Sciatica


Sciatica , sciatic neuritis, sciatic neuralgia, or lumbar radiculopathy is a set of symptoms including pain caused by general compression or irritation of one of five spinal nerve roots of each sciatic nerve—or by compression or irritation of the left or right or both sciatic nerves. Sciatica is generally caused by the compression of lumbar nerves L3, L4, or L5 or sacral nerves S1, S2, or S3, or by compression of the sciatic nerve itself. The pain is characteristically of shooting type, quickly traveling along the course of the nerve.


Cause -


1. Spinal disc herniation - Sciatica caused by pressure from a disc herniation and swelling of surrounding tissue
2. Spinal stenosis - a condition in which the spinal canal (the spaces the spinal cord runs through) narrows and compresses the spinal cord, cauda equina, or sciatic nerve roots.-
3. Piriformis syndrome - It has colloquially been referred to as "wallet sciatica" since a wallet carried in a rear hip pocket compresses the buttock muscles and sciatic nerve when the bearer sits down. Piriformis syndrome cause sciatica when the nerve root is normal
4. Pregnancy - Sciatica may also occur during pregnancy as a result of the weight of the fetus pressing on the sciatic nerve during sitting or during leg spasms
5. Spinal tumors
6. Cauda equina syndrome.
7. Trauma to the spine - such as from a car accident

Symptom -


1. Lower back pain
2. Buttock pain
3. Numbness
4. Weakness in various parts of the leg and foot.
5. "Pins and needles" sensation
6. walking difficult
7. The pain may radiate below the knee, but does not always
8. Pain in the rear or leg that is worse when sitting
9. Burning or tingling down the leg, difficulty moving or controlling the leg.
10. Weakness, numbness, or difficulty moving the leg or foot
11. A constant pain on one side of the rear
12. A shooting pain that makes it difficult to stand up.

Investigation -


1. Straight legs raise to produce Lasègue's sign - positive if pain in the distribution of the sciatic nerve is reproduced with between 30 and 70 degrees passive flexion of the straight leg.
2. Computerised Tomography(CT Scan)
3. Magnetic resonance imaging (MRI)
4. MR neurography
5. Electromyogram
6. X-rays

Treatment -


• Bed rest for two weeks

Physiotherapy -


1. Various modalities for pain relief.
2. Strengthening and stretching exercises.
3. Manual manipulations.
4. Heat or ice packs alleviate the leg pain.
5. Postural re-education.
6. Piriformis Muscle Stretches
7. Low Back Stretches
8. Hamstring Stretches
9. Core Strengthening