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What is Sciatica.?
Sciatica refers to pain that radiates along the path of the sciatic nerve, which runs from the lower back, through the hips and buttocks, and down each leg. It is typically caused by compression or irritation of the sciatic nerve, often due to conditions such as:
- Herniated Disc/ Slipped disc: When the gel-like centre of a spinal disc protrudes through its tough outer shell and presses on the nerve root.
- Spinal Stenosis: Narrowing of the spinal canal that can compress the nerves.
- Degenerative Disc Disease: Wear and tear on the discs between the vertebrae, leading to disc bulge or herniation.
- Spondylolisthesis: A condition where one vertebra slips forward over another.
- Piriformis Syndrome: Irritation or compression of the sciatic nerve by the piriformis muscle in the buttocks.
- Trauma or Injury: Such as a fall or car accident, which can injure the spine
What does sciatica feel like.?
Sciatica is characterized by a distinct set of signs and symptoms that typically affect one side of the body. These signs can vary in intensity and presentation, but commonly include
Pain: The hallmark symptom of sciatica is pain that radiates down the leg. The pain can vary widely from a mild ache to sharp, shooting pain. It often starts in the lower back or buttock and radiates down the back of the thigh, calf, and possibly into the foot or toes. The pain may worsen with movement, sneezing, coughing, or prolonged sitting or standing.
Numbness and Tingling: Along with pain, individuals with sciatica may experience sensations of numbness or tingling in the affected leg or foot. This sensation can range from mild to severe and may be intermittent or constant.
Muscle Weakness: Weakness or difficulty moving the leg or foot, particularly in more severe cases where the sciatic nerve compression affects muscle function. This weakness may make it challenging to walk, stand on tiptoes, or perform other activities requiring leg strength.
Sensory Changes: Changes in sensation, such as a feeling of pins and needles (paraesthesia) or a sensation of burning along the path of the sciatic nerve. These sensory changes often accompany the pain and may fluctuate in intensity.
Bowel or Bladder Changes: In rare cases, sciatica can lead to loss of bowel or bladder control. This is a serious symptom that requires immediate medical attention, as it may indicate severe nerve compression or a condition known as cauda equina syndrome.
Pain Patterns: The pain associated with sciatica tends to follow specific patterns:
- Pain that radiates from the lower back or buttock down the back of the thigh.
- Pain that may extend into the calf and sometimes into the foot or toes.
- Pain that is typically worse on one side of the body.
- Pain that may be aggravated by sitting for prolonged periods, bending, lifting, or twisting movements
How is sciatica treated?
Treatment options for sciatica depend on the underlying cause, severity of symptoms, and individual factors. Here are common approaches to managing sciatica:
Physical Therapy:
- Exercise Therapy: Specific exercises to stretch and strengthen muscles supporting the back and improve flexibility.
- Manual Therapy: Hands-on techniques such as joint mobilization, dry needling, soft tissue massage, and manipulation to reduce pain and improve mobility,
- Chiropractic care: Spinal adjustments may help in some cases.
Steroid Injections:
Epidural Steroid Injections: Injected into the area around the affected nerve root to reduce inflammation and provide temporary pain relief. These injections are typically guided by imaging (e.g., fluoroscopy or ultrasound) to ensure precision.
Lifestyle Modifications:
Posture Correction: Guidance on maintaining proper posture during daily activities to reduce strain on the spine and nerves.
Surgery:
In severe cases where a herniated disk is compressing the sciatic nerve, surgery to remove the portion of the disk may be necessary.
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