Diseases and Disorders

A Brief Overview of Sciatica

Alex Rahal


Introduction

Sciatica results from complications within the sciatic nerve. The sciatic nerve is the largest nerve in the human body, starting in the lower back and traveling down the legs. This nerve controls the muscles located in the back of the knee and lower leg, which in turn maintains sensory perception in the back portion of the legs. Damage to this crucial nerve can result in a set of symptoms known as sciatica, which results in numbness, tingling, or even pain in the back and  legs; however, the symptoms occur regularly on only one side of the body [2]. This article will examine the symptoms, methods of diagnosis, treatments, and prevention techniques of sciatica, perhaps one of the most influential conditions in modern-day America.

 

Symptoms

Although sciatica is relatively unknown among the majority of citizens in America, its reach and effect is widespread in the nation. According to Harvard Health Publishing, nearly 40% of all people will experience sciatica at one point in their life [2]. Due to its wide reach among the American populace, with nearly 3 million reported cases each year, information about sciatica, including its symptoms, is becoming more accessible to those afflicted with this condition [2]. 

Sciatica is associated with a wide range of symptoms, ranging from a simple weakness in the leg to a burning pain. Sciatic pain radiates from the lower back through the leg and down to the foot. The pain associated with sciatica comes in different forms, ranging from a small ache to sharp jolts of pain; such pain often occurs on only one side of the body. This pain can often render it difficult for the affected person to move their legs or stand up. Furthermore, feelings of pain and discomfort can be intensified with coughs or sneezes [3]. In extreme cases, sciatica can lead to loss of bowel or bladder function [4]. However, not all cases of sciatica yield such dire consequences. Some of sciatica’s symptoms can be mild. Examples include a tingling sensation or numbness. Multiple symptoms of sciatica may be present in some patients; pain, numbness, and tingling could all occur simultaneously in different portions of the leg. 

 

Diagnosis

To diagnose a patient with sciatica, doctors will often order their patients to conduct many activities to test their muscle strength and record their pain. Activities, such as raising one leg at a time or rising from a squatting position, are often used to test for sciatica. If the patient truly does have sciatica, their pain should worsen, making it easier for their doctor to diagnose them [5]. Many machines are also used in sciatica’s diagnosis, including X-Ray, Magnetic Response Imaging (MRI), and Electromyography (EMG). All of these methods allow doctors to determine, what, if any, causes of sciatica are present. This includes herniated disks and bone spurs (the overgrowth of a bone), which cause sciatica when they pinch the sciatic nerve [4]. Once a patient is diagnosed with sciatica, their doctor can assign a wide variety of treatments.

Treatments and Prevention

After a patient is fully diagnosed with sciatica, their doctor often prescribes medications such as anti-inflammatories. Medicinal treatments under this category include Ibuprofen, muscle relaxants, narcotics, and tricyclic antidepressants, all of which are designed to mitigate the pain caused by sciatica [3]. In limited cases, doctors may inject corticosteroids into the affected area, which reduces inflammation around the nerve [4]. In the past, bed rest was the recommended remedy for mild cases of sciatica. However, this is no longer seen as a suitable treatment, as a paper by B.W. Koes, a professor from the Department of General Practice at the University of Medical Center Rotterdam, M.W. van Tulder, a professor of health technology assessment at VU Medical Center, and W.C. Peul, a neurologist, indicates. Koes, Tulder, and Peul recommend more physical activities compared to bed rest. “A few hours of bed rest may provide some symptomatic relief but does not result in faster recovery,” the study indicated [7]. In some extreme cases, surgery may be conducted to remove a portion of the bone spur or herniated disk that irritates the sciatic nerve when it is the cause of extreme weakness or worsening pain [4].

While there are many treatments for sciatica, avoiding it entirely is much simpler and appealing. Although not all causes of sciatica can be prevented, including degenerative disc disease, pregnancy, and even age, the majority of causes can be prevented by taking simple precautions [6]. For example, obesity can increase the stress on the spine, which can lead to sciatica. In addition, diabetes increases the risk of nerve damage due to its effect on the body’s use of blood sugar. By managing and maintaining a healthy weight, these contributors to sciatica can be mitigated. In addition, prolonged stillness in one position (particularly sitting) can contribute to the appearance of sciatica. Good posture, which relieves the spine of stress, serves as an effective countermeasure to this neurological disorder. Another way to prevent sciatica is regular exercise, which strengthens the muscles in the back and abdomen, which in turn strengthens the spine. Finally, avoiding smoking products can prevent the degeneration of the spinal discs, which also contributes to the prevalence of sciatica [6]. Many of these precautions not only help prevent sciatica, but also other degenerative physical conditions, increasing the likelihood of living a longer, healthier, and happier life.

 

Conclusion

Sciatica’s reach and effects on American citizens is unparalleled by most conditions. Every person should have a deep understanding of this condition, its symptoms and diagnosis process, and the steps needed to prevent sciatica altogether. Medical treatments to sciatica have been steadily advancing throughout the years, including a rice-sized pellet injected near the inflammation, reducing pain caused by sciatica. As medical knowledge continues to expand, newer treatments such as this will become more common and sciatica may lose its painful influence in America.


References


  1. “NJ Sciatica Treatment-Bergen/Passaic County: New Jersey.” Oakland Spine and Physical Therapy. www.oaklandspinenj.com/ condition/sciatica/. Retrieved: 10/11/2019

  2. Harvard Health Publishing. “Sciatica: Of All the Nerve.” Harvard Health. www.health.harvard.edu/pain/sciatica- of-all-the-nerve. Retrieved: 10/07/2019

  3. “Sciatica.” Healthdirect Australia. www.healthdirect.gov.au/ sciatica. Retrieved: 10/11/19

  4. “Sciatica.” Mayo Foundation for Medical Education and Research. www.mayoclinic.org/diseases-conditions/sciatica/ symptoms-causes/syc- 20377435. Retrieved: 10/20/19.

  5. “Piriformis Injection: Piriformis Syndrome Pain Treatment: Pain Spa, Bristol, UK.” Pain Spa, www.painspa.co.uk/procedure/ piriformis- injection/.

  6. “Sciatica Prevention.” Cleveland Clinic. my.clevelandclinic. org/health/diseases/ 12792-sciatica/prevention. Retrieved: 10/23/19.

  7. Koes, B W, et al. “Diagnosis and Treatment of Sciatica.” BMJ Publishing Group Ltd. www.ncbi.nlm.nih.gov/pmc/articles/ PMC1895638/. Retrieved: 10/23/19.

  8. Stahl, Stephanie. “Experimental New Treatment Showing Promise For Those Who Suffer From Sciatica.” CBS Philly, CBS Philly, 19 Feb. 2019, philadelphia.cbslocal.com/2019/02/19/ experimental-new-treatment-showing-promise-for-those-who-suffer-from-sciatica/.

Alex Rahal

Alex Rahal


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