DON'T IGNORE SCIATICA PAIN

► When does sciatica pain occur?

The sciatic nerve is the longest and thickest nerve in the body with a width up to 2cm. Despite the name, it is not a single nerve but rather a bundle of nerves originating from the five nerve roots that branch off from the spinal cord.

In the human body, there are two sciatic nerves – one on each side - running along the hips, buttocks, down the legs and to the knee. Here, they split into different nerves connecting to the further parts such as the lower legs, feet and toes.

Sciatica is pain that occurs along the sciatic nerve pathway. The main reason for sciatica is herniated disc or bone overgrowth applying pressure on the spinal nerve roots.


 

► Individuals prone to sciatica pain

• Individuals who had or currently have spinal or lumbar spine injuries are prone to developing sciatica pain
• Senior citizens: the natural wear and tear of the spine over time can cause nerve compression, herniated discs or degenerative joints - main causes for sciatica
• Individuals who are overweight, obese or pregnant: increased body weight due to weight gain or pregnancy forces the back muscle to work harder which places pressure on the nerve.
• People works in specific occupation: jobs requiring heavy lifting, excessive bending, or inappropriate postures can increase the risk of having lower back problems. On the other hand, jobs involving prolonged sitting and sedentary time such as office work also increase the risk of lumbar spine issues, if proper back support is not provided.
• Sport enthusiasts: sport players, gymnasts who practice with incorrect postures are also prone to sciatica.
• Diabetes patients: type 2 diabetes increases the risk of peripheral neurological diseases, causing damage to nerves.
• Cigarette smokers: nicotine use might affect circulation and increase the risk of chronic muscle pain, including sciatica.

► Causes of sciatica pain

• Herniated discs
• Degenerative dics
• Spinal stenosis
• Foraminal stenosis
• Spondylolisthesis
• Osteoarthritis
• Trauma
• Pregnancy
• Tumor, cyst or other developing tumors
• Conus medullaris syndrome
• Cauda equina syndrome

► Symptoms of sciatica pain

• Pain: Sciatica pain arises from pressure on the affected nerve. Patients usually describe the sciatica pain as a burning sensation or an electric shock. This pain also runs down the affected leg. Pain often occurs with cough, sneezes, forward bending or leg rising while lying flat.
• Tingling or pins-or-needles sensation: Similar feeling to numbness after sitting with crossed legs for a long time.
• Loss of sensation: Patients lose the sensation in affected areas of the back or legs due to difficulties in signal transmitting from the back or legs to the brain.
• Muscle weakness: This is a more severe symptom - a sign of motor signals having difficulties reaching the back or legs.
• Urinary or fecal incontinence: This is an extremely severe symptom, when the controlling signals are unable to reach the bladder and bowel.

► Complications of sciatica pain

► Diagnosing sciatica pain

• Walking: Sciatica pain may affect the patient's gait. Observing those changes is a part of diagnosing sciatica pain.
• Straight leg raising testing: The patient lies flat on the bed with both legs extended. The doctor will raise one leg at a time, checking the pain level or other symptoms to identify the cause.
• Strength and flexibility testing: Some other tests on strength or flexibility may be conducted to identify other factors, if any, that cause or contribute to the sciatica pain.

► Treating sciatica pain

• Cold compress: Apply cold packs or ice covered in cloth and apply on the sensitive area in 20 minutes, repeat several times a day to aid the pain and swelling for the first few days.
• Heat compress: After using cold compress for several days, patient can switch to warm compress or warm cloth for 20 minutes at a time. The patient can choose either a warm or cold compress depending on its effectiveness.
• Over-the-counter drugs: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain, swelling, and inflammation. However, misuse or prolonged use may lead to unwanted side effects.
• Stretching and movement: Gentle exercises like stretching the back muscles, strengthening exercises, or low-impact aerobics activities can help relieve sciatica pain.

• Prescription medication: Pain relievers, muscle relaxants, and other medications like tricyclic antidepressants or anticonvulsants may help alleviate sciatica pain, especially with chronic pain or nerve-related symptoms.
• Physical therapy: Physical therapy aims to reduce sciatica pain by alleviating pressure on the nerve. Patients might be guided to do stretching or low-impact exercises such as walking, swimming, or water aerobics.
• Spinal injections: Corticosteroid injections may provide temporary relief for up to three months. Doctors will advise patients on their suitability for such treatments.
• Alternative therapies: chiropractic adjustments, yoga, acupuncture, or massage,…

• Discectomy: Depending on the severity, doctors may remove fragments of the herniated disc, partial or entire disc pressing on the nerve.
• Laminectomy: Removal of part of the lamina, the rear portion of the vertebra, to relieve pressure on spinal nerves.

► Preventing sciatica pain

• Maintain proper posture: Practice correct posture techniques when sitting, standing, lifting objects, and sleeping.
• Quit smoking: Nicotine, from all sources (including e-cigarettes), reduces blood flow to the bones, weakening the spine and its components.
• Adopt a healthy lifestyle: Ensure a nutritious diet, ensure sufficient amount of calcium and vitamin D to maintain bone health.
• Build physical strength: Regular exercises of muscle strengthening and flexibility train such as stretching, walking, aerobics, yoga, and swimming can strengthen core muscles and improve back health.
• Avoid falls: Avoid unnecessary high heels, wear slip-resistant shoes, and maintain a clean and well-lit living space to reduce fall risks.
• Allow time for recovery: Avoid heavy work during back pain episodes to prevent more severe injury. Rest, engage in gentle movements, and practice appropriate exercises to give the body time to heal.