The sciatic nerve, which is the nervus ischiadicus in medical terminology, is the thickest and longest nerve in the body, descending from the hip to the heel by the union of the L4 – L5- S1-S2 and S3 nerve roots in the lower back region. The disease, known as sciatica among the people, is actually a clinical picture that manifests itself with pain, numbness, stretching and sometimes tingling that spreads from the waist to the hip and back of the thigh as a result of the stretching or compression of the sciatic nerve.
What is Sciatic Pain?
The sciatic nerve runs down the back of the leg. When it reaches the knee joint, it divides into branches and creates motor and sensory functions. The task of the sciatic nerve is to transmit the motor signals it receives from the spinal cord to the hip, leg and foot muscles and to transmit the sensations it receives from the foot, leg and hip to the spinal nerve. .
If the sciatic nerve is damaged as a result of stretching, compression or trauma, a pain is felt starting from the waist and spreading to the leg area. These pains have been known since ancient times. Cotugno first mentioned sciatic findings in 1746. In the ancient Greeks, 'ischias' was defined as pain around the hip, waist and legs, and Hippocrates defined it as pain that affects men between the ages of 40-60.
Sciatic pain can occur in two ways. The pains are either continuous but mild, or they are seen as severe, sudden pains from time to time. These pains are defined as sciatic pain. Diagnosed as sciatica, this disease is commonly referred to as sciatica.
Types of Sciatica Pain
Sciatica can be seen in different types:
1. Acute Sciatica: Acute sciatica is the sciatic nerve network that is in its infancy and lasts 4-8 weeks. Pain is mild and usually does not require treatment.2. Chronic Sciatica: Chronic sciatica is persistent, persistent sciatic pain that lasts longer than 8 weeks. Treatment is required.3. Alternative Sciatica: Alternative sciatica is sciatic nerve pain that affects both legs alternately. This is a rare type of sciatica and can be caused by degenerative problems in the joint.4. Bilateral (Bilateral) Sciatica: Bilateral sciatica occurs in both legs together. This type of sciatica is rare. It can be caused by degenerative changes in the spine or disc, serious conditions such as cauda equina syndrome.
Symptoms of Sciatica
Sciatica occurs as a result of damage or injury to the sciatic nerve. A pain that descends from the lumbar region to the buttocks and legs is typically sciatica. Different symptoms can be seen along with the pain:
- Pain radiating from the hip, back of the thigh to the leg (the most common and prominent complaint)
- Tingling, numbness or weakness in the lower leg and foot,
- Feeling like pins and needles prick the heels and toes,
- Loss of sensation and difficulty in movement,
- Symptoms increase with sitting (sciatic nerve is stretched), symptoms decrease when standing up
- Pain exacerbated by coughing or sneezing when moving,
- Incontinence of urine and gas,
- Difficulty in standing, bending and turning movements,
- In advanced cases thinning of painful leg muscles.
What Causes Sciatica?
Sciatica can occur for many different reasons:
- Hernia in the spine: Age-related changes such as herniation are among the most important causes of sciatica.
- Sciatic nerve compression syndrome: When the sciatic nerve passes from the hip to the leg, it can be compressed between the thigh bone and the sciatic notch. In this case, if there is no bony prominence, local cortisone injection can be performed under computed tomography. If there is a bony protrusion, the bone compressing the sciatic nerve should be surgically removed.
- Piriformis Syndrome: It is the development of pain, numbness, tingling in the hip and leg as a result of the compression of the sciatic nerve by the piriformis muscle.
- Trauma: Traumatic hip dislocation, wrong hip injection, pelvis fractures can cause direct and acute damage to the sciatic nerve itself. Falling from a place or a blow to the sciatic nerve area can cause pain and loss of function. If you work in a job that requires you to carry heavy loads and use a motor for a long time, the sciatic nerve may be affected.
- Diabetes: Ka Sudden sugar changes in blood sugar can trigger sciatica by causing damage to the nervous system.
- Pregnancy: The weight gained by the mother during pregnancy can put pressure on the spine. The growth in the abdomen and breasts can also cause a change in the body's center of gravity and damage the sciatic nerve.
- Some disorders from birth, spinal and internal organ tumors can also cause sciatica. /p>
How to Prevent Sciatica Disease (Sciatalgia)
A few simple precautions you can take in your life can help prevent damage to sciatic nerves or recurrence of sciatica:
- Exercise frequently and regularly.
- Do not lift weights while sitting (reduce your risk of lumbar hernia)
- Do not smoke (do not increase your hernia risk by impairing your disc health)
- Remove external factors that compress your hip while sitting (wallet , cell phone, etc.).
- Avoid sudden movements.
- Bend your knees and keep your back straight when lifting heavy objects.
Sciatica How Does the Pain Go?
Sciatica pain, which occurs with mild symptoms, can be relieved with commonly recommended home treatment methods. With rest, analgesic and anti-inflammatory drugs, muscle relaxants, mild sciatica usually resolves within a few weeks. Surgical treatment can be applied in cases where conservative treatment is applied for 6 weeks and does not help, loss of strength in the leg or cases of drop foot. must. After the examination, your doctor may refer you to the departments of physical therapy, neurology or rheumatology when necessary.
How is Sciatica Diagnosed?
During the orthopedic examination, the physician checks the person's muscle strength and reflexes. You may be asked to walk on toes or heels, get up from a squatting position, and raise your legs one at a time while lying on your back. Pain from sciatica usually tends to worsen during these activities.
X-rays other than physical examination, With diagnostic tests such as MRI, CT scanning, electromyography (EMG), pressure on the nerve, herniated discs, bone and soft tissue injuries, and the reactions of your muscles are easily determined to diagnose sciatica.Sciatica Treatment
If sciatic pain does not improve with personal care, it should be treated by a specialist doctor. Sciatica needs to be treated early to prevent symptoms from progressing. Sciatica treatment may include non-surgical or surgical methods. Sciatica treatment is primarily preferred non-surgical methods. The treatment is applied with the use of physical therapy, drugs, therapeutic injections and alternative treatments. In cases with mild symptoms, pain relievers, muscle relaxants and anti-inflammatory drugs are sufficient for the treatment of sciatica.
Epidural steroid drug injection can be applied to patients with ongoing complaints despite drug therapy. Corticosteroid drugs are injected into an area called the epidural space, which is the canal that surrounds the spinal cord. With the injection, sciatic pain can be treated.
When your acute sciatic pain subsides with medication and injection therapy, physical therapy can be applied to prevent the disease from recurring and for a stronger body posture. Physical therapy includes a combination of strengthening, stretching and aerobic conditioning. Physical therapy is a core element of many sciatica treatment plans. A program of therapeutic exercises may be included in physical therapy programs. The main purposes of physical therapy and exercises in sciatica treatments are:- Strengthening the spine and muscles of the waist, abdomen, hips and buttocks,
- Increasing core strength,
- Tight and flexible Stretching non-surgical muscles.
What Happens If Sciatica Is Not Treated?
Although acute sciatica usually heals without treatment, progressive and untreated sciatica sciatica can cause permanent nerve damage. Loss of strength and sensation may be seen in the affected leg. If there is sciatic pain associated with severe spinal cord compression due to herniated disc and it is not treated, urinary and stool incontinence may develop.
Sciatica is a disease that causes serious consequences if the necessary treatment is not applied. In cases where sciatica symptoms are seen, applying to a specialist physician prevents possible complications.Read: 31
