Monday 28 June 2021

SCIATICA: Symptoms, causes, best treatment options

From sciaticapain.co.uk

Sciatica is a painful condition caused by pressure on the root of a large nerve coming out of the spinal cord – nervus ischiadicus. Sciatica manifests as pain in the lower back, spreading over the buttocks to the leg and foot. Sciatica is not a disease but refers to a group of symptoms that include lower back pain (lumbago), hip pain, leg pain, numbness, and poor mobility.

The sciatic nerve is one of the longest and largest nerve in the human body. It extends from the root of the spinal cord, across the pelvis, along the back of the leg, and ends at the foot. Pressure on the sciatic nerve causes a recognizable, sharp pain called sciatica, and it makes it even hard to stand or sit.

Sciatica – inflammation of the femoral nerve is still known in terminology as sciatic neuralgia or lumbar radiculopathy.

What causes sciatica and how long does sciatica last? Learn all about the sciatica symptoms and how to treat sciatica in this text.

INTERESTING FACTS ABOUT SCIATICA 

  • The total length of nerves in the human body is approximately 45 miles! The largest one is sciatic nerve
  • Sciatica affects men slightly more often than women
  • Sciatica usually occurs between the ages of 35 and 50
  • Older people are at higher risk of sciatica
  • It is estimated that as many as 40% of people will suffer from sciatica, at least once in their lifetime


SCIATICA

Sciatica causes pain that is extremely sharp, strong, and intense, and the very nature of the pain resembles a sting or even an electric shock. Generally, sciatica pain in the leg covers only one side of the body.
A person suffering from sciatica feels a radiant pain that goes from the lower back through the buttocks to the thigh, and through the lower leg, it can spread to the foot. Sciatica is not a diagnosis, but its name includes symptoms such as:

  • pain in the legs
  • tingling in the legs
  • pain in lower back (lumbago)

Lower back pain spreads over the buttocks to the leg and foot, and prolonged sitting or standing can make the pain worse.

The most common causes are

  • disc herniation
  • spinal stenosis or narrowing of the spinal canal
  • degenerative diseases of the spine
  • spondylolisthesis
  • piriformis syndrome or sacroiliac joint dysfunction.


Although the pain associated with sciatica can be severe, most cases resolve with non-surgical treatment within a few weeks. The pain can vary greatly, from mild to severe. Sometimes it can feel like an electric shock. The pain may intensify if the person coughs or sneezes, and prolonged sitting may worsen the symptoms. Usually, only one side of the body is affected. Some people also feel shivering, tingling in the legs, pain in the hip and legs, or muscle weakness in the affected leg or foot. Some have pain in one part of the leg and stiffness in the other part.

In the majority of cases sciatica pain resolves within six weeks or less.

SCIATICA SYMPTOMS

Sciatica, whose symptoms are very obvious, is characterized by strong and intense pain, accompanied by tingling or lack of any sensation in one part of the leg. Sciatica can manifest through various symptoms, such as:

  • pain that oscillates from moderate to severe
  • sharp pain in the lower back that spreads to one leg
  • a burning or tingling sensation all over the leg
  • leg stiffness
  • limited foot function
  • pain that becomes more intense while sitting

The pain can be felt in various places, such as thigh, buttocks, lower back, lower legs, and continues along the femoral nerve all the way to the feet and toes. Sciatica pain usually occurs in one leg, and any movement or attempt to sit or to stretch the leg or shift body weight from one leg to the other further worsens the condition. Since the sciatic nerve connects the spine to the muscles of the legs and feet, sciatica can lead to a gradual weakening and even partial atrophy of some muscles.

In some cases, bending the lower leg and raising the foot can be a particular problem. In severe cases, urinary incontinence can also develop, as a result of the close interaction of the sciatic nerve with other peripheral pathways of the nervous system responsible for internal organs.

Although sciatica causes severe pain, many people endure the pain for a long time. It is recommended by a doctor to seek help and not delay treatment, even at the appearance of the first symptoms that cause discomfort. Sciatica not only reduces the quality of life but can also have numerous short-term and long-term health consequences.


WHAT CAUSES SCIATICA?

The sciatic nerve, also the largest and longest nerve in the body, located deep in the gluteus and leg, cannot be easily damaged. However, this happens often and several reasons lead to sciatica.

