Causes and risk factors:
Sciatica nerve originates in the lower vertebral column .Any diseases or injury to the spine can lead to complaints of sciatica. Degenerative changes/Aging is the commonest cause. Lumbar spondylosis, spinal herniation or spinal stenosis, cauda equine are some of the common contributing factors. Obesity, diabetes and occupation which include overstretching or overuse of the muscles of the lower extremities are some of the predisposing factors. Increased weight during pregnancy leads to compression of the sciatic nerve leading to set of symptoms. Trauma due to injury to the spine and formation of tumor on the nerve roots can also cause sciatica.
Clinical presentations:
Pain extending from buttock to legs is the cardinal symptom of sciatica. The pain is severe with burning, throbbing or pulsating sensation. Tingling and numbness along with weakness in the leg or heaviness can be the associating complaints. Difficulty in movements can be experienced. Prolonged standing or sitting can aggravate the pain. Coughing and sneezing can also increase the pain.Loss of sensation in lower extremities, loss of bladder and bowel functions are the common complications which can occur due to sciatica.
Diagnosis and investigations:
Symptoms narrated by the patient and the physical examination carried out by the orthopedic doctor will help to confirm the diagnosis. Simple clinical test like SLR (Straight leg raising test) helps in diagnosis. To find out the underlying cause certain sets of investigations like, X-ray, MRI and CT scan of the spine are done.
Treatment:
Resting of the legs is the first step to be implemented. Pain relieving medicines or anti inflammatory drugs or muscle relaxants can be given. Certain physiotherapy exercises can be beneficial. In severe cases corticosteroid injections are administered. Surgery is opted in cases where the nerve is compressed due to tumor. Treatment of the underlying cause needs to be done.
Other Modes of treatment
The other modes of treatment can also be effective in treating sciatic pain. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating pain. Acupuncture has shown promising results in pain relief and neuropathy.
Recent updates:
Cellular Nerve Graft and Stem Cells for Repair of Long-segment Sciatic nerve defect is the new technique developed.
