail to treat your pain effectively, your doctor may suggest you take further steps, What:
physical therapy
Exercises that will help you improve posture and strengthen your back muscles.
Prescription drugs
Doctors may prescribe muscle relaxants, that effectively relieve pain, and even antidepressants. Antidepressants can increase your body's production of endorphins.
Epidural Steroid Injections
Corticosteroid medications are injected into an area known as the epidural space.. The epidural space is the fluid that surrounds the spinal cord. Due to the side effects, these injections are given on a limited basis.
Surgery
Surgery may be needed for severe pain or situations where the patient has lost control of their bowels and bladder.
The two most common types of surgery are discectomy and microdiscectomy.. Discectomy is the removal of the part of the disc that is pressing on the sciatic nerve.
Microdiscectomy is the removal of the disc made through a small cut while the doctor uses a microscope.
Alternative treatments for sciatica
The world of alternative medicine is growing in popularity. There are a number of alternative remedies for sciatica. These include:
Acupuncture
Sterilized needles are inserted at key points that affect the flow of energy within the body. This procedure is practically painless.
Chiropractic treatment
a chiropractor can manipulate the spine for maximum spinal mobility.
Hypnosis
A trained professional can induce hypnosis. Hypnosis is intended to put the patient in a very relaxed and focused state of mind., allowing you to receive healthy suggestions and care instructions.
In the case of sciatic pain, hypnotic messages could include pain relief.
Massages
In all its varieties.
Risk factors for developing sciatica
Certain behaviors or factors can contribute to the chances of having sciatica. The most common factors for the development of sciatica include:
Age: As the body ages, parts become more likely to wear out or break down.
Occupation: certain races put a lot of stress on the back, especially those that involve lifting heavy objects, sitting for long periods of time, or twisting movements.
Diabetes: This condition can increase the risk of nerve damage..
Smokers: Smoking can cause the outer layer of the spinal discs to deteriorate..
How to prevent sciatica
The following steps can help prevent sciatica or treat it if you already have it:
Frequent exercise. Strengthening your back and stomach muscles is the key to maintaining a healthy back.
Be careful with position. Make sure your chairs offer adequate support for your back. You must be able to place your feet on the ground, and make sure to use your arms in a natural position.
How you move matters: Take care of lifting heavy objects the right way, bending your knees and keeping your back straight.
