Sciatica or sciaticanerve pain is pain in the lower back that radiates to the hips, buttocks, legs, to the toes, along the path of the sciatic nerve (sciatic nerve). The sciatic nerve is the longest nerve in the body, starting from the spinal cord and branching down to the legs.
Sciatica can occur when the sciatic nerve is pinched or there is another disorder that causes the nerve to be injured. The severity of this pain varies from mild to severe. Sciatica can recover with self-management, but sciatica can also develop into a serious condition that can cause permanent nerve damage.
Sciatica Symptoms
Sciatica is characterized by pain and discomfort along the path of the sciatic nerve. Usually the pain is felt on only one side of the body, for example back pain on the right or left. The pain can resemble cramping accompanied by hot pain or like an electric shock. Pain will usually increase when the patient sits for a long time, sneezes, or coughs.
In addition to pain, some other symptoms that can also be felt by people with sciatica are:
- Tingling that radiates from the lower back to the feet.
- Leg muscles weaken.
- Numbness or numbness.
When to go to the doctor
Most cases of mild sciatica usually go away on their own. But don't hesitate to see a doctor immediately if symptoms can't be relieved by medication after a few weeks or get worse and interfere with daily activities.
Go to the ER immediately if you experience sciatica accompanied by the following symptoms or conditions:
- Numbness or muscle weakness in the lower body.
- Pain occurs after a serious injury, such as a traffic accident.
- Low back pain accompanied by fever.
- Symptoms of cauda equina syndrome.
- Urinary or stool incontinence.
Pain is felt in people with cancer or HIV. You are also advised to consult a doctor if you are obese or have a history of diabetes. This is because obesity and diabetes can increase the risk of developing sciatica.
Causes of Sciatica
Sciatica occurs when the sciatic nerve around the pelvis is pinched or injured. This condition is generally caused by the following conditions:
- Hernia nucleus pulposus, i.e. the bearing of the spine shifts from its position to press on the nerves.
- Bone spurs, namely calcification of bones, especially in the spine area.
- Spinal stenosis, which is a narrowing of the nerve pathways in the spine.
- Spondylolisthesis, namely the displacement of one part of the spine from its position.
- piriformis syndrome, where there is spasm of the piriformis muscle.
- Hip fracture.
- Pregnancy.
- The growth of a tumor pressing on the sciatic nerve.
- Blockage of blood vessels.
A person will also be more at risk of developing sciatica if they have the following factors:
- Often sits too long.
- Often lift heavy weights.
- Driving for a long time.
- Old age.
- Have a smoking habit.
- Experiencing obesity.
- Have a history of diabetes.
Sciatica Diagnosis
Sciatica can generally be diagnosed through a review of the patient's symptoms and medical history, as well as a physical exam to check muscle strength and reflexes.
Follow-up tests are carried out to confirm the correct diagnosis as well as to find out if there are other more serious conditions, such as tumors. Some of these inspection methods include:
- Scanning with X-rays, CT scans, or MRIs to determine if there is a problem pressing on the spinal cord.
- Electromyography (EMG), to measure the electrical impulses carried by the nerves and the response of the muscles.
Sciatica Treatment
Most cases of sciatica can recover without requiring treatment from a doctor. Self-handling can be done at home by:
- Rest the body for about three days. Patients are advised to lie more on a mattress that is not too soft.
- Compress the painful area with a warm or cold compress to relieve pain.
- Perform lower back stretching exercises to relieve symptoms and reduce pressure on the nerves.
- Take over-the-counter pain relievers, such as paracetamol.
However, if the above methods do not help you in overcoming the symptoms of sciatica, then visit a doctor. It is likely that the doctor will recommend the following medical treatment options:
Physiotherapy
Physiotherapy is done to determine the right physical exercise to reduce pressure on the back nerves. This physical exercise includes stretching and aerobic exercise. This therapy can also help improve posture, strengthen lower back muscles, and increase flexibility.
Drug administration
Commonly prescribed medications are anti-inflammatory, muscle relaxants (such as diazepam), anticonvulsants (such as gabapentin and pregabalin), or antidepressants (such as amitriptyline).
Corticosteroid injections
Anti-inflammatory injections, such as corticosteroids, may be given to relieve pain and inflammation around the affected nerves. However, the administration of injections will usually be limited because of the risk of serious side effects.
Operation
A surgical procedure will be recommended if other treatments have not worked and there is a more serious condition, such as pain that gets worse and doesn't go away, unable to control urination (urinary incontinence), fecal incontinence, or when the movement of the affected body muscles is getting weaker.
This procedure aims to remove bone growth, treat a pinched nerve, or treat other conditions that compress the spinal cord. The most common surgery is spinal surgery.
Sciatica Complications
In severe conditions, sciatica has the potential to cause complications due to nerve damage. Complications that can arise are chronic pain, permanent numbness, bladder and bowel disorders, and paralysis.
Sciatica Prevention
Although difficult to prevent and prone to recurrence, maintaining the health of the tissues around the lower back can help reduce the risk of developing this condition.
Here are some ways this can be done:
- Doing exercise regularly, especially exercises that can strengthen the abdominal and pelvic muscles, such as swimming.
- Maintain good posture when standing, sitting, and sleeping.
- Be careful when moving your body, especially when lifting heavy weights.
- Avoid standing or sitting for too long.
- Avoid using high heels.
- Maintain ideal body weight.
- Quit smoking.