Sciatica: Causes, Symptoms, Diagnosis, Treatment, and Prevention
An individual with sciatica has pain, numbness, tingling, or weakness in the lower back, hips, buttocks, or legs. Sciatica occurs when the longest and thickest nerve in the body is compressed or irritated by a spinal problem. It affects one or both sides of the body, depending on which nerve roots are involved.
Causes of Sciatica
Disc herniation is the most common cause of sciatica, which occurs when a tear in the outer layer of a spinal disc allows the soft inside material to bulge out. Sciatica can also be caused by the following factors: Inflammation and pain can result from pressure on the nerve roots that form the sciatic nerve.
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Spinal stenosis, which is a narrowing of the spinal canal that can compress the nerve roots.
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Spondylolisthesis, which is a condition where one vertebra slips forward over another, creating instability and pressure on the nerve roots.
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Piriformis syndrome, which is a condition where the piriformis muscle, located deep in the buttock, spasms and irritates the sciatic nerve.
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Pregnancy, which can cause changes in the spine, pelvis, and posture that can affect the sciatic nerve.
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Tumor, infection, or trauma, which can damage or compress the sciatic nerve or its roots.
Symptoms of Sciatica
Pain radiating from the lower back into the hip and buttocks, and down the back of the leg is the main symptom of sciatica. The pain can vary from a mild ache to a sharp, burning, or electric shock-like sensation. Coughing, sneezing, sitting, or bending can worsen the pain. The affected leg or foot may also feel numb, tingly, or weak. It can affect different parts of the leg, depending on which nerve roots are affected, and can cause mild to severe symptoms.
Diagnosis of Sciatica
Symptoms, medical history, and physical activities are all considered by a doctor when diagnosing sciatica. As well as performing a physical examination, the doctor will check muscles, reflexes, and sensation in the lower extremities. Also, the doctor may order imaging tests, such as X-rays, MRIs, or CT scans, to confirm the cause and location of nerve compression. A doctor may also perform an electromyography (EMG), which measures the electrical activity of muscles and nerves.
Treatment of Sciatica
With or without treatment, sciatica typically resolves on its own within a few weeks or months. Depending on the severity and duration of the symptoms, as well as the underlying cause of the nerve compression, there are a variety of treatment options for sciatica.
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Medications, such as anti-inflammatory drugs, pain relievers, muscle relaxants, or antidepressants, to reduce the inflammation, pain, and muscle spasms associated with sciatica.
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Physical therapy, which involves exercises, stretches, and massage, to improve the flexibility, strength, and posture of the spine and the muscles that support it.
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Alternative therapies, such as acupuncture, chiropractic, or yoga, which may help relieve the pain and improve the function of the sciatic nerve.
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Injections, such as epidural steroid injections or nerve blocks, which deliver medication directly to the affected area of the spine, to reduce the inflammation and pain of the nerve roots.
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Surgery, which is usually reserved for severe or chronic cases of sciatica that do not respond to other treatments, or for cases that involve serious complications, such as loss of bladder or bowel control, or progressive weakness of the leg. The surgery involves removing the part of the disc or bone that is compressing the nerve root, or creating more space for the nerve to pass through.
Prevention of Sciatica
Sciatica can be prevented or reduced by taking some measures to protect the spine and the sciatic nerve, such as:
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Maintaining a healthy weight, to avoid putting extra stress on the spine.
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Practicing good posture, to keep the spine aligned and balanced.
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Avoiding prolonged sitting, or using a cushion or ergonomic chair, to reduce the pressure on the sciatic nerve.
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Lifting objects properly, by bending the knees and keeping the back straight, to avoid twisting or straining the spine.
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Exercising regularly, to strengthen the core and back muscles that support the spine.
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Quitting smoking, to improve the blood flow and oxygen supply to the spine and the nerves.
