Nervous System
Sciatica

​​​​​What is sciatica? 

Sciatica is a general term that refers to any type of pain caused by pressure on or inflammation of the sciatic nerve.
The sciatic nerve is the longest nerve in the body. It starts at the back of the pelvis and runs under the buttocks and down through the legs until it ends down in the bottom of the feet
Pain often occurs in the buttocks and legs and usually lasts for several weeks to then resolve spontaneously, except in some cases where it may persist for a year or more.

Cause: 
In most cases, sciatica is caused by a herniated disc at one of the vertebrae, which often occurs with age.
The less common causes include:
  • Spinal stenosis
  • Spondylolisthesis
  • Inflammation or injury of the spine
  • Spinal tumors
  • Cauda equina syndrome
Symptoms: 
If the sciatic nerve becomes compressed or inflamed, this may cause:
  1. Pain
  2. Numbness
  3. Tingling sensation extending from the lower back down to the toes
  4. Weakness of leg muscles or the muscles that move the foot and the ankle
The severity of pain varies from mild to very severe and it intensifies when sneezing or coughing or after prolonged sitting.
Although many people with sciatica suffer from back pain, pain associated with this condition is usually confined to the buttocks and legs.

Diagnosis:
It can be diagnosed by:
  • Spinal CT scan
  • Spinal MRI scan
Risk factors:
  1. Age
  2. Bodyweight
  3. Nature of work
  4. Prolonged sitting
  5. Diabetes                                                         
Complications:
 Although most people recover completely from sciatica and often without treatment, it can cause permanent nerve damage. Therefore, a doctor should be consulted in case of any of the following symptoms:
  • Loss of sensation in the affected leg
  • Weakness of the affected leg
  • Loss of bowel or bladder function
Treatment:
If the pain does not improve spontaneously with self-care, a doctor may recommend some of the following treatments:
  • Medications:

There are some medications that can be prescribed for sciatica pain, including:

Anti-inflammatory medicines

Muscle relaxants

Narcotics

Antidepressants

  • Physiotherapy: 

Once the acute pain improves, the physiotherapist or doctor would set a plan or program to rehabilitate the patient in order to avoid future injuries. The program usually includes special exercises to correct the posture, strengthen the muscles of the back and improve flexibility.

  • Steroid Injection:

In some cases, your doctor may recommend injecting a corticosteroid drug into the area around the root of the nerve to help reduce the pain by eliminating the inflammation around the inflamed nerve. Its effect lasts only for several months.

It should be noted that steroid injections are attempted only on a limited basis because the risk of side effects increases with frequent use.

  • Surgery may be considered as the last resort.
Prevention:
Sciatica is not thought to be preventable and it may recur. However, there are several measures that may contribute significantly to the protection of your back, including:
  • Practicing back-specific exercises as prescribed regularly;
  • Maintaining a healthy sitting posture, and choosing a good and healthy chair.

Health Promotion and Clinical Education General Department
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