Sciatica is the pain, tingling, discomfort, or "shock" that originates in the lumbar spine region and radiates to the buttock, thigh, leg, or foot.
It is caused by the compression or inflammation of the sciatic nerve, which is the longest nerve in the body. The function of the sciatic nerve is to control certain muscles in the legs and sensitivity in the back of the thigh, leg, and sole of the foot. Due to its close proximity to the spinal discs, the most common cause of sciatica is a herniated disc.
Depending on the level of compression of the nerve, symptoms like tingling, numbness, pain, and shock may extend to the buttocks, thighs, legs, and feet. It is uncommon for the spine to hurt in the groin or inner thigh area. This condition is more common in men aged 30 to 50, but can also affect women. People who frequently strain their spine due to routine activities are more likely to suffer from sciatica.
When is it sciatica?
Patients often report pain when lying down, upon waking, when extending the leg, or when walking. In cases where sciatica is caused by narrowing of the spinal canal (lumbar stenosis), a symptom called claudication may appear, where the person feels the need to stop walking due to pain or loss of leg strength.
How is sciatic nerve inflammation diagnosed?
The proper way to diagnose a sciatic nerve issue is through evaluation by a specialist in orthopedics or neurosurgery. With a physical exam, medical history, and physical tests in the office, the orthopedist can suspect the condition. Additionally, the specialist may request an X-ray and/or an MRI for diagnostic confirmation.
Treatment
Generally, treatment for an inflamed sciatic nerve or sciatica is diverse and includes painkillers, anti-inflammatory medications, nerve modulators, physical therapy, spinal blocks or injections, and even nerve decompression surgery in more complex cases.
Medications for the inflamed sciatic nerve
There are several options for managing sciatic nerve pain or sciatica. The orthopedist is trained to prescribe pain relievers such as acetaminophen, ibuprofen (which works as an anti-inflammatory), neuromodulators like pregabalin, and corticosteroids like dexamethasone. Self-medication and informal treatments are not recommended due to the risk of complications.
Physical Therapy
Physical therapy is a crucial part of managing an inflamed sciatic nerve and sciatica. It aims to improve the posture of the spine, stretch contracted leg muscles, relieve spasms and pain, and strengthen the core abdominal and back muscles.
Alternative therapies and physical methods
According to the orthopedist's advice, acupuncture, yoga, neural therapy, and functional medicine can be very helpful in the joint treatment of sciatic nerve issues.
Lumbar block or spinal injection
In order to relieve the pain, the orthopedist may propose a lumbar epidural block or injection. This involves applying an anesthetic and an anti-inflammatory (corticosteroid) inside the spine to numb the sciatic nerve and gradually relieve the pain.
Decompression surgery
When medications, physical therapy, and injections are ineffective, or when there is a loss of leg mobility (no response), decompression surgery may be necessary to remove the herniated disc (discectomy). In cases of lumbar stenosis, laminectomy (removal of part of the vertebrae) and screw fixation may be required.
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