What is Sciatica?

Sciatica is a type of neuropathy that produces symptoms such as pain, weakness, and loss of sensation along the course of the sciatic nerves. The sciatic nerves branch off of the spinal column in the lower back or lumbar area and run down the back of the legs. Information from the brain or spinal cord is transferred to the muscles of the back, thigh and lower legs via the sciatic nerves. Damage to this nerve can be caused by a number of injuries and can affect one or both legs.

Causes, Incidence and Risk Factors

The main causes of sciatica are:

• A prolapsed intervertebral disc in the lower back (lumbar disc) is the most common cause for this condition. The slipped disc puts pressure on the nerve roots and may reduce nerve conduction.
• Degenerative changes in the vertebra, due to ageing.
• Tumor
• Infection
• Pelvic fractures
• Trauma to buttocks or thighs

People in the age group of 35-50 years are more prone to it. Diabetes and other chronic conditions increase the risk of developing sciatica.

Signs and Symptoms

• Pain in the lower back or hip, that radiates down to the thighs and lower legs
• Numbness in leg
• Loss of sensation in leg
• Pin-pricking sensation
• Leg cramps
• Tingling and burning sensation in the areas where the sciatic nerve passes

Screening and Diagnosis

• A complete physical examination may be essential, particularly a neurological assessment. There may be abnormal reflexes and pain may accompany changes in position.
• The patient's history provides insights into the nature of the pain, the areas affected, extent of disability and the course of the disease.
• X-ray studies are necessary to determine the level of bone involvement
• Electromyogram is a handy muscle- function test.
• Nerve conduction tests
• Blood tests may be needed to rule out systemic pathology
• MRIs and a CT scan can be prescribed to confirm the involvement of particular nerve roots

Surgery, as an option would be considered, based on the findings of the above-mentioned tests.

Treatment

Conservative Treatment Methods

• Rest
• NSAIDs may reduce the pain and inflammation
• Continue moderate activities
• Stretching exercises can be relaxing
• Symptoms may also get relieved with local corticosteroid injections
• Hot or cold compresses may soothe the inflamed muscles
• Avoid straining the muscles in the back

Surgical Treatment Methods

Surgery is required, if there is any structure pressing upon the nerve. In these cases, a procedure known as a lumbar decompression may be recommended to relieve the pain.

Prevention

• Maintain body mechanics while lifting and bending.
• Do exercises to strengthen the muscles of the back and abdomen.
• Practice maintaining good posture
• Avoid prolonged sitting