Sciatica or Sciatic Nerve Pain - What is That?
Sciatic nerve pain is a serious problem, which is called "sciatica" in medicine.
Typical symptoms of this disease include pain in the buttock, extending to the back side of the thigh and lower leg, and sometimes reaching the foot, numbness of the skin of these areas and weakness (up to paralysis) of the leg muscles, as well as strong sciatic pain and involuntary muscle contraction, when the doctor is trying to raise and straighten the leg of supine patient.
All these symptoms depend on functional characteristics and location of the sciatic nerve, which starts from the sacral plexus, passes under the buttocks muscles through the back side of the thigh, and bifurcates into two descending branches short before the popliteal fossa. The sciatic nerve provides cutaneous sensitivity of the corresponding areas, carries motor impulses to muscles, which unbend trunk and hip, lift up the foot etc.
4 main facts about sciatica:
1. The sciatic nerve is the biggest nerve in the human body.
2. Sciatic nerve pain is usually caused by annoyance or
inflammation of this nerve.
3. Treatment methods and remedies for sciatica depend on the basal cause and level of the pain.
4. This pain is usually felt from the low part of back to behind the femur and emanating down below the knee.
What causes sciatic nerve pain?
The most common of this painful condition is squeezing of the sciatic nerve. Symptoms appear differently, depending on where it takes place and what causes it. How does it look when one of the spinal roots of sacral plexus is compressed? If the cause is hernial protrusion of intervertebral disc, patient may feel sudden sharp pain, aggravated by movement and coughing.
Simultaneously, during the first day patients feel growing violations of skin sensitivity and muscle weakness. Spine, strangled by thickened ligament or bone growths in osteochondrosis, is exposed to gradually growing sciatic pain and numbness. Muscle weakness will join later, in serious lesions it can be accompanied by muscle atrophy.
Compression of the sciatic nerve by muscles is called “tunnel syndrome”. It can be caused by some spine and joints diseases, injuries, flat feet and even unsuccessful injections in the buttocks. Tunnel syndrome manifestations range from pain in the buttock to the burning foot sole pain, when you cannot control the movements.
Sciatic nerve injuries (bruises, fractures, stab and cut wounds) are commonly accompanied by moderate pain, but violate the transmission of motor impulses. They can lead to muscle atrophy, paralysis, emergence of dry skin and venous leg ulcers.
A number of diseases, impairing the metabolism, can violate the operation of the sciatic nerve. It’s diabetes mellitus, some diseases of the thyroid gland, different poisoning.
Shingles, caused by herpes sometimes gives pain and rash in the form of bubbles on the sciatic nerve.
Sciatica Treatment and Pain Relief
Self-care remedies are quite helpful for many people with sciatica pain. You may use alternating cold and hot packs, special exercises, stretching. In some cases, physician may appoint an anti-inflammatory remedy and a muscle relaxant.
Medication also may be used for short-term sciatic nerve pain relief. Anticonvulsant and antidepressants medications also help to lower chronic pain.
Physical therapy is very important part of treatment, especially if the cause of pain is a herniated disk. When severe pain improves, your physical therapist has to work out a rehabilitation program to preclude repeating injuries.
This program usually includes exercises that help to correct your posture, reinforce your back muscles and develop your flexibility. You should start this physical therapy as early as possible. Try to make these exercises at home your daily indispensable program.
What if traditional treatment methods don't help?
If conservative methods of treatment don't relieve your sciatic nerve pain within a few months, you may try more "agressive" options:
- Surgery. Surgical variants include diskectomy and microdiskectomy. Diskectomy is removing a portion of a herniated disk which is pushing a nerve. A surgeon is trying to leave most of the disk intact to keep normal anatomy form. Sometimes this operation is conducted through a tiny incision, and a surgeon is looking to operable zone through a microscope (it's called microdiskectomy).
- Epidural steroid injections. Sometimes, physicians recommend injection of a steroid medication into the injured region. Corticosteroids inhibit inflammation in the irritated sciatic nerve and help to alleviate pain.
Diagnosis of the sciatic nerve lesions
Modern diagnostic methods can accurately identify the reasons for trouble. First of all, as a rule, doctors use X-ray of the lumbosacral spine. It allows them to assess the condition of the vertebrae and identify bony growths. Information about the intervertebral joints functioning is taken from radiography with functional tests (flexion, extension). In some cases they make a radiography with the injection of contrast material into the spinal canal.
Computed tomography helps to study in detail not only the bony structures, but also the intervertebral discs. It is indispensable for the diagnosis of disk herniation, as well as tumors and traumatic injuries. Magnetic-resonance tomography helps to distinguish the spinal cord, and give a forecast of its viability at squeezing. Electromyography is used to determine the nature of sciatic nerve lesions. It’s a study of muscles bioelectric activity under the influence of different stimulation types.
Sciatic nerve pain is a very unpleasant thing, but the main goal is to eliminate its cause, not just the symptoms.