sciatica

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Sciatica
is the name of pain along the course of a sciatic nerve especially in the back of the thigh caused by compression, inflammation, or reflex mechanisms; broadly : pain in the lower back, buttocks, hips, and/or various parts of the leg and foot.



Sciatica is the name of pain along the course of a sciatic nerve especially in the back of the thigh caused by compression, inflammation, or reflex mechanisms; broadly : pain in the lower back, buttocks, hips, and/or various parts of the leg and foot. In addition to pain, there may be numbness, muscular weakness, and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body. Any one of five nerve roots that are branches of the sciatic nerve may be affected. Vertebrae are stacked one below another and discs separate the vertebrae, thereby allowing room for the nerve roots to properly exit through the spaces between them. In Sciatica, vertebrae L4, L5, S1, S2, and the disks between them and the Cauda Equina can be affected.
Diagnosis of Back Pain - Sciatica
Major Diagnostic Tool is the Physical Examination. Increased pain will occur during movements or positions tested by the Surgeon.
Imaging methods such as MR neurography, a MRI technique diagnoses 95% of severe sciatica patients. MR neurography is preferred over plain X ray or CT scan because it provides better pictures of the spinal nerves and the effect of compression on these nerves.
Treatment
Treatment of the underlying cause of the compression is often the most effective course. When the cause is due to a prolapsed or lumbar disc herniation, research has shown that, with supportive treatment to help relieve pain, 90% of disc prolapse will recover with no specific intervention. Surprisingly, genetics appears to influence the risk of developing disc herniation.
Because of the many conditions which can compress nerve roots and cause sciatica, treatment and symptoms often differ from patient to patient.

Most cases of sciatica can be effectively treated by one or a combination of the following:
Medication therapies


  1. * Anti-inflammatory medications (i.e. NSAIDs or oral steroids)

  2. * Pain medications (e.g. acetaminophen)

  3. * Epidural steroid injections to deliver local anti-inflammatory agents (and possibly a pain medication) directly to the affected area


Invasive therapies

  1. * Surgery

  2. * Minimally invasive procedure


Minimally invasive procedures

Intradiscal Electrothermoplasty (IDET)
Radiofrequency Discal Nucleoplasty (Coblation Nucleoplasty)
Alternative therapies

  1. # Acupuncture

  2. # Chiropractic manipulation

  3. # Massage therapy

  4. # Structural Integration


References

  • 1. Oxford English Dictionary, 2nd Ed. "a1450a Mankind (Brandl)."

  • 2. Spine Health.com

  • 3. Lewis AM, Layzer R, Engstrom JW, Barbaro NM, Chin CT (2006). "Magnetic resonance neurography in extraspinal sciatica". Arch. Neurol. 63 (10): 1469-72. DOI:10.1001/archneur.63.10.1469. PMID 17030664.

  • 4. Filler, Aaron; Haynes, J., Sheldon, E., Prager, J., Villablanca, J.P., Farahani, K., McBride, D., Tsuruda, J.S., Morisoli, B., Batzdorf, U. & Johnson, J.P. (February 2005). Sciatica of nondisc origin and piriformis syndrome: diagnosis by magnetic resonance neurography and interventional magnetic resonance imaging with outcome study of resulting treatment. 99-115.

  • 5. SpineUniverse: New Sciatica Treatments

  • 6. Cramer GD: Basic and Clinical Anatomy of the spine, spinal cord and ans, St Louis, 1995, Mosby

  • 7. Jeffries B: Facet Joint Injections, Spine: State of the Art Reviews 2:409, 1988

  • 8. Sall JS: The role of inflammation in lumber pain, Spine 20:1821, 1995

Source:
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