Do you experience severe pain, discomfort in your lower back and/or the back of one or both legs? It is possible that you have sciatica. Also known as lumbar radiculopathy or disc herniation, it is nerve pain affecting the sciatic nerve. This is a very common condition.
Dr Vivek Loomba, pain consultant at the Spinal Injury Center of India, New Delhi, says, “the intervertebral disc is a jelly-like substance found between adjacent vertebrae that acts as shock absorbers. When a disc herniates, meaning it is pushed out of place, it puts pressure on the adjacent spinal nerves, which can be extremely painful. A herniated disc of this nature can occur in the upper, middle or lower back.
If it occurs in the upper back, it manifests as neck pain that travels down to one of the upper limbs. According to Dr. Vivek Loomba, the term “sciatica” refers to intense pain that radiates from the lower back down into the leg and occasionally into the foot, and is often caused by a herniated disc in the lower back.
What are the symptoms of sciatica?
According to Dr. Loomba, you should not ignore the symptoms and see a doctor if you experience mild to severe back pain that persists for several days, numbness or pain in one or both legs for several days, tingling and pins-and-needles in the lower extremities, muscle cramps or weakness, and loss of bladder or bowel control.
Although symptoms may be minimal at first, they may worsen as the disease progresses. Therefore, see a pain management specialist who can help you in the early stages and guide you to the right treatment.
What puts you at risk for sciatica?
It is most likely to affect people in the age group of 30 to 50 years and is more common in men than women. Triggers are
– Sedentary lifestyle
– Sitting for long periods in the same position and working at a desk
– Obesity
– Lifting very heavy loads
– Smoking
– Being obese
How can sciatica be diagnosed?
There is no single test that can accurately identify sciatica. Several diagnostic and imaging procedures are performed. Clinical evaluations are performed based on symptoms. In addition, MRI, X-ray, NCV or EMG can be performed to detect sciatica, the former being the most helpful in making an accurate diagnosis.
Is surgery necessary to treat sciatica?
Dr. Loomba explains that “nine out of 10 patients get relief with conservative treatment and various epidural injections. These injections are given under x-ray guidance, which helps in targeting the specific nerves of the herniated disc. It is important to precisely target the right nerve for relief. Epidural injections can avoid the need for surgery, offer good pain relief and ensure safety. Surgery is only necessary in a few cases. If a patient has extreme symptoms (red flag signs) such as loss of bladder or bowel control, leg weakness, or inability to bear weight, surgery is urgently needed.”
How can sciatica be treated conventionally?
Treatment for sciatica includes various options and depending on the severity of the problem, your doctor may suggest pain management
– Physiotherapy and back strengthening exercises
– Pain relievers such as ibuprofen
– Neuropathic medicines such as Gabapentin or Pregabalin
– Antidepressants such as amitriptyline
– Oral steroids
“If symptoms persist, interlaminar or transforaminal steroid epidural injection may be considered. Some patients with large disc herniations or red flag symptoms require surgery, such as discectomy and laminectomy,” says Dr. Loomba.
Is there a way to prevent sciatica?
Following a healthy lifestyle, regular physical activity, smoking cessation and a sedentary lifestyle can largely prevent sciatica. Dr Loomba says: “It is essential to maintain good posture when sitting. He says that if your job requires long periods of sitting, even short breaks every two hours and short five-minute walks will help relax your back muscles.’
Sciatica can be treated without surgery and epidural injections have been shown to be very effective in providing pain relief. Ignoring the symptoms of sciatica can not only cause excessive physical strain on the body, but also has an impact on the patients’ daily activities, mental and emotional well-being. Additionally, if not treated early, sciatica can permanently damage nerves and worsen back and leg pain.