Sciatica is a nerve condition that is caused due to pain and inflammation in the sciatic nerve. The sciatic nerve arises from the lower back and moves posterior to the thigh and then on the side of the leg. It usually affects only one of the extremities, but both side pain can also be present in some cases. This nerve has the longest route in the body and is also the largest in diameter. It has a greater affinity to getting inflamed and causing pain. It can cause discomfort owing to multiple pathologies and biomechanical flaws in the back or leg. Some of the causes are listed below.
Causes of Sciatica
Our vertebral column joints have cartilaginous discs to allow smooth movements. These discs can get slipped from their position due to muscle weakness. It goes further to block the nerves exiting the vertebral column causing pain. Sciatic nerve stenosis can also occur due to disc herniation into the lumbar foramen. Most of the time, back pain exists with radiating lower extremity pain in such cases.
Degeneration of vertebrae
As a result of aging, the vertebral column gets arthritic. The height of vertebrae is reduced and osteophytes are formed due to age-related wear and tear. The joint spaces are also reduced due to vertebrae collapse and narrowing of the spinal canals and foramen, which again blocks the nerve.
The sciatic nerve can get impinged in muscles. The most common form of sciatic nerve impingement is piriformis syndrome. The piriformis is a muscle that is present in the buttock and the sciatic nerve passes underneath it. If the piriformis muscle is shortened or inflamed, the nerve gets trapped and causes pain in the area.
Space occupying lesion
Sciatica can also be caused due to any space-occupying lesion, such as a tumor in the lower lumbar region. If the pain doesn't go away with pain killers and exercise, orthopedic doctors advise further investigation to rule out any such growth./p>
The cause of pain and Sciatica can be a deformity, usually in the back. Deformities such as scoliosis and kyphosis should be assessed, which may cause a cascade of biomechanical alterations that cause pain. Long-standing deformities can lead to irreversible damage and may require surgery.
Fall or road traffic accidents can also lead to sciatic nerve pain and damage. The severity of the condition depends upon the intensity of the trauma. Keeping the back immobilized after trauma is recommended to avoid further damage to the nerve.
Symptoms of Sciatica
Sciatica pain might be disguised as normal age-related pain in joints and other body parts. But to narrow it down, the following symptoms can be looked out for. If any of the below symptoms are there, it is best to consult an orthopedic specialist to confirm and start the treatment at the earliest.
Radiating pain is the most common symptom of Sciatica. Unlike everyday trauma-related pain, the pain moves along the nerve route. The pain persists in the lower back, buttock, back of the thigh, knee, and lateral side of the leg. Depending on the case, it can be continuous or sometimes relieved by rest.
Long-standing sciatic pain may lead to weakness of muscles due to incompetence of nerve and limited movement of the extremity. Weakness of the core muscles is often associated with Sciatica. Regular exercise can help manage such symptoms and help get relief from continuous pain.
Altered sensations and tingling are often present in Sciatica. A burning or tingling sensation is present in the lower part of the extremity and usually bothers the individual with everyday activities. Such discomforts, no matter how minute as compared to the pain, should be discussed with the doctor during the treatment of Sciatica.
Once Sciatica is confirmed by an orthopedic doctor, the treatment starts right away. The mode and swiftness of the treatment depend on the case, and it's your doctor who knows best. The treatment of two patients (even in a family) with the same condition can also differ.
Pain killers can help mitigate acute pain and provide relief for some time, but dependence on painkillers is discouraged due to their side effects in the long run. Your doctor can prescribe some multivitamins to improve nerve compliance along with other drugs to neutralize other deficiencies.
Therapeutic exercises are often effective as an adjunct to medicines in the long run. Stretching of muscles regularly can help avoid impingement of nerves, and physiotherapists usually prescribe strengthening exercises to reduce core instability and degeneration of the vertebral column. Regular exercise can also improve tingling sensation and reduce hurdles in everyday activities.
Some ergonomic changes are required in one's lifestyle to shield from Sciatica. Correct body posture during sitting and standing can often do wonders in managing pain. A sedentary lifestyle can also accelerate the aging of the musculoskeletal system leading to Sciatica. Leading a more active lifestyle can keep the bones, joints, and muscles healthy.
In acute and severe pain, rest is indicated to avoid further deterioration of the condition. Proper positioning is also required to prevent stretching of the nerve and reduce the burden on the nerve. The individual is gradually rehabilitated back to function when the pain subsides.
In lower back pain and Sciatica, orthotic devices such as lumbosacral braces are prescribed for some time to improve the body's posture. It also provides support to weak muscles and offers stability. However, dependence on orthotics can cause further weakening of muscles.
If conservative methods do not treat the pain, surgery is often indicated, which helps release any pressure on nerves that may be caused due to degeneration or tumor-like lesions. An individual should always discuss the process and prognosis of the condition before surgery.