Sciatica

A sciatic nerve is a long nerve that runs from the lower back, through each hip into the back of each leg. This is the longest and most important nerve in your body. It affects your ability to control and feel your legs. Any damage to the nerve can lead to sciatica.

Sciatica is the pain that appears along the path of the sciatic nerve. Usually, it affects one side of the body. The following people are at a greater risk of sciatica.

• Age: Changes in spine such as bone spurs and herniated disks are caused due to growing age which can lead to sciatica
• Obesity: Increased body weight puts pressure on every joint including the spinal cord and the sciatic nerve.
• Ankylosing spondylitis; and
• Prolonged sitting posture: People who work jobs that require constant sitting can damage their sciatic nerve.
• Diabetes: Uncontrolled diabetes can increase the risk of nerve damage.

The following factors can lead to sciatica:

• Herniated spinal discs: The disks in the spinal cord are separated by cartilage. This cartilage is filled with cushioning material. Sometimes, the cartilage weakens and breaks. The cushioning material pushes itself out creating a hernia in the disk. This hernia can exert pressure on the sciatic nerve leading to pain and numbness.
• Spinal stenosis: This condition is characterised by abnormal narrowing of the spinal cord which puts pressure on the sciatic nerve.
• Spondylolisthesis: In this condition, one vertebral disc extends forward on another vertebral disc. The forward movement can put pressure on the nerve and cause pain in the back.
• Piriformis syndrome: In this rare neuromuscular disorder, the piriformis muscle (the muscle that connects the lower portion of the spine to thigh bones) contracts or tightens involuntarily causing pressure on sciatic nerve.

Symptoms of sciatica:

The pain radiated along the sciatic nerve is the biggest indication of sciatica. Other symptoms of sciatica include:

• Severe pain in the lower back
• Hip pain
• Radiating pain in the leg
• Tingling pain or numbness in the leg
• Weakness in leg
• Difficulty in moving the leg
• Shooting pain that makes it difficult to stand up
• Pain in the rear leg that worsens while sitting

Diagnosis of sciatica:

A detailed medical history is studied and a physical examination is conducted to assess muscle strength and reflexes. The following imaging tests are suggested:

• X-ray: X-rays reveal the bone spur that may be exerting the pressure on the sciatic nerve.
• MRI (Magnetic Resonance Imaging): The disc extrusion seen between lumbar vertebra is visible on MRI scan. It also produces detailed images of herniated spinal disks.
• CT Scan: During a CT scan, a dye is introduced in your spinal cord. The dye circulates around the spine leaving the nerves to appear white.
• Electromyography (EMG): This test measures the electrical impulses from nerves and muscles. The change in electrical impulses indicates damaged nerves or muscles.

Treatment of sciatica:

To treat sciatica, a number of lifestyle changes such as weight management and stretching exercises are suggested by the orthopaedic doctor. Other treatments include:

• Medications: Medications that are anti-inflammatories, muscle relaxants, narcotics, tricyclic antidepressants, anti-seizure medications are prescribed by the doctors.
• Physiotherapist: A physiotherapist helps you in improving the postures, strengthening your muscles through exercising techniques.
• Surgery: Delay in the treatment of sciatica may lead to urinary incontinence. In such cases, surgery is conducted to tackle the cause of sciatica like a bone spur or a hernia.
• Alternative therapies: Alternative therapies like acupuncture and chiropractic help in pain management and posture correction respectively.

OMNI Hospitals Visakhapatnam has the best orthopaedic department in Vizag. We have top orthopaedics who are adept at the treatment of sciatica. We provide the best orthopaedic care for your joints and bones.