Are you experiencing severe pain, discomfort along your lower back and/or down the back of one or both legs? It’s possible that you have sciatica. Also known as lumbar radiculopathy or disc herniation, it is a nerve pain affecting the sciatic nerve. This is a very common condition.
Says Dr Vivek Loomba, Consultant Pain Physician at the Indian Spinal Injuries Centre, New Delhi, “the intervertebral disk is a jelly-like substance that is present between adjacent vertebrae that act as shock absorbers. In case the disk herniates, which means it is pushed out from its location, pressure is generated on the adjacent spinal nerves, which could be extremely painful. Disc herniations of this nature can happen in the upper, middle, or lower back.
If it occurs in the upper back, it manifests as neck pain that travels down into one of the upper limbs. According to Dr Vivek Loomba, the term “sciatica” refers to intense pain that radiates from the lower back down the leg and occasionally into the foot and is frequently brought on by disc herniations in the lower back.
What are symptoms of sciatica?
According to Dr Loomba, you shouldn’t ignore the symptoms and visit a doctor if you feel mild to severe back pain that persists for several days, a numbness or pain in one or both the legs for a few days, tingling pins and needles sensation in the lower extremities, cramping or weakening of muscles and loss of bladder or bowel control.
Although the symptoms may be minimal at first, as the illness worsens, they can become more severe. Therefore, visit a pain management specialist who can help you in the early stages and can guide you with the right treatment.
What puts you at risk of sciatica?
It is most likely to affect people in the age group of 30 to 50 years and occurs more in men than women. The triggers are
– Sedentary lifestyle– Prolonged sitting in the same position and desk jobs– Obesity– Lifting very heavy weights– Smoking– Being obese
How can sciatica be diagnosed?
There isn’t a single test that can accurately identify sciatica. Several diagnostic and imaging procedures are carried out. Clinical evaluations based on symptoms are done. Additionally, an MRI, X-Ray, NCV, or EMG can be performed to detect sciatica with the former helping the most in establishing an accurate diagnosis.
Is surgery needed to treat sciatica?
Dr Loomba explains that “nine out of 10 patients get relief with conservative management and various epidural injections. These injections are done under X-ray guidance, which help in targetting specific nerves of disc herniation. It is important to precisely target the right nerve for relief. The epidural injections may prevent the need for surgery, offer good pain relief, and have a track record of safety. Surgery is needed in only a few cases. If some patient has extreme symptoms (red flag symptoms) such as loss of bladder or bowel control, frailty in legs or inability to bear weight, then surgical intervention is needed urgently.”
How can sciatica be treated conventionally?
Sciatica treatment includes a variety of options and as per the severity of the problem your pain management physician can suggest– Physiotherapy and back strengthening exercises– Painkillers like ibuprofen– Neuropathic medications such as Gabapentin or Pregabalin– Antidepressants like Amitriptyline– Oral steroids
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“In case the symptoms persist an interlaminar or transforaminal epidural steroid injection can be considered. In some patients with large disc herniations or red flag symptoms, surgery such as discectomy and laminectomy is required,” says Dr Loomba.
Is there a way to prevent sciatica?
Following a healthy lifestyle, being diligent about regular physical activity, quitting smoking and junking the sedentary lifestyle can to a great extent prevent sciatica. Says Dr Loomba, “It is essential to maintain proper posture while sitting. He says if your job requires prolonged sittings, even short breaks every two hours and brief walks of five minutes will help in relaxing your back muscles.”
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Sciatica can be treated without surgery, and epidural injections prove to be very effective in providing relief from the pain. Ignoring the signs of sciatica may not only cause an excessive amount of physical strain on the body, it also has an impact on patients’ daily activities, mental and emotional well-being. Additionally, if not treated on time, sciatica can permanently harm nerves, worsening back and leg pain.
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