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Define sciatic pain


Causes, Symptoms, Treatment, Prevention & Pain Relief

Overview

True sciatica is an injury or irritation to the sciatic nerve, which starts in your buttock/gluteal area.

What is sciatica?

Sciatica is nerve pain from an injury or irritation to the sciatic nerve, which originates in your buttock/gluteal area. The sciatic nerve is the longest and thickest (almost finger-width) nerve in the body. It’s actually made up of five nerve roots: two from the lower back region called the lumbar spine and three from the final section of the spine called the sacrum. The five nerve roots come together to form a right and left sciatic nerve. On each side of your body, one sciatic nerve runs through your hips, buttocks and down a leg, ending just below the knee. The sciatic nerve then branches into other nerves, which continue down your leg and into your foot and toes.

True injury to the sciatic nerve “sciatica” is actually rare, but the term “sciatica” is commonly used to describe any pain that originates in the lower back and radiates down the leg. What this pain shares in common is an injury to a nerve -- an irritation, inflammation, pinching or compression of a nerve in your lower back.

If you have “sciatica," you experience mild to severe pain anywhere along the path of the sciatic nerve – that is, anywhere from the lower back, through the hips, buttocks and/or down your legs. It can also cause muscle weakness in your leg and foot, numbness in your leg, and an unpleasant tingling pins-and-needles sensation in your leg, foot and toes.

What does sciatica pain feel like?

People describe sciatica pain in different ways, depending on its cause. Some people describe the pain as sharp, shooting, or jolts of pain. Others describe this pain as “burning,” "electric” or “stabbing.”

The pain may be constant or may come and go. Also, the pain is usually more severe in your leg compared to your lower back. The pain may feel worse if you sit or stand for long periods of time, when you stand up and when your twist your upper body. A forced and sudden body movement, like a cough or sneeze, can also make the pain worse.

Can sciatica occur down both legs?

Sciatica usually affects only one leg at a time. However, it’s possible for sciatica to occur in both legs. It’s simply a matter of where the nerve is being pinched along the spinal column.

Does sciatica occur suddenly or does it take time to develop?

Sciatica can come on suddenly or gradually. It depends on the cause. A disk herniation can cause sudden pain. Arthritis in the spine develops slowly over time.

How common is sciatica?

Sciatica is a very common complaint. About 40% of people in the U.S. experience sciatica sometime during their life. Back pain is the third most common reason people visit their healthcare provider.

What are the risk factors for sciatica?

You are at greater risk of sciatica if you:

  • Have an injury/previous injury: An injury to your lower back or spine puts you at greater risk for sciatica.
  • Live life: With normal aging comes a natural wearing down of bone tissue and disks in your spine. Normal aging can put your nerves at risk of being injured or pinched by the changes and shifts in bone, disks and ligaments.
  • Are overweight: Your spine is like a vertical crane. Your muscles are the counterweights. The weight you carry in the front of your body is what your spine (crane) has to lift. The more weight you have, the more your back muscles (counterweights) have to work. This can lead to back strains, pains and other back issues.
  • Lack a strong core: Your “core” are the muscles of your back and abdomen. The stronger your core, the more support you’ll have for your lower back. Unlike your chest area, where your rib cage provides support, the only support for your lower back is your muscles.
  • Have an active, physical job: Jobs that require heavy lifting may increase your risk of low back problems and use of your back, or jobs with prolonged sitting may increase your risk of low back problems.
  • Lack proper posture in the weight room: Even if you are physically fit and active, you can still be prone to sciatica if you don’t follow proper body form during weight lifting or other strength training exercises.
  • Have diabetes: Diabetes increases your chance of nerve damage, which increases your chance of sciatica.
  • Have osteoarthritis: Osteoarthritis can cause damage to your spine and put nerves at risk of injury.
  • Lead an inactive lifestyle: Sitting for long period of time and not exercising and keeping your muscles moving, flexible and toned can increase your risk of sciatica.
  • Smoke: The nicotine in tobacco can damage spinal tissue, weaken bones, and speed the wearing down of vertebral disks.

Is the weight of pregnancy the reason why so many pregnant women get sciatica?