Sciatica can be caused by:

  • Disc herniation – each disc has a strong outer layer and a softer inner part that acts as a shock absorber lining the vertebrae during movement. If the disc collapses, which occurs during the aging process or due to injury, the inner part of the disc may bulge or crack through the outer layer (disc herniation). The protruding inner part of the disc can press on or irritate the nerve root, and can even injure it.
  • Lumbar spinal stenosis – narrowing of the lumbar spinal canal presses on the roots of the sciatic nerve (sometimes the spinal cord). It can be innate and acquired. Acquired lumbar spinal stenosis is a common cause of sciatica in middle-aged or elderly patients. Its causes are mostly degenerative, such as spondylosis or discopathy.
  • Causes of lifestyle diseases – age, obesity, physically hard work, long sitting, irregular exercise, wearing high heels, sleeping on a soft mattress.
  • Causes due to other diseases – spinal tumour, infection, fracture, diabetes, muscle spasm
  • Pregnancy as a separate condition that causes changes in the body. Pain in the lower back often occurs during pregnancy as a result of pressure on the sciatic nerve.
    This can happen when the foetus is too heavy and thus puts pressure on nearby organs. Also, being overweight in pregnancy puts extra strain on the intervertebral discs and joints, which can lead to sciatica.

Very often people do not notice the development of sciatica and repeated painful conditions and discomfort ascribe to fatigue. In doing so, the person does not change the usual way of life, continues to work in the same way, burdening the lower back. But that can make the condition even worse. Anxiety, stress, negative emotions and fear for the future also cause muscle tension and affect health.

HOW DO I KNOW IF I HAVE SCIATICA?

The pain caused by sciatica can be so severe that it can make it impossible to walk or stand. The pain intensifies with movement and strain, even with minimal actions, such as laughing, sneezing, or coughing. In this case, it is recommended to arrange an examination with a neurologist who will, after talking with the patient, determine the nature of the pain, its duration, and several factors that contribute to the onset of pain. Since the pain is strongest when a person tries to lift an outstretched leg, this is exactly the situation in which doctors can safely recognize sciatica – Lasegue test. During this test, the patient lies on his back with legs outstretched. The doctor slowly and evenly lifts the straightened leg upwards. At the same time, holds the knee with the palm of the other hand so that it is not bent. The leg rises in height until the pain or discomfort begins to be felt in the buttocks and along the back of the thighs. The angle of the legs is measured approximately. The test is considered positive if the angle to which the leg is raised is less than 90 degrees, which indicates a strong irritation to the nerve and requires additional tests and therapy.


Other diagnostic methods used for sciatica are:

  • X-ray examination, which can determine the involvement of the spine or intervertebral discs
  • Ultrasound diagnostics, MRI – which can determine the exact location of damage and nerve involvement.

SCIATICA-RELATED COMPLICATIONS REQUIRING MEDICAL INTERVENTION

Although most people recover completely from sciatica, often without treatment, sciatica can potentially cause permanent nerve damage. Therefore, it is important to seek medical help in case of:

  • Muscle weakness – occurs as a result of a pinched nerve and if this condition lasts for a long time it can lead to chronic muscle weakness and even muscle atrophy.
  • Foot dysfunction – the foot literally ‘falls’. This occurs due to extreme muscle weakness in the front of the lower leg and foot. It is one of the most extreme complications of sciatica.
  • Loss of sensation – since the ischiadic nerve is responsible for sensitivity to touch in the buttocks and legs, nerve compression can lead to a tingling sensation, as if ants are crawling all over the leg, and in severe cases to complete loss of sensation.
  • Incontinence – severe cases of pressure on the sciatic nerve can cause urinary and / or stool incontinence. Incontinence is the involuntary escape of urine whether it is a larger or smaller amount of urine. Several factors can lead to incontinence, and one of the rarer is sciatica.

SCIATICA TREATMENT

Treatment of sciatica should not be neglected, at the first appearance of symptoms of the disease. Before applying any therapy, it is necessary to determine the exact cause of sciatica, on which the entire treatment will depend. As sciatica can occur quite suddenly, before you can arrange an examination with a specialist, these steps can provide first aid for sciatica.

SCIATICA FIRST AID

  • Rest, limit movement – in the initial phase of severe pain, it is necessary to limit movement until the pain subsides. The body should always be warm and dry.
  • Lie on a hard surface. It is important to relieve back pressure, and you can put a pillow or towel under your feet.
  • Cold compresses help at the first sign of pain. Put on the sore spot for about 15-20 minutes and repeat the procedure every 2-3 hours
  • Take a painkiller

In the case of chronic sciatica, the use of a hard surface for sleeping and sitting is recommended. It is also necessary to avoid any physical overload, hypothermia, back muscle overload, and lifting heavy loads. But at the same time, it is necessary to lead an active lifestyle, take care of proper nutrition, and maintain a healthy body weight.

