Sciatica has always been misunderstood or misdiagnosed for lower back pain or leg pain because of similar symptoms. The word sciatica was first used in the 15th century and so its definition has evolved since then. There is a common misconception about sciatica that it is a form of diagnosis of the sciatic nerve root disorders but in reality sciatica is more of a set of symptoms. To clear all of these misconceptions, here is an all you need to know guide on sciatica.
What is sciatica?
The sciatic nerve is the largest nerve in the body with nerve roots in the lower part of the spinal cord and extends through the buttocks, back of your thigh to the lower extremities of your foot. Sometimes the five spinal nerve roots of the sciatic nerve in both the limbs are compressed or irritated due to various causes. This compression or irritation leads to a set of symptoms which includes lumbar pain, buttock pain, numbness or weakness in the leg, loss of control and tingling sensation in the leg. The pain caused by sciatica usually radiates from lower back to the back of the thigh and might go below the knee as well.
There can be multiple causes of nerve compression which occurs at the spinal nerve roots or general compression of any of the sciatic nerves.
- Spinal disc herniation
Around 90% of sciatica cases are caused by compression of one of the five sacral nerve roots due to a herniated disc pressing against it. The extrusion from disc herniation pressurises the sciatic nerve causing pain but it can easily subside if the disc heals.
- Lumbar Spinal Stenosis
Another cause of nerve compression is the narrowing of the spinal canal (the space spinal cord runs through) caused by bone spurs, inflammation and herniated discs which compress and irritate the spinal cord nerves connecting the sciatic nerves.
There is also a strong possibility of sciatica in pregnant women as the weight of the foetus presses the sciatic nerve while sitting or during spasms.
The most commonly observed symptom of sciatica is pain in the back of the leg which aggravates on sitting. A burning or tingling sensation down the leg might also be observed. Loss of control due to weakness or numbness is also associated with sciatica.
First point of diagnosis is a thorough physical exam and evaluation of patient history. Sciatica diagnosis is confirmed if a patient displays neurological indications of nerve root tension along with the regular leg pain and tingling sensation symptoms. Imaging tests such as X-ray, Computerised Tomography (CT) Scan and Magnetic Resonance Imaging (MRI) are used to define the exact cause of sciatica.
Treatment for managing sciatica depends on the underlying cause of the compression or irritation. For pain relief, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen or COX-2 inhibitors are prescribed. For herniated discs, surgery might be performed to remove the protrusion causing compression. Physical therapy techniques like spinal manipulation have also proved to be effective against acute sciatica.
If you experience constant pain in the rear of your leg, contact your physician immediately for evaluation as it could turn out to be sciatica which will worsen with time.