It’s true that sciatica is common in pregnancy but increased weight is not the main reason why pregnant women get sciatica. A better explanation is that certain hormones of pregnancy cause a loosening of their ligaments. Ligaments hold the vertebrae together, protect the disks and keep the spine stable. Loosened ligaments can cause the spine to become unstable and might cause disks to slip, which leads to nerves being pinched and the development of sciatica. The baby’s weight and position can also add pressure to the nerve.

The good news is there are ways to ease sciatic pain during pregnancy, and the pain goes away after birth. Physical therapy and massage therapy, warm showers, heat, medications and other measures can help. If you are pregnant, be sure to follow good posture techniques during pregnancy to also ease your pain.

Symptoms and Causes

What causes sciatica?

Sciatica can be caused by several different medical conditions including:

  • A herniated or slipped disk that causes pressure on a nerve root. This is the most common cause of sciatica. About 1% to 5% of all people in the U. S. will have a slipped disk at one point in their lives. Disks are the cushioning pads between each vertebrae of the spine. Pressure from vertebrae can cause the gel-like center of a disk to bulge (herniate) through a weakness in its outer wall. When a herniated disk happens to a vertebrae in your lower back, it can press on the sciatic nerve.

  • Degenerative disk disease is the natural wear down of the disks between vertebrae of the spine. The wearing down of the disks shortens their height and leads to the nerve passageways becoming narrower (spinal stenosis). Spinal stenosis can pinch the sciatic nerve roots as they leave the spine.
  • Spinal stenosis is the abnormal narrowing of the spinal canal. This narrowing reduces the available space for the spinal cord and nerves.

  • Spondylolisthesis is a slippage of one vertebra so that it is out of line with the one above it, narrowing the opening through which the nerve exits. The extended spinal bone can pinch the sciatic nerve.
  • Osteoarthritis. Bone spurs (jagged edges of bone) can form in aging spines and compress lower back nerves.
  • Trauma injury to the lumbar spine or sciatic nerve.
  • Tumors in the lumbar spinal canal that compress the sciatic nerve.
  • Piriformis syndrome is a condition that develops when the piriformis muscle, a small muscle that lies deep in the buttocks, becomes tight or spasms. This can put pressure on and irritate the sciatic nerve. Piriformis syndrome is an uncommon neuromuscular disorder.
  • Cauda equina syndrome is a rare but serious condition that affects the bundle of nerves at the end of the spinal cord called the cauda equina. This syndrome causes pain down the leg, numbness around the anus and loss of bowel and bladder control.

What are the symptoms of sciatica?

The symptoms of sciatica include:

  • Moderate to severe pain in lower back, buttock and down your leg.
  • Numbness or weakness in your lower back, buttock, leg or feet.
  • Pain that worsens with movement; loss of movement.
  • “Pins and needles” feeling in your legs, toes or feet.
  • Loss of bowel and bladder control (due to cauda equina).

Diagnosis and Tests

Straight leg raise test helps spot your point of pain. This test helps identify a disk problem.

How is sciatica diagnosed?

First, your healthcare provider will review your medical history. Next, they’ll ask about your symptoms.

During your physical exam, you will be asked to walk so your healthcare provider can see how your spine carries your weight. You may be asked to walk on your toes and heels to check the strength of your calf muscles. Your provider may also do a straight leg raise test. For this test, you’ll lie on your back with your legs straight. Your provider will slowly raise each leg and note the point at which your pain begins. This test helps pinpoint the affected nerves and determines if there is a problem with one of your disks. You will also be asked to do other stretches and motions to pinpoint pain and check muscle flexibility and strength.

Depending on what your healthcare provider discovers during your physical exam, imaging and other tests might be done. These may include:

  • Spinal X-rays to look for spinal fractures, disk problems, infections, tumors and bone spurs.
  • Magnetic resonance imaging (MRI) or computed tomography (CT) scans to see detailed images of bone and soft tissues of the back. An MRI can show pressure on a nerve, disk herniation and any arthritic condition that might be pressing on a nerve. MRIs are usually ordered to confirm the diagnosis of sciatica.
  • Nerve conduction velocity studies/electromyography to examine how well electrical impulses travel through the sciatic nerve and the response of muscles.
  • Myelogram to determine if a vertebrae or disk is causing the pain.

