SCIATICA


What is sciatica?
Sciatic nerve dysfunction is known as sciatica. The main nerve traveling down the leg is the sciatic nerve. Pain associated with the sciatic nerve usually originates higher along the spinal cord when nerve roots become compressed or damaged from narrowing of the vertebral column or from a slipped disk. Symptoms can include tingling, numbness, or pain, which radiates to the buttocks legs and feet.

The sciatic nerve is located in the back of the leg. It supplies the muscles of the back of the knee and lower leg. The sciatic nerve also provides sensation to the back of the thigh, part of the lower leg, and the sole of the foot. Partial damage to the nerve may demonstrate weakness of knee flexion (bending), weakness of foot movements, difficulty bending the foot inward (inversion), or bending the foot down (plantar flexion). A person's reflexes may be abnormal, with weak or absent ankle-jerk reflex. Several different tests can be performed to find the cause of sciatic nerve dysfunction.

What are the symptoms of sciatica?
Sciatica doesn’t have symptoms. It is a symptom itself, consisting of pain, burning, tingling or electric shock-like feelings in the path of the sciatic nerve. It usually results from injury to the fibers that make up the sciatic nerve. If you feel pain, weakness and/or changes in sensation (tingling, jolts, hot and cold, numbness) along the anatomical path the sciatic nerve travels, or numbness or weakness in the skin and/or muscles that the nerve’s fibers serve, then you are suffering from sciatica.

Also unpleasant feelings along the following routes constitute sciatica:
Down the back of the leg to say- the back of the knee
from the mid-buttock down the back of the leg to the knee and/or the outside of the calf and top of the foot, ending in the space between the last two toes inside the calf, behind the inner ankle to the sole of the foot lower back pain may also be present.

How is sciatica diagnosos confirmed?
To help diagnose sciatica and pinpoint which nerves, if any, are affected, your doctor will ask about your medical history and perform a thorough physical exam, paying special attention to your spine and legs.

You're also likely to have some basic tests that check your muscle strength and reflexes.

If your pain lasts longer than six weeks or is very severe, or you have another serious condition such as cancer, you may have one or more imaging tests to help identity why the sciatic nerve is compressed and to rule out other causes for your symptoms.
These tests include:
Spinal X-ray.
Magnetic resonance imaging (MRI).
Computerized tomography (CT) scan.

Occasionally, laboratory studies may be helpful. A CBC (complete blood count) may suggest infection, anemia due to certain cancers, or other unusual causes of sciatica. Elevated sedimentation rate may suggest inflammation somewhere in the body. Urinalysis can suggest a kidney stone, if there is blood in the urine, or infection, if there are bacteria and pus in the urine.

What can I do myself?
Try a cold pack to see if it helps the pain. If you don't have a cold pack, use a large bag of frozen vegetables; it makes a good first aid cold pack. Or have someone close to you massage you in a triangular pattern with an ice cube over the sore areas. The person should move the ice cube if your skin gets too cold (this may melt several ice cubes).

After the cold massages, try alternating with heat from an electric heating pad to see if it helps the pain. (Do not sleep with a heating pad on your back. It could cause a bad burn.)

If you don't have an electric heating pad, put a hand towel under hot water, wring it out, and place it on your back. Some physical therapy experts believe that moist heat penetrates more deeply and gives better relief of pain. (Do not use wet packs with your electric heating pad because electrical shock may result.)

You may feel better lying on your back on a firm surface with a pillow under your knees. Another option is lying on your side with a pillow between your knees to keep your back straight. Also, you might find that a recliner chair is helpful.

Take it easy, but do not lie in bed for longer than 2 days because this has been shown to actually worsen the condition. Do activities you are able to tolerate, and do not expect to feel better overnight.

What are the main causes of sciatica?
Sciatica arises from injury to the fibers of the sciatic nerve. The injury can occur in one of the places: Inside the spinal canal (cauda equina) where bundles of sciatic nerve fibers pass through bony openings in the spine (neuroforamina) In the pelvis (lumbrosacral plexus) Where the sciatic nerve exits the pelvis, below the piriformis muscle in the buttock (Piriformis Syndrome), or along the leg. Most of the time you will not remember doing anything to hurt yourself. Occasionally, you will suddenly get the pains after lifting something heavy or moving quickly.

Herniated or slipped disc (herniated nucleus pulposus). This is by far the most common cause of sciatica. Discs are the cushions between the bones in the back. They act like "shock absorbers" when we move, bend, and lift. Pressure by the piriformis muscle in the buttock on the sciatic nerve. (Piriformis Syndrome) Misalignment of the bones in the lower back and buttocks (Sacroiliac Joint Derangement) Spinal stenosis is a narrowing of the canal that contains the spinal cord. As we age, the bone can overgrow and put pressure on the sciatic nerve. Many people with spinal stenosis have sciatica on both sides of the back Spondylolisthesis is a condition in which one backbone has slipped forward over another backbone, resulting in pressure on the sciatic nerve Sciatica can also be caused by other effects of aging, such as osteoarthritis and osteoporosis.

Abnormality of the nervous system itself, so that nerve fibers don’t transmit signals properly, especially to feet and calves (neuropathy)
Extremely Rare conditions like Tumor blood clot, abscess (boil), lyme disease, fibromyalgia, pelvic infections, Reiter syndrome, and various infectious causes of arthritis (which could be caused by bacteria, a virus, or a fungus).

What are the common treatments for sciatica patients in general elsewhere?
Taking over-the-counter painkillers, Physical Therapy, rest, exercise, spinal manipulation, injections of anaesthetics, steroids or Botulinum toxins, surgery.
Acupuncture and Yoga can also be effective Changing environmental factors: bed, chair, desk height, etc.

What should be my level of physical activity?
Current research recommends that you stay active, within limits imposed by your pain. If you can avoid reinjuring yourself, you should try to stay at work. If the pain forces you to rest, do so, but avoid staying in bed just because you have back pain.

Will I always have sciatica, or can I be cured?
Proper diagnosis is very important. Homoeopathic treatment can significantly reduce pain & help you live a normal life.