Doctor in Pain Clinic of India
Patient Review Highlights
Sciatica pain arises due to compression or injury to the sciatic nerve, which is the single largest nerve in our body. It consists of individual nerve roots, which branching out from the lower back (spine) to the back side of each leg. It supplies the sensation to the leg structures and power to the muscles of the legs. The origination of the sciatic pain lies in the lower back of the body and radiates down the buttock to the sciatic nerve.
Causes of the sciatica pain
- Herniated disc (also known as PIVD/DISC bulge) : Most common cause of low back pain and radiating leg pain could be a herniated disc in the lower back of the body.
- Spondylosis: Spondylosis in the lower back would also be a reason for the development of the sciatica pain.It can cause reduction in the size of the gap though which the nerve exits.
- Muscles and ligaments: In some cases spasm of the muscles in lower back may cause sciatica pain. Other causes are a spinal injury, degenerative disc disease, infection in and around the lower back. The pain would worsen, if an individual is in an occupation where he or she has to stand or sit for hours at length without physical activities. The lifting of heavy things would strain the sciatic nerves as well.
How to identify sciatica pain?
Sciatica pain varies from infrequent aching pain to a constant throbbing pain travelling down the lower back. So initially it is difficult to detect whether it is sciatic pain or not. But when the constant pain in the lower back leads right down in the leg, most of the times till the toes and foot, it is really time for an individual to get in touch with a doctor. The pain can give a burning or pricking sensation, sometimes very severe, making it difficult for the person to stand up or walk properly. Along with the pain, one can feel fatigued. If left untreated, it may cause permanent damage to the nerves and spinal cord (Rare). Treating it early is very important to prevent long term problems.
Treatment for sciatica pain
Sciatica can be treated in both surgical and non-surgical way. The non-surgical pain treatment would include physical exercises and oral medications along with natural treatment.
- Medications: Painkiller medications prescribed by the doctor can be used to reduce sciatica. Medicines like aspirin, non-steroidal, mild opoioids or oral steroids can help reduce the pain.
- Pain Management Steroid injection: Epidural steroid injection acts faster as it is injected in the affected area, thus providing relief from the pain quickly. This is done when other non surgical treatments are not working. This helps in avoiding surgery in almost 80% of the cases.
- Exercise: Early morning exercises can be quite helpful. Surgery : Surgical treatment is required rarely as sciatica tends to respond well with non-surgical treatments. If the pain continues for over a month despite treatment, or patient is having some serious complications like loss of bladder and bowel function, surgical treatment will be considered.
- Percutaneous Endoscopic Discectomy: The surgical treatment named Percutaneous endoscopic disc discectomy and foraminotomy constitutes a large part of interventional pain physicians and it has evolved considerably in terms of surgical technique and instrumentation. Percutaneous endoscopic discectomy is a relatively new technique for removing lumbar disc herniation. It involves using an endoscope to visualize the disc removal. The discectomy is performed from under local anesthesia and sedation using specially developed instruments. The advantage of percutaneous endoscopic discectomy is that the disc is approached posterolaterally through the triangle of Kambin without the need for bone or facet resection thus preserving spinal stability. The procedure is day care and is done under local anaesthesia. Minimally invasive surgical options like endoscopic discectomy are boon for patients as they avoid any cut or sutures on the skin.
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