Management and Treatment

How is sciatica treated?

The goal of treatment is to decrease your pain and increase your mobility. Depending on the cause, many cases of sciatica go away over time with some simple self-care treatments.

Self-care treatments include:

  • Appling ice and/or hot packs: First, use ice packs to reduce pain and swelling. Apply ice packs or bag of frozen vegetables wrapped in a towel to the affected area. Apply for 20 minutes, several times a day. Switch to a hot pack or a heating pad after the first several days. Apply for 20 minutes at a time. If you’re still in pain, switch between hot and cold packs – whichever best relieves your discomfort.
  • Taking over-the-counter medicines: Take medicines to reduce pain, inflammation and swelling. The many common over-the-counter medicines in this category, called non-steroidal anti-inflammatory drugs (NSAIDs), include aspirin, ibuprofen (Advil®, Motrin®) and naproxen (Naprosyn®, Aleve®). Be watchful if you choose to take aspirin. Aspirin can cause ulcers and bleeding in some people. If you’re unable to take NSAIDS, acetaminophen (Tylenol®) may be taken instead.
  • Performing gentle stretches: Learn proper stretches from an instructor with experience with low back pain. Work up to other general strengthening, core muscle strengthening and aerobic exercises.

How long should I try self-care treatments for my sciatica before seeing my healthcare professional?

Every person with sciatic pain is different. The type of pain can be different, the intensity of pain is different and the cause of the pain can be different. In some patients, a more aggressive treatment may be tried first. However, generally speaking, if a six-week trial of conservative, self-care treatments – like ice, heat, stretching, over-the-counter medicines – has not provided relief, it’s time to return to a healthcare professional and try other treatment options.

Other treatment options include:

  • Prescription medications: Your healthcare provider may prescribe muscle relaxants, such as cyclobenzaprine (Amrix®, Flexeril®), to relieve the discomfort associated with muscle spasms. Other medications with pain-relieving action that may be tried include tricyclic antidepressants and anti-seizure medications. Depending on your level of pain, prescription pain medicines might be used early in your treatment plan.
  • Physical therapy: The goal of physical therapy is to find exercise movements that decrease sciatica by reducing pressure on the nerve. An exercise program should include stretching exercises to improve muscle flexibility and aerobic exercises (such as walking, swimming, water aerobics). Your healthcare provider can refer you to a physical therapist who’ll work with you to customize your own stretching and aerobic exercise program and recommend other exercises to strengthen the muscles of your back, abdomen and legs.
  • Spinal injections: An injection of a corticosteroid, an anti-inflammatory medicine, into the lower back might help reduce the pain and swelling around the affected nerve roots. Injections provide short-time (typically up to three months) pain relief and is given under local anesthesia as an outpatient treatment. You may feel some pressure and burning or stinging sensation as the injection is being given. Ask your healthcare provider about how many injections you might be able to receive and the risks of injections.
  • Alternative therapies: Alternative therapies are increasingly popular and are used to treat and manage all kinds of pain. Alternative methods to improve sciatic pain include spine manipulation by a licensed chiropractor, yoga or acupuncture. Massage might help muscle spasms that often occur along with sciatica. Biofeedback is an option to help manage pain and relieve stress.

When is surgery considered?

Spinal surgery is usually not recommended unless you have not improved with other treatment methods such as stretching and medication, your pain is worsening, you have severe weakness in the muscles in your lower extremities or you have lost bladder or bowel control.

How soon surgery would be considered depends on the cause of your sciatica. Surgery is typically considered within a year of ongoing symptoms. Pain that is severe and unrelenting and is preventing you from standing or working and you’ve been admitted to a hospital would require more aggressive treatment and a shorter timeline to surgery. Loss of bladder or bowel control could require emergency surgery if determined to be cauda equine syndrome.

The goal of spinal surgery for sciatic pain is to remove the pressure on the nerves that are being pinched and to make sure the spine is stable.

Surgical options to relieve sciatica include:

Microdiscectomy: This is a minimally invasive procedure used to remove fragments of a herniated disk that are pressing on a nerve.

  • Laminectomy: In this procedure, the lamina (part of the vertebral bone; the roof of the spinal canal) that is causing pressure on the sciatic nerve is removed.

