Sciaticas

What is Sciatica?

Sciatica refers to pain that radiates along the sciatic nerve, the largest nerve in the body. This nerve runs from the lower back, through the hips and buttocks, and down each leg. Sciatica typically occurs when the nerve is compressed, irritated, or inflamed, causing discomfort that ranges from mild to severe. While most cases are resolved with conservative treatments, some may require further evaluation to address the underlying cause.

Types of Sciatica

Sciatica can be broadly categorised into two main groups: structural and secondary sciatica.

Structural SciaticaThis is the most common type, caused by physical issues that compress or irritate the sciatic nerve. Common subtypes include:

• Herniated Disc: A common cause of sciatica, where a bulging or ruptured spinal disc presses on the sciatic nerve.

• Spinal Stenosis: Narrowing of the spinal canal, leading to compression of the nerve roots.

• Piriformis Syndrome: Irritation of the sciatic nerve caused by the piriformis muscle in the buttocks.

• Spondylolisthesis: A condition where a vertebra slips forward over the one below it, narrowing the spinal canal and pinching the sciatic nerve.

Secondary SciaticaThis occurs as a result of other conditions or factors that indirectly affect the sciatic nerve. Examples include:

• Pregnancy: Pressure from the growing uterus on the sciatic nerve.

• Tumours: Rare but serious causes that may compress the sciatic nerve.

• Trauma or Injury: Direct injury to the nerve or surrounding tissues.

• Systemic Conditions: Conditions such as diabetes can lead to nerve damage (diabetic neuropathy), including the sciatic nerve.

Symptoms of Sciatica

The symptoms of sciatica may vary in intensity and presentation, depending on the cause. Common symptoms include:

• Radiating pain from the lower back through the buttocks and down the leg.

• Sharp, burning, or shooting pain that worsens with movement, coughing, or sneezing.

• Numbness, tingling, or "pins and needles" sensation in the leg or foot.

• Muscle weakness in the affected leg.

• Difficulty sitting, standing, or walking for prolonged periods.

Warning Signs: Seek immediate medical attention if you experience:

• Severe pain accompanied by weakness, numbness, or difficulty moving the leg or foot.

• Loss of bladder or bowel control (a rare condition called cauda equina syndrome).

• Persistent, worsening pain that does not improve with rest or conservative treatments.

  
  

Diagnosis and Treatment Options

Diagnosis: A comprehensive evaluation is essential to determine the underlying cause of sciatica. Diagnostic steps may include:

• Detailed Medical History and Physical Examination: To assess symptoms, reflexes, and mobility.

• Imaging Studies: X-rays, MRI, or CT scans to identify structural issues such as herniated discs or spinal stenosis.

• Electromyography (EMG): To assess nerve function and pinpoint areas of nerve compression or damage.

Treatment Options: The treatment of sciatica focuses on relieving pain and addressing the root cause. Options include:

• Lifestyle Modifications:

  • Regular low-impact exercises, such as swimming or walking, to improve flexibility and strength.

  • Ergonomic adjustments at work or home to reduce strain on the lower back.

  • Weight management to minimise pressure on the spine.

• Medication:

  • Over-the-counter pain relievers, such as paracetamol or ibuprofen, for mild symptoms.

  • Prescription medications, including muscle relaxants or anti-inflammatory drugs, for more severe cases.

  • Nerve block injections or corticosteroids to reduce inflammation around the sciatic nerve.

• Physical Therapy:

  • Specific stretches and strengthening exercises tailored to relieve pressure on the sciatic nerve.

  • Manual therapy to reduce muscle tension and improve mobility.

• Surgical Interventions:

  • Reserved for severe cases where conservative treatments have failed, such as for a herniated disc or spinal stenosis.

  • Common procedures include microdiscectomy or laminectomy to relieve nerve compression.

• Alternative Therapies:

  • Acupuncture or chiropractic care to alleviate pain and promote healing.

  • Yoga and mindfulness-based stress reduction to manage chronic symptoms.

Conclusion

Sciatica can significantly impact daily life by limiting mobility and causing persistent discomfort. Understanding the underlying cause of your symptoms is crucial for effective treatment. At Singapore Brain Spine Nerves Center, we provide expert evaluation and personalised care to help you recover and regain your quality of life. If you or a loved one are struggling with sciatica, schedule a consultation with us today to take the first step toward lasting relief. Visit the Singapore Brain Spine Nerves Center to learn more.