Sciatica is the
pain, tingling, discomfort, or "electric shock" that originates in the lumbar spine region and radiates to the buttock, thigh, leg, or foot.
It is caused by compression or inflammation of the sciatic nerve, which is the longest nerve in the body. The sciatic nerve controls some muscles of the legs and provides sensation to the back of the thigh, leg, and sole of the foot. Due to its close relationship and proximity to the vertebral discs, the most common cause of sciatica is a herniated disc. Depending on the level at which the nerve is compressed, symptoms such as tingling, numbness, pain, and electric shock can reach the buttock, thigh, leg, and foot. It is uncommon for the spine to hurt in the groin or inner thigh. This condition is more common in men aged 30 to 50 but can also affect women. People who frequently strain their spine through various routine activities are more prone to suffer from sciatica.
When is it sciatica?
Patients report pain more frequently when lying down, waking up, extending the leg, or walking. In cases where sciatica is caused by narrowing of the spinal canal (narrow
lumbar canal), a symptom called claudication may occur, which is the need to stop walking due to pain or loss of leg strength.
How is sciatic nerve inflammation diagnosed?
The correct way to diagnose a sciatic nerve problem is through the evaluation of a specialist orthopedic or neurosurgeon. Through physical examination, clinical history, and some office tests, the orthopedist can suspect this condition. Additionally, the specialist may order X-rays and/or MRI to confirm the diagnosis.
Treatment
In general,
treatment of inflamed sciatic nerve or sciatica varies and includes analgesics, anti-inflammatories, nerve modulators, physical therapy, nerve blocks or spinal infiltrations, and even decompression surgery in more complex cases.
Medications for inflamed sciatic nerve
There are several options to manage
sciatic nerve pain. The orthopedist is qualified to prescribe analgesics like acetaminophen, anti-inflammatory ibuprofen, neuromodulators such as pregabalin, corticosteroids like dexamethasone, among others. Self-medication or informal treatments are not recommended due to the risk of complications.
Physical Therapy
Physical therapy is a very important part of managing inflamed sciatic nerve and sciatica. It aims to improve spinal posture, stretch contracted leg muscles, relieve spasm and pain, and strengthen the core abdominal muscles and the
back structure.
Alternative therapies and physical methods
According to the orthopedist’s evaluation, acupuncture, yoga, neural therapy, and functional medicine can be very helpful in the combined treatment of the sciatic nerve.
Lumbar block or spinal infiltration
To relieve pain, the orthopedist may recommend an epidural block or infiltration of the spine. This involves injecting an anesthetic and an anti-inflammatory (corticosteroid) inside the spine to numb the sciatic nerve and progressively relieve the pain.
Decompression surgery
When medications, physical therapy, and blocks do not work or when there is impaired leg mobility (no response), decompression surgery of the nerve may be necessary by removing the distal hernia (discectomy). In cases of narrow lumbar canal, a laminectomy (removal of part of the vertebrae) and fixation with screws may be required.
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