How long does it take to perform spine surgery and what’s the typical recovery time?

Discectomy and laminectomy generally take one to two hours to perform. Recovery time depends on your situation; your surgeon will tell you when you can get back to full activities. Generally the time needed to recover is six weeks to three months.

What are the risks of spinal surgery?

Though these procedures are considered very safe and effective, all surgeries have risks. Spinal surgery risks include:

  • Bleeding.
  • Infection.
  • Blood clots.
  • Nerve damage.
  • Spinal fluid leak.
  • Loss of bladder or bowel control.

What complications are associated with sciatica?

Most people recover fully from sciatica. However, chronic (ongoing and lasting) pain can be a complication of sciatica. If the pinched nerve is seriously injured, chronic muscle weakness, such as a “drop foot,” might occur, when numbness in the foot makes normal walking impossible. Sciatica can potentially cause permanent nerve damage, resulting in a loss of feeling in the affected legs. Call your provider right away if you lose feeling in your legs or feet, or have any concerns during your recovery time.

Prevention

Can sciatica be prevented?

Some sources of sciatica may not be preventable, such as degenerative disk disease, sciatica due to pregnancy or accidental falls. Although it might not be possible to prevent all cases of sciatica, taking the following steps can help protect your back and reduce your risk:

  • Maintain good posture: Following good posture techniques while you’re sitting, standing, lifting objects and sleeping helps relieve pressure on your lower back. Pain can be an early warning sign that you are not properly aligned. If you start to feel sore or stiff, adjust your posture.
  • Don’t smoke: Nicotine reduces the blood supply to bones. It weakens the spine and the vertebral disks, which puts more stress on the spine and disks and causes back and spine problems.
  • Maintain a healthy weight: Extra weight and a poor diet are associated with inflammation and pain throughout your body. To lose weight or learn healthier eating habits, look into the Mediterranean diet. The closer you are to your ideal body weight the less strain you put on your spine.
  • Exercise regularly: Exercise includes stretching to keep your joints flexible and exercises to strengthen your core – the muscles of your lower back and abdomen. These muscles work to support your spine. Also, do not sit for long periods of time.
  • Choose physical activities least likely to hurt your back: Consider low-impact activities such as swimming, walking, yoga or tai chi.
  • Keep yourself safe from falls: Wear shoes that fit and keep stairs and walkways free of clutter to reduce your chance of a fall. Make sure rooms are well-lighted and there are grab bars in bathrooms and rails on stairways.

Outlook / Prognosis

What can I expect if I have been diagnosed with sciatica?

The good news about sciatic pain is that it usually goes away on its own with time and some self-care treatments. Most people (80% to 90%) with sciatica get better without surgery, and about half of these recover from an episode fully within six weeks.

Be sure to contact your healthcare provider if your sciatica pain is not improving and you have concerns that you aren’t recovering as quickly as hoped.

Living With

When should I contact my healthcare provider?

Get immediate medical attention if you experience:

  • Severe leg pain lasting more than a few hours that is unbearable.
  • Numbness or muscle weakness in the same leg.
  • Bowel or bladder control loss. This could be due to a condition called cauda equina syndrome, which affects bundles of nerves at the end of the spinal cord.
  • Sudden and severe pain from a traffic accident or some other trauma.

Even if your visit doesn’t turn out to be an emergency situation, it’s best to get it checked out.

Is the sciatic nerve the only source of “sciatica” pain?

No, the sciatic nerve is not the only source of what is generally called “sciatica” or sciatica pain. Sometimes the source of pain is higher up in the lumbar spine and causes pain in front of the thigh or in the hip area. This pain is still called sciatica.

How can I tell if pain in my hip is a hip issue or sciatica?

Hip problems, such as arthritis in the hip, usually cause groin pain, pain when you put weight on your leg, or when the leg is moved around.

If your pain starts in the back and moves or radiates towards the hip or down the leg and you have numbness, tingling or weakness in the leg, sciatica is the most likely cause.

Is radiculopathy the same as sciatica?

Radiculopathy is a broader term that describes the symptoms caused by a pinched nerve in the spinal column. Sciatica is a specific type, and the most common type, of radiculopathy.

