Sciatica
Sciatica
Sciatica refers to pain caused by inflammation that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. The sciatic nerve is the longest and thickest nerve in your body, and is one of the most important ones as it has a direct effect on your ability to control and feel your legs.
Sciatica typically affects only one side of your body and can cause pain in the legs and feet which usually feels like a burning or pins-and-needles sensation. Sciatica is commonly caused by a herniated disc, which places pressure on the nerve root.
WHAT ARE THE SYMPTOMS?
Symptoms of sciatica include:
- Pain radiating from your lower spine to your buttock and down the back of your leg
- Pain that varies from a mild ache to a burning pins-and-needles sensation
- Numbness and tingling in the affected foot
- Unable to control your bladder and bowel movements
- Worsening pain with movement
WHAT ARE THE CAUSES AND RISK FACTORS?
One main cause of sciatica is a herniated disc. A herniated disc occurs when the disc nucleus is pushed out of the annulus due to a tear or rupture. As there is limited space in the spinal canal, this results in added pressure on the spinal cord or surrounding nerve root, producing pain that may be severe.
Other risk factors of sciatica include:
- Age
As we get older, changes in the spine such as herniated discs and bone spurs are more common
- Occupation
If your job involves heavy physical work that puts stress on your spine, your risk of sciatica increases
- Obesity
Extra weight puts pressure on your spine, increasing your risk of sciatica
- Prolonged periods of inactivity
Sitting for long periods increase your chance of getting sciatica
- Medical conditions such as diabetes may increase your risk of nerve damage
WHAT IS THE DIAGNOSIS?
A history of the injury and a physical examination of your spine will be conducted by the Doctor. He will get you to walk around for him to examine how your spine carries your weight. Leg raise tests may also be conducted.
Imaging tests may also be be taken, such as a x-ray, CT scan and MRI scan to help your doctor get a better idea of your spine and nerves.
WHAT ARE THE TREATMENT OPTIONS?
Most cases of sciatica will resolve with nonsurgical treatments. These include:
- Application of ice and hot packs
- Medications (over-the-counter) such as acetaminophen and nonsteroidal anti-inflammatory drugs such as ibuprofen to relief pain and reduce swelling
- Steroid injection such as corticosteroid injected directly into the spine, to relief pain and reduce swelling
- Physiotherapy such as gentle stretches and exercise to regain muscle strength
Surgery is not recommended, unless symptoms have not improved with nonsurgical treatments. Surgical options include:
- Microdisectomy
In this minimally invasive procedure, fragments of the herniated disk that are pressing on the sciatic nerve.
- Laminectomy
This procedure involves the removal of the lamina – the roof of the spinal canal and part of the vertebrae that is causing pressure on the sciatic nerve.
WHAT IS THE RECOVERY PROCESS AFTER SURGERY FOR SCIATICA?
In general, the time required for recovery will be six weeks to three months, depending on the type of surgery performed.
WHAT ARE THE RISKS AND COMPLICATIONS OF A SCIATICA SURGERY?
Generally, surgery for sciatica is very safe. However, there may be complications arising from the surgery. These include:
- Bleeding
- Infection
- Blood clotting
- Nerve damage
- Spinal fluid leak
- Loss of bladder or bowel control
HOW CAN WE PREVENT SCIATICA?
Some steps that can be taken to prevent the chances of developing sciatica are:
- Maintaining a good posture, while sitting, standing, lifting and carrying objects
- Maintaining a healthy weight
- Regular exercise and keeping active
- Do not smoke
- Take the proper precautions whenever exercising or doing physical activities
- Keeping yourself safe from falls