Sciatica - Symptoms, Risk factors and Treatment

Sciatica is a condition commonly referred to as pain that runs along the sciatic nerve.


The sciatic nerve is the largest nerve in the body. It originates from the lower back (lumbosacral plexus) and passes through the hips to the back of the leg, ending below the knee. From here, it branches into different nerves that supply muscles of the leg. There are two sciatic nerves, one on each side of the body.


Causes of sciatica:


Problems with the intervertebral disc:


Sciatica usually occurs due to intervertebral disc problems such as disc herniation. Disc herniation can put pressure on the nerve, thereby irritating it. Other than herniation, sciatica can also be caused due to disc degeneration. 


Disc degeneration releases inflammatory chemicals that can irritate the nerve. 


Wrong administration of intramuscular injection:


The sciatic nerve passes through the gluteal region (hips), making it vulnerable to injury during the administration of IM injection in the buttocks. Care must be taken to avoid the course of sciatic nerve when administering an injection in the buttocks. In rare cases, the administration of IM injection at the wrong place can irritate the nerve causing pain.


Sciatica can also be due to other causes such as:


  • Osteoarthritis

  • Injury to the sciatic nerve

  • Tumors in the back

  • Abscess in the back

  • Spinal stenosis (narrowing of the spinal canal)

  • Spondylolisthesis

  • Cauda equina syndrome


Symptoms of sciatica:


The symptoms of sciatica are generally felt on one side of the body such as:


  • Pain in the lower back and buttocks that radiates down the leg

  • Numbness  in lower back and leg

  • Tingling sensation in the legs, feet, or toe

  • Worsening of pain upon exertion

  • Weakness in the leg


Risk factors for getting sciatica:


Certain factors increase the risk of developing sciatica at some point in life. Some of those risk factors are:


Health conditions like osteoarthritis, diabetes mellitus, etc.


  • Obesity

  • Old age

  • Heavy weight lifting

  • Lack of physical activity

  • History of trauma to the spine


Diagnosis of sciatica:


Sciatica can be diagnosed by a history and physical exam. Other than that, your doctor may advise you on different tests to confirm the diagnosis such as:


  • X-ray

  • CT scan 

  • MRI

  • Electromyography

  • Myelogram


Treatment of sciatica:


The treatment of sciatica can involve the following:


Medicines 

Mostly, the healthcare provider will prescribe you a painkiller drug like ibuprofen or naproxen to treat back pain. 

 

Exercise 

Regular stretching exercise can help in treating back pain due to sciatica, But make sure that you do that on the advice of a physiotherapist or an orthopedic surgeon. 

 

Topical applications 

Topical applications also help in getting rid of back pain. Mostly they contain analgesics like diclofenac or ibuprofen that give some relief. Moreover, topicals containing lidocaine may also help, as it numbs the area. 

 

 

Muscle relaxants 

Muscle relaxants help in treating back pain, especially when it occurs due to muscle strain or muscle tear.

 

Antidepressants 

At times your healthcare provider may prescribe you antidepressants to treat back pain, on off-label use. Antidepressant-like amitriptyline may help in getting rid of back 


Spinal injections

Your doctor may advise you administration of corticosteroid injections in the back that help reduce inflammation and pain.


Conclusion:


Sciatica is a painful condition and may become bothersome for the affected individual. But with proper treatment, the condition can be managed and normal quality of life can be restored. If you notice any symptoms of sciatica, it is important to see your healthcare provider. 

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