Should I rest if I have sciatica?

Some rest and change in your activities and activity level may be needed. However, too much rest, bed rest, and physical inactivity can make your pain worse and slow the healing process. It’s important to maintain as much activity as possible to keep muscles flexible and strong.

Before beginning your own exercise program, see your healthcare provider or spine specialist first to get a proper diagnosis. This healthcare professional will refer you to the proper physical therapist or other trained exercise or body mechanics specialist to devise an exercise and muscle strengthening program that’s best for you.

Can sciatica cause my leg and/or ankle to swell?

Sciatica that is caused by a herniated disk, spinal stenosis, or bone spur that compresses the sciatic nerve can cause inflammation – or swelling – in the affected leg. Complications of piriformis syndrome can also cause swelling in the leg.

While all these conditions affect either the spinal cord, nerves, muscles, ligaments or joints and all can cause pain, none are directly related to sciatica. The main causes of these conditions are different. Sciatica only involves the sciatic nerve. That being said, the most similar condition would be carpal tunnel syndrome, which also involves a compression of a nerve.

A final word about sciatica. . . .

Most cases of sciatica do not require surgery. Time and self-care treatment are usually all that’s needed. However, if simple self-care treatments do not relieve your pain, see your healthcare provider. Your healthcare provider can confirm the cause of your pain, suggest other treatment options and/or refer you to other spine health specialists if needed.

Causes, Symptoms, Diagnosis, & Treatments

Written by WebMD Editorial Contributors

In this Article

  • How Sciatica Works
  • Risk Factors
  • Treatment

Back pain comes in all shapes and sizes. It can flare up immediately after an injury or appear slowly and mysteriously over a period of months. It might be sudden and short-lived (acute) or long-lasting (chronic).

Over-the-counter medicines help with some types of back pain, but only powerful drugs and surgery can fix others.

Sometimes it’s hard to identify the source of your back pain, but other times you can pinpoint it easily. Sciatica is one of those that’s pretty simple to identify. Home remedies can work fast, so you might not even have to call a doctor.

How Sciatica Works

Sciatica usually starts with a herniated disk in your lumbar (lower) spine. Your vertebrae (the bones that make up your spine) are separated and cushioned by flat, flexible, round disks of connective tissue. When a disk gets worn down -- either because of an injury or just years of use -- its soft center can begin to push out from the hard outer ring.

When a disk herniates, it might put pressure on the nerves around it. This can cause a lot of pain when that happens to be the sciatic nerve.

The sciatic nerve is the longest nerve in your body. It starts in your lower back and splits to run through your hips, buttocks, legs, and feet on both sides. Bone spurs and spinal stenosis (narrowing) can also put pressure on the sciatic nerve in the lower back. When that happens, it can cause a lot of problems all the way down the nerve.

The most distinctive sign of sciatica is pain that radiates from your lower back into the back or side or your legs. It can range from a mild ache to sharp, severe pain. You can also get numbness, tingling, and weakness in your leg or foot.

Risk Factors

Age. Most people who get sciatica are between 30 and 50 years old.

Weight. Extra pounds can puts pressure on your spine, which means people who are overweight and pregnant women have a greater chance of getting a herniated disk.

Diabetes can cause nerve damage.

Your job. Lots of heavy lifting -- or prolonged sitting -- can damage disks.

Treatment

Most people with sciatica get better in a few weeks without surgery. Over-the-counter pain relievers like ibuprofen (Advil) and naproxen sodium (Aleve) can help relieve pain, although they should be only a short-term solution.

Your doctor might also recommend putting cold packs on your lower back for a couple of days and then switching to hot packs for a few days after that. There are also lots of good stretches for lower-back and sciatic pain relief.

Your first instinct might be to rest and take it easy when you have sciatica, but it’s actually more important to keep moving. If you sit still, the nerve will continue to be irritated in that spot. Staying in motion will reduce the inflammation.

If home remedies don’t work, your doctor will probably prescribe stronger medication, like anti-inflammatories or muscle relaxants. You might also try steroid injections, physical therapy, acupuncture, or chiropractic care.

If your pain lasts for more than 3 months, it might be time for surgery. See your doctor immediately if your sciatica causes severe pain and weakness, numbness, and loss of bladder or bowel function.

