Sciatica

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What is sciatica?

Apart from a muscle injury, hamstring pain can be due to other causes. One example is sciatica. Sciatica is when the sciatic nerve is irritated or compressed, causing pain. Sciatica causes pain in the back of the thigh and leg and can easily be mistaken for a hamstring injury. 

What causes sciatica?

A herniated disc that causes pressure on a nerve root is the most common cause of sciatica. The disc is a gel-like structure between the vertebrae, which cushions between the bones. When the disc is injured or overused, pressure from vertebrae can cause it to bulge through a weakness in its outer wall. When this happens, it may press and irritate the sciatic nerve and cause sciatica.

 

Spinal stenosis is the narrowing of the spinal canal. It reduces the available space for the spinal cord and nerves. If it pinches the sciatic nerve, it can cause sciatica.

Osteoarthritis. Bone spurs can form in degenerative spines and compress lower back nerves.

Piriformis syndrome. The piriformis muscle sits on the sciatic nerve in the buttocks and can compress the sciatic nerve if the muscle becomes too tight.

 

Symptoms

The severity of symptoms varies significantly from patient to patient. The symptoms are not constant for some patients but may come and go. Symptoms of sciatica may include:

  • Pain in the lower back, buttock and leg.

  • Numbness or weakness in your lower back, buttock and any part of the lower limb.

  • Pain worsens with movement, walking upstairs or sitting for a long time.

  • “Pins and needles” feeling in your lower limbs.

  • In severe cases, you could lose bowel and bladder control due to the compression of nerves.

 

When should I seek medical help?

There are circumstances when pain in the hamstring area might be caused or accompanied by severe issues. If such symptoms are present, it is best to seek immediate medical attention to avoid further complications:

  • Numbness or muscle weakness in the lower limbs

  • Loss of bladder and bowel control could be due to a condition called cauda equina syndrome, which affects the nerves at the end of the spinal cord.

 

Diagnosis

To diagnose sciatica, your doctor will consider your case history and past medical history. Then they will perform a physical examination. The doctor will do a straight leg raise test during the physical examination. For this test, you will lie on your back with your legs straight, and the doctor will slowly raise each leg and note the point at which your pain begins. They will ask you to move your legs to check muscle flexibility and strength. Your doctor will suggest further imaging like MRI to show if there is any pressure on the nerve, any disk herniation or any arthritic condition that is irritating the nerve.

 

Treatment

In general, if the pain does not go away after six weeks of home care (including ice/ heat pads, over the counter medication), it’s time to return to a healthcare professional and try other treatment options.

 

Other treatment options include:

  • Prescription medications. Your healthcare provider may prescribe muscle relaxants to relieve the discomfort associated with muscle spasms. Other medicines with pain-relieving action that include anticonvulsants like Gabapentin can be given.

  • Physical therapy. Physical therapy aims to use exercise to decrease sciatica by reducing pressure on the nerve. Stretching exercises can improve muscle flexibility.

  • Spinal injections. An injection of a corticosteroid, an anti-inflammatory medicine, into the lower back might help reduce sciatica symptoms. 

 

If the other treatment options do not improve your pain, or your pain is worsening, you experience weakness in your lower limb muscles, or you have lost your bladder and bowel control, your doctor may discuss the option of surgery with you. The goal of surgery is to relieve pressure on the nerve.

 

Prevention of sciatica

There are ways to prevent sciatica. Here are some examples:

  • Maintain good posture: Following good posture techniques helps relieve pressure on your lower back.

  • Avoid smoking: Smoking reduces the blood supply to soft tissues around bones. Without an adequate blood supply, the discs and bones take longer to recover and degenerate faster, which causes back and spine problems.

  • Maintain a healthy weight: Extra weight is associated with inflammation and pain throughout your body.

  • Exercise regularly: Exercise includes stretching and strengthening your core and back muscles.

  • Choose physical activities wisely: Consider low-impact activities such as swimming, walking, yoga or tai chi.