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The term Sciatica is described as a pain going through the distribution of sciatic nerve, commonly known as a symptom of spinal disorder and not a spinal disorder itself. Symptoms of sciatica includes pain from sciatic nerve compression which may feel dull, sharp, tingling, numbness, burning or accompanied with pain starting from buttock and traveling downward into the back of thigh or leg. It usually affects one side of the body. It gets painful when trying to stand up as it extends below the knee and maybe felt in the feet. Coughing and sneezing intensifies the pain. Sciatic Nerve fibres begin at the 4th & 5th lumbar Vertebrae. Sciatic nerve passes through the sciatic foramen below the piriformis muscle to the back extension of the hip and to the lower part of the gluteus maximus. It then runs vertically downward into the back of thigh, behind the knee, calf and further downward to the feet. Nerve damage is rarely permanent but paralysis is seldom a danger since the spinal cord ends before the first lumbar vertebrae. One should seek medical help when there is an increase in leg weakness or incontinent bladder or bowel movement.
The most common cause of sciatica are herniated discs. Degenerative disc disease is a common natural biological process associated with aging which causes disc weakness which may lead to a disc herniation. Other causes include lumbar spinal stenosis which is narrowing of one or more neural passageways, causing sciatic nerve to become impinged because of these changes. Isthmic spondylolisthesis results from a stress fracture often at the 5th lumbar vertebrae combined with disc space collapse which allows the vertebrae to slip forward on first sacral segment. Spinal tumors and infections are other disorders which may rarely compress the sciatic nerve. While diagnosing sciatica, the doctor may discuss about the patient’s medical history, recent accidents or injuries and review the current medications. A physical evaluation will be performed using one or more movement tests to determine the cause of pain. The imaging tests may be done to help confirm the diagnosis.
Dr. Garfin described the causes of sciatica very nicely. There are many structures in the spine which can cause these types of pain, not all buttock and leg pain is sciatica. For example, the sacroiliac joint can cause pain to the buttock and so can a sprain of facet joints. Sometimes a tear of disc can cause pain down into one’s leg. Severe neurologic symptoms along with bladder or bowel control problem is considered to be an emergency and needs to be evaluated by a spine care specialist. Its important for the individuals to be physically active to avoid Sciatica as being physically active can maintain a healthy balance in life and avoid many health concerns which future can be life threatening. Maintaining a healthy lifestyle and introducing a good healthy diet and moderate physical activity can proper sitting postures can play a major role in avoiding sciatica.
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