Next Article

Sciatica: symptoms, treatment, diagnosis of the disease

Neurologist

Alekseeva

Oksana Aleksandrovna

Experience 24 years

Doctor of the highest category. Member of the European Association of Neurologists, the Russian Interregional Society for the Study of Pain (ROIB), the Association of Interdisciplinary Medicine. She has experience in hospital and outpatient services. He has seven publications on neuroscience.

Make an appointment

Sciatica is an inflammatory process that is accompanied by compression or irritation of the sciatic nerve along its entire length and severe pain in one or both limbs. The sciatic nerve is the longest in the human body. It runs from the sacrum to the toes, and pinching of the nervous tissue in any part of it leads to the development of the disease.

Types and forms of the disease

In accordance with the reasons that caused the development of sciatica, two main forms are distinguished:

  • primary, or symptomatic, in which the disease begins with damage to the sciatic nerve or its branches in the limb;
  • secondary, in which the disease first covers the tissues adjacent to the sciatic nerve, and then passes to the nerve fibers.

According to the localization of the site of the lesion, lower, middle and upper sciatica are distinguished.

Symptoms

The main symptom of sciatica is severe pain, which is initially localized in the lumbar region and sacrum, and as the disease progresses, it spreads along one, less often, both lower limbs. The pain may be burning or dull, continuous or "shooting", intermittently occur in the form of attacks, or be present all the time with variable intensity. The pain intensifies with movements of the spine, and in some cases even a slight movement of the affected limb leads to a severe pain outbreak.

In some patients, the pain is moderate, but there is a tingling or numbness of the limb or its specific area. Some time after the onset of sciatica, individual muscle groups gradually weaken, due to which the patient has difficulty walking. In the most severe cases, nerve entrapment leads to urinary and defecation disorders due to sphincter paralysis.

Causes of the development of the disease

All diseases and conditions that cause sciatica are divided into two groups:

  • vertebrogenic, i.e. associated with injuries and diseases of the spine - this includes osteochondrosis, injuries and deformities of the vertebrae or intervertebral discs, spondylosis, stenosis of the lumbosacral region;
  • non-vertebral, i.e. not associated with the spine, are infectious inflammations of the genitourinary system or muscle tissue, hypothermia, excessive physical exertion on the muscular corset of the lower back and pelvic region, sedentary lifestyle, overweight, pregnancy, tumor development, etc. .

Any compression of the sciatic nerve leads to the development of the disease. Most often, its cause is a herniated disc - a ring of fibrous tissue that separates the vertebrae.

Diagnostics

The primary diagnosis of sciatica begins with an examination by a neurologist, who during the conversation finds out the nature and location of pain, their frequency and duration. The doctor then checks for some of the symptoms of sciatica:

  • asks the patient to bend and straighten the leg - there should be pain in the popliteal fossa;
  • asks to bend a straight leg in the hip joint, and then in the knee - pain in the lower back and hip first appears, then disappears.

To clarify the prevalence of the inflammatory process, instrumental diagnostic methods are used:

  • x-ray of the lumbar spine to check for the presence of spondylosis and screen out a number of other diseases as the cause of pain;
  • Ultrasound to detect inflammation, injury or tumor in soft tissues;
  • MRI, which allows to detect abnormalities in the bone structure and soft tissues;
  • electroneuromyography to check the condition of nerve fibers (appointed for violations of sensitivity).

In many patients, at the beginning of the disease, the pain is not too strong and is of a short-term nature, so people are in no hurry to seek medical help. However, the signals that your body gives should in no case be neglected, because the earlier treatment is started, the less complicated and lengthy it will be.

Therapy

The greatest discomfort to the patient, as a rule, is caused by a pain symptom, and the treatment of sciatica is aimed not only at eliminating the cause that caused its appearance, but also at relieving pain. To do this, the neurologist prescribes:

  • non-steroidal anti-inflammatory drugs that relieve inflammation and reduce pain;
  • antispasmodics and muscle relaxants to eliminate muscle spasms that lead to compression of the nervous tissue;
  • analgesics for pain relief;
  • glucocorticosteroids to reduce inflammation and relieve pain;
  • vitamins to strengthen the function of nerve fibers and improve the conduction of nerve impulses.

