Sciatica
Sciatica
Sciatica arises from injury or irritation to the sciatic nerve, causing pain in the buttocks or gluteal area. This nerve, the body’s longest and thickest, consists of five nerve roots: two in the lumbar spine of the lower back and three in the sacrum at the spine’s base.
Causes and Risk Factors of Sciatica
Various conditions can lead to irritation, pinching, or compression of the sciatic nerve, including:
- Compressed nerve in the lower back: The most common cause of sciatica is a compressed nerve root in the lumbar spine. This compression can result from a herniated disc, spinal stenosis, or a bone spur.
- Slipped disc and its impact on the sciatic nerve: A slipped, or herniated, disc occurs when the soft inner portion of the disc protrudes through the tougher outer ring. This protrusion can press against or irritate the nearby sciatic nerve, leading to pain and discomfort.
- Rare causes: In some cases, sciatica can be caused by non-spinal issues such as tumors, diabetes, or infections. These are less common but can have a significant impact on the sciatic nerve.
Factors that increase the risk of developing sciatica include:
- Have an injury
- Being overweight
- Have diabetes
- Have osteoarthritis
- Smoke
- Have a sedentary lifestyle
Symptoms of Sciatica
Pain
Lower back pain radiating down the leg: The hallmark symptom of sciatica is pain that originates in the lower back and travels down one or both legs.
Pain intensification during certain activities: Activities such as sitting for prolonged periods, coughing, or standing can exacerbate the pain.
Other Symptoms
Numbness or weakness in the leg: Some individuals may experience numbness, tingling, or muscle weakness in the affected leg or foot.
Duration and sudden onset of symptoms: While some people may experience intermittent symptoms, others might have persistent pain. The onset can be sudden or gradual.
Diagnosis of Sciatica
Physical examination
A thorough physical examination, including testing reflexes and muscle strength, can help determine if the sciatic nerve is affected.
Activities to determine nerve irritation
Specific tests, such as walking on toes or heels, rising from a squatting position, or lifting legs while lying down, can help pinpoint the source of the pain and determine the extent of nerve irritation.
Treatment Modalities
Pain Medication
This involves the use of medications such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), opioids, and other specialised medications designed for pain management. The type and dosage are tailored to the individual’s condition and medical history.
Myospan
Minimally invasive treatments aim to effectively relieve common pain conditions by targeting pain sources.
- Coreflex Injections: Typically contain a corticosteroid and are used for inflamed joints or tissues.
- Platelet-Rich Plasma (PRP) injections: Utilise own platelets to promote healing in damaged tissues.
- Intra-Articular Injections: Most commonly used to treat osteoarthritis in the hip or knee, but they can also be given in other joints, including shoulders, wrists, ankles, hands, and fingers.
For chronic pain conditions originating from spinal issues, Neurospan can be performed by our team of pain specialists from Singapore Paincare Center.
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Frequently Asked Questions
Are there specific risk factors that increase the likelihood of developing sciatica?
Yes, factors such as age, obesity, prolonged sitting, diabetes, and physically demanding occupations can increase the risk of developing sciatica.
Can pregnancy lead to sciatica?
Yes, pregnancy can contribute to the development of sciatica. As the uterus expands, it may exert pressure on the sciatic nerve, causing irritation or compression. Hormonal changes during pregnancy can also increase the flexibility of ligaments around the pelvis, potentially exacerbating symptoms associated with sciatica. Discuss any back or leg pain with our doctors.
How can I differentiate between sciatica and other types of back pain?
Sciatica is characterised by pain that radiates from the lower back down one or both legs, often accompanied by numbness or tingling. Other back pains might not have this radiating pattern.
Are there any lifestyle changes I can make to prevent sciatica or reduce its recurrence?
Maintaining a healthy weight, regular exercise, proper posture, and avoiding prolonged sitting can help prevent sciatica or reduce its recurrence.
How long should I wait before seeking medical attention for sciatica symptoms?
If sciatica symptoms persist for more than a week or are severe, it’s advisable to consult a doctor. Immediate medical attention should be sought if there’s sudden, severe pain or if the pain is accompanied by loss of bowel or bladder control.
Are there any complications associated with untreated sciatica?
Untreated chronic sciatica can lead to permanent nerve damage, loss of feeling in the affected leg, and weakness in the muscles of the leg.
Can sciatica be a symptom of a more serious condition?
While sciatica is often due to a herniated disc or bone spur, it can sometimes be a symptom of a more serious condition, such as a tumour pressing on the sciatic nerve.
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