Sciatica is very often disabling, but not life-threatening, it is easily treatable in most cases by simple techniques, however, one needs to be aware of true sciatica features, other available treatment options and red flags to prevent complications and maintain the best quality of life. Ultimately, prevention is always better than cure. Slipped disc is one of the common but not the only cause of sciatica. It can also be caused due to compression of the roots due to degeneration, fractures, misalignment, growths, or due to pinching as it passes through certain holes, canals and spaces along its course.
According to Dr Gaurav Gomez, Consultant Intervention Pain Medicine & Neuro Rehabilitation, KMC Hospital, Mangalore, “The sciatic nerve is the largest peripheral nerve. It is the lower limb’s predominant wiring transmitting signals for muscle movements and sensations. Its structure is akin to an upside-down tree- roots emerging at various levels of the spine, trunk in the thigh and branches in the thigh and leg. “Sciatica” is a fancy, blanket term used to describe any pain in the distribution of the Sciatic nerve. Irritation to the nerve anywhere along its course can trigger the characteristic “electric”, “pricking”, “pulling” or “funny bone” like discomfort which is worsened by coughing, straining, bending or twisting.”
Here is a short interaction with the expert, Dr Dr Gaurav Gomez to better understand Sciatica pain, read on:
How to Identify Sciatica Pain?
There are various mimics of sciatica including pains generated from muscles and back joints Eg: Facet and Sacroiliac joints, each of which can radiate pain from the back down to the back of the thigh. Alternately, sciatica typically is a pain in the lower limb more than in the back.
Sciatica: Risk Factors
Age, obesity amplified by weak core strength, poor posture, improper lifting techniques, certain professions and pregnancy can predispose one to sciatica.
Although it is extremely common with a lifetime incidence of up to 40% of adults, it is often misunderstood.
Is Sciatica Preventable?
Do the opposite- practice proper ergonomics and lifting techniques, reduce body fat and most importantly strengthen core muscles via exercises such as planks, superman or yoga. Pregnancy can predispose to sciatica by changing the body’s centre of gravity, weakening stretched core muscles, relaxing ligamentous supports and adding load on the spine. Building an adequate fitness base before and during the early part of pregnancy, proper weight management and pregnancy yoga are good ways to prevent sciatica.
When to see a Doctor for your Sciatica pain?
If the pain is debilitating, progressively worsening instead of improving, preceded by a significant trauma, associated with weight loss, fever or lower limb weakness, numbness or changes in bladder/bowel control, it is imperative to seek urgent medical evaluation to pick up and treat reversible causes efficiently and prevent potentially more permanent lower limb and/or bowel-bladder deficits. Although pain can be managed later, neurological deficits are notoriously stubborn to reverse.
Sciatica Pain: Treatment
Most cases resolve with conservative care- ‘relative rest’ of a maximum of 1-2 days with the continuation of ambulation as far as possible, oral medications, physiotherapy/chiropractic treatment, acupuncture and heat/cold compresses can help. For those with persistent, nagging or severe sciatica or its mimics, treatment optimization and Ultrasound/X-ray-guided injections or certain conditions do warrant surgical management under Ortho-Spine specialists or Neurosurgeons.