In addition to drug treatment, with sciatica, physiotherapy procedures have a positive effect on health:

  • electrophoresis - the effect of a weak electric current and a drug on the skin in the area of ​​inflammation;
  • UHF - exposure to weak currents of ultrasonic frequency, which has a warming and stimulating effect;
  • laser beam therapy, which has a stimulating and analgesic effect;
  • magnetic therapy to anesthetize the affected area, reduce tissue edema, relieve inflammation;
  • therapeutic massage;
  • manual therapy;
  • acupuncture (acupuncture).

Patients with acute pain need bed rest to avoid further irritation of the nerve fibers and increase the inflammatory process.

During the period of remission, special physical exercises are of great benefit; in sciatica, they are prescribed to stimulate metabolic processes in weakened muscles, improve blood circulation and strengthen muscle tissue.

Surgical intervention for the treatment of sciatica is used in extremely rare cases:

  • when a benign or operable malignant tumor is detected;
  • if severe pain does not decrease after one and a half months of active therapy;
  • for severe pelvic dysfunction.

With a timely visit to the doctor, the prognosis is usually favorable, and the patient for a long time or completely gets rid of pain.

Prevention

To prevent the return of the disease, you must:

  • lead a healthy lifestyle, including proper nutrition and adequate physical activity;
  • regularly perform special exercises recommended by your doctor;
  • avoid drafts and injury;
  • to use a mattress of medium hardness for sleeping, supporting the physiological curvature of the spine.

Diagnosis and treatment of sciatica in Moscow

The modern clinic JSC "Medicina" offers Muscovites and guests of the capital the services of qualified treatment of sciatica. Reception is conducted by experienced neurologists, modern medical equipment from the best world manufacturers is used for diagnostic and treatment procedures.

Questions and answers

Which doctor treats sciatica?

Regarding the diagnosis and subsequent treatment of sciatica, it is necessary to make an appointment with a neurologist or orthopedist.

Can there be a temperature with sciatica?

An increase in body temperature during sciatica indicates the infectious nature of the inflammatory process. In this case, the pain syndrome is accompanied by the usual symptoms for infections - fever, malaise, general weakness, muscle pain, loss of appetite.

How to cure sciatica quickly?

The duration of treatment for sciatica is from two to six weeks, if the process proceeds without complications. With severe pain, the doctor prescribes special drugs to relieve pain, but after its termination, the patient still needs to complete the course of treatment. Interruption of therapy is fraught with a rapid return of the disease in an even more severe form.


Sciatica of the sciatic nerve: symptoms, treatment, diagnosis of the disease

Neurologist-algologist

Vasilenko

Marina Gennadievna

Experience 26 years

Neurologist-algologist. Member of the Society of Neurologists and Neurosurgeons, Russian Society for the Study of Pain, Association for Interdisciplinary Medicine, International Association for the Study of Pain (IASP). Head of the Pain Treatment Center.

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Sciatica of the sciatic nerve is an inflammatory disease, which, according to the degree of discomfort it causes, is included in the list of the most painful human pathologies. The sciatic nerve is the largest nerve fiber in the human body, connecting the spinal column to the lower limb. It starts in the lumbar region and ends in the phalanges of the toes. It is a paired organ present in both lower extremities. When the nerve fiber is compressed, severe pain occurs, which is localized in the sacrum, spreads to the buttock, femoral part and lower down to the foot.

Symptoms of the disease

The most important symptoms of sciatica of the sciatic nerve are:

  • pain localized in any part of the body along the passage of the nerve fiber: in the lower back, buttock, back of the thigh, lower leg, foot;
  • loss of sensation, numbness of the lower limb along the nerve fiber;
  • paresthesia - tingling sensations, "goosebumps" in the foot and toes.

The nature of the pain is most often shooting, but it can also be burning, dull, aching, etc. During periods of exacerbation, with movements of the spine or leg, it can intensify and become unbearable. As a rule, the disease affects one limb, but sometimes the pain appears in both legs at once. In the most severe cases, the disease leads to paralysis of the muscles of the leg, sometimes spreading to the muscles of the small pelvis, causing urinary and fecal incontinence in the patient.

