Sciatica is nerve pain caused by an injury or irritation to the sciatic nerve, originating in the buttock/gluteal area. It commonly describes pain starting in the lower back and radiating down the leg. The sciatic nerve, the longest and thickest nerve in the body, runs from each side of the lower spine through the hips, buttocks, and down each leg, ending just below the knee. It then branches into other nerves that continue down to the foot and toes.
Symptoms of Sciatica:
Sciatica typically manifests as pain radiating from the lower spine to the buttock and down the leg, which can occur anywhere along the nerve pathway. The pain ranges from mild to severe and may cause muscle weakness, numbness, or a tingling pins-and-needles sensation in the leg or foot. The pain can vary from a mild ache to a sharp, burning sensation or excruciating pain, often feeling like an electric shock. Usually, only one side of the body is affected, and the pain may worsen with movement, potentially leading to loss of movement. Severe cases may result in loss of bladder and bowel control.
Causes of Sciatica:
Several conditions can cause sciatica. A herniated disc, the most common cause, occurs when pressure from vertebral movements causes the intervertebral discs to bulge and rupture, putting pressure on a nerve. Age-related wear and tear of the discs can cause spinal stenosis, narrowing the nerve passageways and pinching the sciatic nerve roots. Spondylolisthesis, the slippage of one vertebra out of alignment, can also pinch the sciatic nerve. Long-term inflammation can cause bony protrusions (spurs) that compress the lower back nerves. Additionally, accidents or trauma to the spine can damage or pinch the sciatic nerve. Cauda equina syndrome, a rare but serious condition, affects the nerve bundle at the spinal cord’s end, causing leg pain, numbness around the anus, and loss of bladder and bowel control.
Diagnosis of Sciatica:
Sciatica is diagnosed through medical history, physical examination, and diagnostic imaging. Physical exams assess the degree of motion, pain location, and nerve and muscle function. Most sciatica cases are diagnosed this way. Imaging, such as X-rays, CT scans, and MRIs, is used when sciatica is severe or cauda equina syndrome is suspected, helping to visualize bones, muscles, nerves, ligaments, and cartilage. Diagnosis is essential for determining the appropriate treatment.
Treatment of Sciatica:
Treatment aims to reduce pain and improve mobility. Many sciatica cases resolve with self-care, including cold or hot compresses, over-the-counter painkillers, and gentle stretches. Doctors may recommend physiotherapy, steroid medications (oral or injected), and postural modifications. If these treatments are ineffective, surgery may be considered, with the type depending on the sciatica’s cause and location. Minimally invasive surgeries like endoscopy are now preferred.
