Sciatica describes a pain along the sciatic nerve pathway – the longest nerve in human body - induced by a compression of lumbar nerves L4/L5 or sacral nerves S1/S2/S3 or by compression of the sciatic nerve itself. Sciatica is not a disease it is a symptom and synonymous used as sciatic neuritis, sciatic neuralgia or lumbar radiculopathy. The pain radiates along the path of the sciatic nerve formed by branches from lower back on one side of the body. A sudden onset is characteristic following activities like heavy lifting.

2% to 40% of people suffer sciatica during lifetime. Men are more frequently affected than women.

Causes

• Herniated disk
• Bone spur on the spine (spondylolisthesis)
• Narrowing of the spine (spinal stenosis)
• Piriformis syndrome - the sciatic nerve runs through the piriformis muscle. If the muscle shortens or spasms due to trauma or overuse occur it is inducing compression on the sciatic nerve. It is as well-known under "wallet sciatica" since a wallet carried in a rear hip pocket compresses the buttock muscles and sciatic nerve when the bearer sits down.
• Pelvic tumours
• Compression by a baby's head during pregnancy

Symptoms

Sharp, burning or excruciating pain radiating from buttock down the back of thigh and calf, worsening while coughing or sneezing, aggravated by prolonged sitting.

Risk factors

• Obesity/ pregnancy
• Profession requesting to twist the back, carry heavy loads or drive a motor vehicle for long periods
• Sedentary lifestyle
• Diabetes

Complications

• Loss of feeling in the affected leg
• Weakness in the affected leg
• Loss of bowel or bladder function

Diagnosis

We at KindCare Medical Center are starting the diagnostic clarification by taking an extensive medical history addressing your symptoms, the trigger factors, the duration and the frequency, work environment, social habits, toxic exposure, risk of infectious diseases and family history of neurological disease. Check of vital signs such as blood pressure and pulse, followed by a proper physical examination with focus on musculoskeletal system. Additional laboratory tests, Electromyography (EMG), Nerve Conduction Studies (NCS), x-ray studies, CT and MRI scans are recommended for ruling out underlying conditions.

Treatment

Apart from Anti-inflammatory drugs, Serotonin re uptake inhibitors and antiepileptic medications which are prescribed for pain relief and muscle relaxation we offer Physical therapy including exercises to correct posture, strengthen the muscles supporting the back and improve flexibility and acupuncture. Application of cold packs wrapped in a thin towel placed on the painful area for up to 20 minutes several times a day, followed by hot packs after 3 days will help as well to improve.

Prevention

• Exercise regularly
• Maintain proper posture when you sit. Choose a seat with good lower back support, armrests and a swivel base. Consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Keep your knees and hips level
• Use good body mechanics. If you lift something heavy, let your lower limbs do the work. Move straight up and down. Keep your back straight and bend only at the knees. Hold the load close to your body. Avoid lifting and twisting simultaneously. Find a lifting partner if the object is heavy or awkward