 

CONSERVATIVE TREATMENT OF SCIATICA

Conservative methods of treating sciatica include:

  • Painkillers that in the acute phase aim to reduce pain, relieve muscle cramps, improve blood circulation in the affected area, and eliminate swelling and inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs) belong to the group of analgesics and have anti-inflammatory and analgesic effects. In case of severe pain and when the inflammation cannot be eliminated with non-steroidal painkillers, corticosteroid drugs can also be used, although treatment with this method is not recommended for more than 2 weeks.
  • Injections – in case the pain is severe, the inflammation can be reduced by epidural injection of steroids. The injection is given directly into the painful area and in a short period leads to pain relief, although it does not affect all patients equally. The injections are aimed at reducing inflammation and pain so that the patient can continue to function normally to conduct physical therapy.
  • Physical therapy – It is recommended to combine medical treatment of sciatica with physiotherapy, as such an integrated approach helps to shorten the course of taking drugs that have several side effects and improve the results of therapy.

Physical therapy can include:

  • Ultrasound treatment, which can penetrate the tissue to a depth of 5 cm and thus stimulate blood circulation and lymphatic drainage. This method has an anti-inflammatory and strong analgesic effect and reduces muscle cramps.
  • Magnetic therapy is a method of treatment using a magnetic field that improves cell function and relieves pain.
  • Electrophoresis is a long-used method in physiotherapy in which the drug is injected into the affected area using an electric current.

ALTERNATIVE TREATMENT FOR SCIATICA

Although the mentioned therapy with analgesics and non-steroidal drugs is quite effective, it is important to mention the numerous side effects that these drugs cause and how long-term use can cause serious complications and harm the body. It is therefore not surprising that many patients are turning to alternative treatments for sciatica, which have also been effective in relieving sciatica pain.

  • Chiropractor for sciatica – this method performed by a professional chiropractor is aimed to straighten the spine, which helps reduce pain, relieve muscle compression, and reduce muscle spasms that can occur with sciatica.
  • Acupuncture for sciatica– an ancient alternative treatment where sciatica is treated with painless needle sticks near the area of ​​pain
  • Sciatica massage – after the acute inflammation has passed, any type of massage can be useful (eg classical massage, cupping massage, and acupuncture). This procedure helps to relieve tension, relieve pain, and eliminate discomfort. No matter what type of massage it is, massage improves blood flow, helps remove lymph congestion, and relieves pain. Sciatica massage combined with physiotherapy greatly helps reduce pain.

SCIATICA MEDICINES

There are many pharmaceutical or natural remedies that alleviate the symptoms of sciatica or have a preventive effect. Doctors and patients generally decide to take pharmaceutical and natural medicines in combination at the same time. Usually, pharmaceutical drugs are taken in the short term because they can cause side effects, unlike natural ones.

SCIATICA NATURAL TREATMENT

You can also buy natural medicines such as Acuraflex without a prescription. Acuraflex capsules and cream are effective in mild symptoms or the initial stage of sciatica, and in moderate to severe cases as an addition to pharmaceutical therapy. Acuraflex products are available in capsules and creams.

Acuraflex capsules contain curcumin extract, which has a strong anti-inflammatory effect, comparable to prescription anti-inflammatory drugs. They also contain ginger and resin extract of Indian incense, whose anti-inflammatory properties are also very well known. They contain calcium and magnesium and vitamins B1 and B6 which are important for the normal functioning of the nervous system and muscle function.

Acuraflex cream contains high-quality oils, vitamin E, aloe vera, cayenne pepper, mint, whose analgesic properties bring instant relief by rubbing on the sore spot and also nourish the skin. It also contains herbal ingredients like curcumin, ginger, aloe vera, and others that have anti-inflammatory effects. Capsules and cream do not cause side effects and can be combined with other drugs.


HOW TO PREVENT SCIATICA PAIN?

It is not always possible to prevent sciatica pain because its causes are very different, but with the way of life and general care for one’s health, it is possible to avoid it or get over it with as few complications as possible. Here are some of the measures to prevent sciatica pain:

  • Practice sciatica exercises regularly – when exercising, pay attention to the torso muscles (abdominal and back muscles) and the buttock muscles that are necessary for proper posture and painless spine. Exercises for sciatica can be practiced at home after the acute phase of inflammation had passed. Sciatica exercises greatly improve the painful condition, increase blood circulation, and reduce lumbar pain. The most common exercises are performed for stretching the back, followed by exercises aimed at strengthening the abdominal and back muscles. Depending on several factors, sciatica exercises and therapy needs to be tailored to each patient individually.
  • Pay attention to posture while sitting – choose a seat with lower back support, armrests, and a swivel base. If you do not have such a chair, put a smaller pillow behind your back.
  • Learn to use your body so that you put less strain on it – if you stand for a long time, occasionally rest one leg on a chair or small box. When you lift something heavy, let your lower extremities do most of the work.
  • Be active, move more, and lead a healthy lifestyle – give preference to foods rich in vitamins and minerals and do not forget to control the amount of salt you eat. Limit the use of fatty, fried, and smoked foods, as well as coffee and strong tea.
  • Avoid stress or learn to control your emotions
  • Avoid hypothermia
  • Control your weight, being overweight is the enemy of all organs and systems.

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