Sciatica

Sciatica is an umbrella term people usually use to classify symptoms which are associated with pain and radiation in the legs and foot which usually comes after an episode of back pain or as a result of disc herniation. It usually is a result of disc bulge or disc herniation which compresses the sciatic nerve going from your buttocks to your thighs, legs and feet.

CAUSES

  • Bad postures for prolonged periods of time like working on a laptop, reading a novel/book, watching television, prolonged phone usage etc.
  • Weakness in core muscles.
  • Doing excessive gymming or weight training without proper coaching.
  • Awkward bending twisting motions of the back.
  • Picking up of heavy weights/furniture/suitcase in improper position.

SYMPTOMS

  • Back pain which can be continuous or intermittent in nature.
  • Stiffness in the back.
  • Paraspinal muscle spasm.
  • Trigger points in and around back, thighs and calves.
  • Walking and standing for prolonged period of time usually increases the pain.
  • Difficulty in bending.
  • Increase in the intraabdominal pressure usually increases the intensity of pain like sneezing, coughing, constipation.
  • Pain is of radiating nature which usually start from the back and then goes to the back or sides of thighs (in most of the cases).
  • If the bulge is significant the pain can also radiate upto the legs and feet too. There may or may not be tingling and numbness.
  • Weakness in the muscles of the lower limb.
  • Tiredness in the calf muscle and foot.
  • Tight hamstring (back of the thigh) muscle which further reduces flexibility.

DIAGNOSIS

  • X-ray: Gives us an idea of reduced disc space and we can suspect a disc bulge there. The clinical symptoms are corelated with the physical finding then.
  • MRI: though not always reliable but gives us a complete picture of disc bulge, herniations and nerve compression.
  • Physical Examination- Further confirms the diagnosis./li>

TREATMENT

  • Release of the paraspinal muscles by IASTM, manual therapy, cupping therapy etc.
  • Supporting the back muscles via kinesiotape or lumbar belt especially if patients has to travel by road for more than 20 mins in a day.
  • For pain management- Ultrasonic therapy, Interferential therapy, TENS modalities can be used.
  • Daily Hot and cold packs (whatever suits you)twice or thrice a day helps in managing spasm, stiffness and pain.
  • Gentle stretches helps maintaining flexibility of the spine.
  • Spinal decompression therapy is the top most therapy of choice in such cases and is gold standard in treatment.
  • Once the pain settles a bit than strength training of the core muscles has to be started to treat the problem from the root!
  • If the pain and radiation limits you from standing or walking for more than 5 -10 min than your doctor may recommend taking Gaba, pain killers and muscle relaxants etc.
  • Sciatica usually responds well tvo conservative management and only 5-10% of people require surgery.