Neuro Spine Care

SCIATICA

The sciatic nerve is the longest and thickest nerve made up of five nerve roots- two from the lumbar spine and three from the sacrum forming right and left sciatic nerve. Sciatica is referred to as the pain developed due to compression and irritation of sciatic nerves. The sciatic nerve radiates along the path from the lower back and buttocks down to each leg. The pain can vary from moderate to severe and weakness and numbness can be experienced in these areas that can cause muscle weakness and tingling. About 40 percent of people suffer from Sciatica at some point in their lives.

SYMPTOMS

Seek medical attention if you notice the following signs :-

Constant pain one side of the rear
Pain and inflammation in the lower back
Hip pain
Weakness and numbness in the legs and feet
Burning and tingling down the leg
Loss of bowel and bladder control due to cauda equina
Loss of movement

CAUSES

The doctor will examine your back and assess your ability to sit, stand, walk and lift your legs. If there is a reason to suspect that a specific condition is causing your back pain, your doctor might prescribe one or more tests :-

Pregnancy
Degenerative disk disease
Excess weight
Ageing spine compresses lower back nerves
Diabetes
Lumbar spinal stenosis
Spondylolisthesis is a condition that occurs when one vertebra slips over another
Piriformis syndrome can cause muscle & compress sciatic nerves
Spinal tumors in the lumbar spine can cause nerve compression

RISK FACTORS

Diabetes increases the risk of nerve damage
Heavy lifting and prolonged sitting
The body parts tend to experience break downs and wear and tear with ageing.
Smoking causes the breakdown of the outer layer of the spinal disc
The obese body increases stress on the spine which triggers Sciatica.
Vitamin B 12 deficiency
Poor work ergonomics
Genetic susceptibility

DIAGNOSIS

Physical Examination

The doctor might check for pain in the buttocks, lower back and legs.
Response to certain stimuli and leg movement

Clinical Tests

Slump Test - The patient is asked to sit upright with his hands behind the back and bending forward at the hip. The neck is bent down with the chin touching the chest and one knee is extended to a degree possible. If the pain occurs, Sciatica may be present.
Straight leg raise test- The patient is asked to lie on his back and lift one leg at a time with another bent at the knee. If the pain occurs, Sciatica may be present.

Medical History and Test Imaging

The doctor might order some imaging test and inquire about the patient’s medical history. MRI and CT scan allow the doctor to visualize the sciatic nerve and a discogram helps in determining the abnormalities in intervertebral discs.

Nature and duration of pain
Trauma or injury in lower back or buttocks
The occurrence of muscle spasms
Cramps in the pelvic area
The onset of pain and other symptoms

TREATMENT

It is advisable to treat Sciatica at the initial stages only to avoid the progression of symptoms.

Non- surgical methods

Acute sciatic nerve conditions are generally treated by non-surgical methods. Non- surgical methods are a combination of physical therapy, medications and therapeutic injections that provides a cure in about 4 to 6 weeks.

Physical therapists and trained professionals formulate an effective treatment plan essential for treating Sciatica which includes exercises that provide relief from sciatic pain and increase core strength.

Medications are used to relieve sciatic pain. Nonsteroidal anti-inflammatory drugs, anticonvulsant medications, oral steroids, antidepressants and opioid analgesics are generally prescribed for pain-relieving.

Chiropractic and massage therapy are used to address the underlying cause of sciatic nerve pain that can be herniated discs or spinal stenosis. Massaging improves blood circulations induces the release of endorphins which acts as natural pain relievers. It relaxes the tight muscles that can be a contributing factor to pain.

Some common steroid injections and selective nerve blocks are administered for controlling the inflammatory response around the sciatic nerve. Selective nerve root blocks provide instant relief from the pain and inflammation in some cases.

Surgical methods

Surgery is needed if the pain persists for a long duration even after trying several non-surgical treatments. Surgeries are performed in case of tumors, Cauda equina syndrome, bilateral Sciatica and infection in the pelvic region that cannot be cured by medications.

Microdiscectomy

Microdiscectomy is a minimally invasive approach used for treating Sciatica caused by a lumbar disc herniation. It is done by making small incisions and causing minimal damage to the surrounding tissues.

Laminectomy

Laminectomy is performed to treat the Sciatica pain caused by lumbar spinal stenosis. In this, all part of the lamina is removed making more space for the spinal nerves. It provides relief from nerve root compressions and irritation.

PREVENTION

Regular exercising can strengthen the core muscles and back muscles for maintaining a healthy spine and proper posture.
Properly lift heavy objects by bending at your knees and keeping your back straight.
Change your positions more often, don’t stand or sit for too long. Pain can be an early warning that your body is not perfectly aligned. If you start to feel sore, change your posture.
Quit smoking as Nicotine weakens the spine and vertebral discs by reducing the blood supply to the bones.
Avoid consumption of high calories and fats. Maintaining a healthy weight is essential as the increased body can put extra pressure on the spine.