Causes

Sciatica of the sciatic nerve is a disease that can be caused by a number of causes of a vertebrogenic, i.e. associated with the spine, or non-vertebrogenic nature.

  • Compression of the sciatic nerve or its branches is the most common cause of pain due to deformity, herniated disc, inflammation of the piriformis muscle, or displacement of a vertebra.⁠
  • Injuries to the lower spine, pelvis, or limb can result in nerve compression and nerve damage.
  • Degenerative-dystrophic changes in the structure of the spine - osteochondrosis, spondylarthrosis - lead to compression of the sciatic nerve.
  • Infectious diseases - scarlet fever, influenza, malaria, etc. - are accompanied by the release of toxins, leading to inflammation of the nerve fiber.
  • Toxins that enter the body from the outside - at work, when drinking alcoholic beverages - can also cause inflammation.
  • Systemic diseases - diabetes mellitus, gout, etc. - become the background for the appearance of pain.
  • A malignant or benign tumor that compresses a nerve is another likely cause of the pathology.
  • Hypothermia or excessive physical activity sometimes become the beginning of the inflammatory process.

Some experts single out the psychosomatics of sciatic nerve sciatica as a separate group of causes, believing that the disease can develop against the background of excessive psychological stress, stress, chronic fatigue, fear or phobia.

Diagnosis

This disease is characterized by a rather complicated diagnosis, the first stage of which is the conduct of reflexological tests for flexion and extension of the leg. To finally clarify the clinical picture, as necessary, appoint:

  • laboratory tests;
  • radiography of the affected area;
  • MRI;
  • CT;
  • electroneuromyography;
  • Ultrasound of the pelvic region.

The task of a neurologist is to identify symptoms characteristic of sciatica, and treatment should be aimed at eliminating the causes of nerve fiber compression.

Treatment

The choice of therapeutic methods depends on how severe the clinical manifestations of the disease are. When first contacting a neurologist, conservative methods of treating sciatica of the sciatic nerve prevail:

  • non-steroidal anti-inflammatory drugs;
  • hormonal preparations for the most severe cases;
  • analgesics that relieve pain;
  • antispasmodics, muscle relaxants.

Great importance is attached to all kinds of physiotherapeutic methods, which are used both during exacerbations (UHF, electrophoresis, laser or magnetic therapy), and at their end.

Massage for sciatica is of great benefit, significantly prolonging the periods of remission. Depending on the nature of the squeezing factor, the patient may be prescribed a general massage to relax the spinal muscles, therapeutic, acupressure or cupping. In many cases, acupuncture sessions bring considerable benefits.

Therapeutic exercises for sciatica is another extremely useful technique that is widely used after the acute phase of the disease. Moderate physical activity aimed at strengthening the muscular corset and improving the blood supply to the tissues of the back, pelvis and limbs allows patients to maintain their body in good physical shape and prevent the recurrence of pain attacks.

Statistics

Sciatica of the sciatic nerve is a fairly common disease in the age group from 35 to 50 years. It is the most active age that accounts for the majority of primary visits to the doctor. The disease affects men more often than women. According to some experts, during the whole life, up to 40% of people have experienced at least once an attack of pain in the sacral part of the lower back, buttock or back of the thigh, but not all of these attacks become chronically protracted. Cases of visiting a doctor are about 20-25 people per 100 thousand of the population.

Diagnostics and treatment of sciatica of the sciatic nerve in Moscow

JSC "Medicina" invites Muscovites and guests of the capital for consultations on the diagnosis and treatment of sciatica of the sciatic nerve. At your service - the most modern diagnostic and physiotherapy equipment, as well as the qualifications and experience of medical personnel. In our clinic, neurologists and orthopedists of the highest category are treated, who will be able to relieve pain in the shortest possible time and return you to a full life. Call us to make an appointment with a specialist, or leave a request online on our website.

Questions and answers

Which doctor treats sciatica of the sciatic nerve?

If pain occurs, you should immediately contact a qualified neurologist in order to carry out the necessary diagnostic procedures and determine the best method for treating sciatica sciatica.

How to sleep with sciatica of the sciatic nerve?

Severe pain often interferes with healthy sleep.


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