What is sciatica? Types and treatments
Sciatica is a pathology that appears in a common way, from the age of 50. It usually causes acute pain that is sometimes disabling. It is important to treat it correctly and early to avoid more complicated injuries and the transformation into chronic pain
What is sciatica and what are its causes?
Sciatica is caused by pressure on or injury to the sciatic nerve, which runs from the lower back to the back of the leg. Typically, it manifests as pain, weakness, or tingling that radiates down the leg.
Sciatica usually alerts to the existence of another more serious pathology. One of the most common causes of sciatica is a herniated disc, in which the displaced disc is putting pressure on the sciatic nerve. This can also happen if there is a tumor in the area.
It can also be caused by a pelvic injury or spinal stenosis, that is, narrowing of the spinal canal, which can cause pressure on the nerves.
In some cases, sciatica can cause what is known as piriformis syndrome, which occurs when the piriformis muscle presses on the sciatic nerve, causing pain and numbness in the buttocks and legs.
Types of sciatica
Depending on where it occurs, there are different types of sciatica that can have different symptoms.
Sciatica of the L4 nerve root occurs at the lumbar level l3-l4, and usually produces pain in the inner area of the foot and leg. In the case of L5 nerve root sciatica, the injury occurs in the lumbar region L4-L5, causing pain in the top of the foot and on the web between the first and second toes, which is known as the “drop finger”.
Lastly, the S1 nerve root sciatica is differentiated, which is related to a problem at the S1 lumbar level and is the cause of pain in the inner and outer part of the foot.
symptoms of sciatica
Regarding the symptoms to identify sciatica, the most characteristic are intense pain and tingling in the legs. In addition, the pain usually occurs unilaterally, that is, only in one of the legs.
Sciatica can often cause numbness, stiffness, and weakness in the joints. It is normal for the pain to be more intense when the person is sitting or getting up.
How is sciatica diagnosed?
For the diagnosis of sciatica, the professional first usually performs a physical examination, in which he tests various exercises on the patient. Among them, the elevation of the leg or lassegue test, and the, known as, slump test, in which the patient sits on the stretcher and extends the leg checking if acute pain appears. Once it has been verified whether the nerve is affected, imaging tests such as radiography, magnetic resonance imaging, computed tomography or electromyography are usually carried out. These tests will provide more precise information about the injury and its exact location. Additionally, they will measure the electrical impulses produced by the nerves, as well as the responses of the muscles.
Regarding the treatment of sciatica, the first step is usually the supply of anti-inflammatories or muscle relaxants, which mitigate or make the patient's intense pain disappear.
Normally, before starting any treatment, the patient should rest for a period of time, with the acute pain diminishing. Usually, sciatica is treated with physiotherapy, although it is often accompanied by acupuncture or chiropractic treatments. In other cases, steroid injections are used, which can help reduce inflammation in the area around the affected nerve, thus reducing pain.
Sometimes, if the patient has not experienced improvement with other treatments or has lost control of the bowel or bladder, surgery is performed to remove the element that is compressing the nerve.
prevention of sciatica
Sciatica, to a certain extent, can be prevented or, at least, certain guidelines can be taken into account to care for the area and, therefore, avoid the appearance of sciatica. Some of the recommendations are as follows:
- Postural control, to avoid forced positions for the spine, which can lead to more serious injuries.
- Body weight control, as being overweight could increase the pressure on the intervertebral discs.
- Practice moderate exercise, avoiding impact sports.
- Do not lift heavy weights, which can overload the spine.
- Stretch after playing sports.
- Strengthen the lower back and abdominal muscles, which will help prevent injuries.
- Importance of rest and mattress type.
As has been observed, sciatica is a very common pathology among the population that, many times, may be giving clues about the existence of more complicated pathologies. To a certain extent, it can be avoided by maintaining good postural hygiene, controlling body weight and avoiding a sedentary lifestyle.