What is Sciatica?
Sciatica is a term given to the pain that shoots from the lower back, hips, buttocks and behind the thighs down to the leg along the path of the sciatic nerve.
It usually affects the person only on one side of the body.
Sciatica occurs due to the compression of the sciatic nerve which can be due to various reasons like a prolapsed disk, bony growths (osteophytes) over the spine or narrowing of the spine.
There is swelling, severe pain, and numbness in the affected leg.
Symptoms of Sciatica
Pain starting at the lower back and shooting down from the buttocks, hip joint, thigh and then to the calf along the path of the sciatic nerve is the main symptom of sciatica. Usually, only one side is affected in sciatica.
The pain is worse when the patient moves the affected leg or coughs or sneezes. It can worsen more by sitting for a long time.
Numbness, tingling or weakness of the leg muscles may also be seen in the affected leg.
Causes of Sciatica
Sciatica occurs due to compression of the sciatic nerve. Sciatic nerve may get compressed due to various reasons like:
- A slipped disk in the lower back
- Bony overgrowths (spur) on the vertebrae
- A tumor
- Diseases like diabetes.
- Age: the changes in the spine that take place with increasing age like a slipped disk or bony overgrowths (Spurs) commonly cause sciatica.
- Obesity: an excess of body weight can put pressure on the spine leading to changes that can cause sciatica.
- Occupation: works that need exertion of the body like lifting, pulling, pushing, twisting of the back, driving for long periods can cause sciatica.
- Prolonged sitting: people who sit for long times due to their occupation or may be due to their sedentary lifestyle may come up with sciatica.
- Diabetes mellitus: people suffering from DM can come up with sciatica.
Diagnosis of Sciatica
The diagnosis can be easily made by asking the patient to do certain easy activities like walking on his toes or heels, getting up from a squatting position and lifting the leg up one by one while lying straight on the back. If the pain increases during these activities then the person is diagnosed of having sciatica.
Other tests that can help to confirm the diagnosis are:
- X-ray: X-ray examination shows if there is any bony overgrowth in the spine which may be compressing the nerve and leading to sciatica.
- CT scan and MRI scanning: these tests show the changes in the bones and soft tissues like slipped disks and the condition of the nerves that are affected.
- Electromyography: this is done to see the response of the muscles to nerve impulses that are generated and sent by the nerves. This test helps to confirm the diagnosis of sciatica by showing whether the nerve is compressed by a slipped disk.
- Losing of body weight in those who are obese can help tremendously in reducing the complaints of sciatica.
- Cold or hot applications over the areas where there is an intense pain can help in reducing the pain.
- Stretching exercises of the lower back can help to relieve the symptoms by relieving the compressed nerve roots.
- Avoid doing heavy works which put more pressure on the affected side of the body.
- left-sided sciatica
- pain starts in the lower back and radiates down the leg to toes
- pain is located in the left hip or pain in hip radiates to the knee
- drawing, tearing, shooting pains
- > lying on left side > pressure
- > warm application
- right-sided sciatica
- cutting, shooting, stabbing or stitching
- Pain starts in the lower back and extends down the right hip, thigh, hollow of knee and leg
- < uncovering lower limbs
- > warmth, pressure
- sciatica < walking
- > rest
- > lying on affected side
- sciatica pain that gets worse from rest or while sitting
- < lying on affected side
- sciatica that arises from lifting a heavy weight
- Indicated in Sciatica when pain is associated with numbness of affected part
- Better lifting up the leg, flexing thigh on abdomen
- Muscular Rheumatic pain of neck and back, chronic in nature
- Cramps in feet and calf muscle while lying down
- Gouty pain in big toe
- Chronic Lumbago with numbness in lower back and weight in pelvis
- Neuralgic pain
- Pain worse from pressure or cold application
- Cramp in calf muscles
- Tingling burning pain with numbness
- Injury of Coccyx , with pain radiating upwards to spine and down the limbs
- Jerking and Twitching of muscles.