What Is Sciatica?

Sciatica uncoded

It is quite common that a back pain is accompanied by a leg pain or a progressive numbness in the legs. But, for those people, taking back pains for granted, this new weird kind of pain forces them to seek medical help. This running pain down the legs is commonly referred to as Sciatica. It may affect people of any age group but it is mostly common among the working age group.

Sciatica

The term Sciatica originated from Sciatic nerve, which is the main nerve controlling sensations and the movements of our lower limbs. The nerve is made from many smaller nerve roots coming out of the lower spinal cord which in turn join hands to form the sciatic nerve. We refer to pain sensations perceived in the region from where sciatic nerve carries signals, as Sciatica. Since sciatic nerve is made from different nerve roots, any irritation of a single root can also cause sciatica. Even a small inflammation affecting the nerve roots or anywhere along the course of sciatic nerve would cause sciatic pain.

Reasons of sciatica

Slipped disc or disc herniation:

spinal disc herniation

This the most common cause and one generally comes across in working individuals. This is caused due to tear in the covering of the disc through which some of the disc material comes out. This initiates severe inflammation which irritates and puts pressure on the neighbouring nerve which results in chronic back pain with a pain running down the legs.

Degenerated spine:

Spinal Canal Stenosis

This is more common among elderly population where due to ageing there occurs some changes in form of growth of tissues in the spinal canal. This narrows the spinal canal where the spinal cord rests. Eventually, this starts compressing on the nerves so much so that the person gets pain or heaviness in legs after walking for some distance. This is a progressive condition where the person cannot move without pain.

Inflammation: Many a time inflammation in the lower back muscles from usage or some trauma leads to tensing of the muscles and generate pain in pelvis and legs. Other joints of pelvis and lower discs if inflamed due to some infection or trauma may also cause pain in the legs.

Spinal canal

There are many methods apart from the clinical examination, which is the most important, for the diagnosis of sciatica. Mri of the spine and electrophysiological studies of the nerve helps in defining the area of conflict which is causing the pain. These areas are then specifically treated for the relief of the symptom due to the nerve compression.

Treatment for sciatica:

Traditionally sciatica was treated conservatively especially in the younger population. A surgery was avoided in view of the risks involved. And this reason applied to both the surgeons and the patients to avoid a surgery even if it meant living with some pain. But when the pain didn’t improve or the progressive numbness or weakness in the legs ensues it becomes necessary to do an open spine surgery. And this is followed till date and practised.

sciatica treatment

During the recent time the newer ways of treatment for the same conditions came into being in form of minimally invasive endoscopic procedures where the same objective is achieved without cutting open the spine or damaging its integrity. These so called interventions are much safer and carry minimal risks to the patient. This could be said to be a treatment which addresses the fears of the patient yet treating him effectively. These stitchless endoscopic procedures are intended to be targeted and precision driven. The lesser invasive nature causes lesser collateral damage in return and enables the patient to go home in a short time after the surgery just like a sci- fi movie.

Staying pain free is a human right and I believe no one should be left out with a chance to treatment especially the working and the elderly people who are left out citing the complications of an open spine surgery. This fast growing minimally invasive interventions would definitely bring a positive change and a ray of hope in the lives of people who are living with pain of sciatica.

Dr Madhujeet
Author
Dr Madhujeet Gupta
Senior Spine & Pain Specialist

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