Overview - Back Pain & Sciatica Treatment

​

Back pain is a major cause of disability Around The World ranking only second to Respiratory infections. back pain if not taken care  properly may progress to significant disability & Absence of work. In many cases lower back pain is also accompanied by sciatica symptoms. 

 

Sciatica in simpler terms can be understood as any pain which typically starts from persons lower back or buttock area and migrates down to back of the thigh, back of the leg (ie calf area)  and may go up to foot & toes.It must be noted that Sciatica is not any disease in itself. In fact it is the symptom of an underlying problem. Sciatica happens if there is compression nerves which arise from the spine and give rise to to one of the thickest nerve in the human body called sciatic nerve.

 

Symptoms - Back Pain & Sciatica

 

Now the question arises how do we identify that oneself or the concerned person is suffering from Sciatica symptoms.Sciatica generally presents with very typical symptoms which can be easily identified by key features. 

 

Below mentioned list can be used as typical set of symptoms patient will usually present with in our clinical practice : 

 

• Low back pain which is radiating to one or both the legs.

• Patient  may complaint that her one leg is heavier than the other.

• Complaints of tingling numbness or pin-pricking feeling in one or both the legs. Usually symptoms are  present only in one leg only.

• The symptoms are generally worsened by standing or walking and are relieved by rest.

• Patients may complain of weakness in the Leg and may feel that Leg is not responding to commands properly.

• In advanced stages patients may also complain of loss of control of bladder & Bowel.

 

Causes (Why do I have Sciatica) ?

 

Back Pain Sciatica can happen due to multiple causes. However all the back pain causes (which leads to sciatica) will irritate the Sciatic Nerve or the smaller spinal nerves ( called spinal roots) which form the thicker Sciatic Nerve later.

 

Various reasons for sciatica can be  under the following headings:

 

Prolapsed Disc : Prolapsed disc is the most important cause of low back pain and sciatica symptoms in patients. Prolapsed intervertebral disc refers to the Migration of the disk towards the back of the spinal canal which is the area reserved for the passing the nerve roots.When disc material migrates towards the nerve root area, it compresses the spinal nerve roots leading to the irritation of the whole area of the lower leg which the compressed nerve supplies and this leads to the symptoms in the the affected side of the leg.

   

Canal Stenosis : Canal stenosis refers to decrease in the diameter of spinal canal. Now the now the question arises what is the spinal canal? Spinal Canal is the hollow tube-like area at the back of the spine through which the spinal nerves pass. Canal stenosis refers to narrowing of the diameter of the bony sinal canal which leads to compression of the passing (traversing) spinal nerves.This compression leads to symptoms of sciatica. This may happen at one Level or multiple levels depending  upon the nature and extent of disease . 

 

Slipping of Spinal Bones (Spondylolisthesis) : Spondylolysis refers to slipping of one vertebral bone over another. This slipping Leads to severe lower back pain patients and also in advanced cases leads to see Sciatica like symptoms in one or both the legs because the canal gets compromised and nerves get throttled in between the both vertebral bodies.

 

Piriformis syndrome : Piriformis is a muscle in both hip regions. This muscle if irritated or spasmed may lead to compression of the sciatic nerve leading to a complex of symptoms included in sciatica.

   

Spinal Tumors : Many tumors extending into the spine and irritating the spinal nerve roots also leads to sciatica symptoms

 

Sciatica Prevention Methods and Risk Factors :

 

Sciatica can be prevented by taking few everyday precautions and modifying lifestyle. There are risk factors many of which are avoidable in order to prevent Sciatica.

 

Exercise :  Regular exercise is the key to good health and sciatica remains no exception. Regular exercise which includes strengthening of the core muscles of the spine leads to a stronger back which is less vulnerable to injuries and in turn less vulnerable to sciatica symptoms. 

 

Quit Smoking : Multiple studies approve in that smoking  who has a direct links with prolapsed intervertebral disc which in turn leads to sciatica.Quitting smoking helps in to regain the spine health

 

Reducing Weight : More weight means more loading of spine and faster ageing of spine. Decreasing weight leads to significant back pain relief. correct posture: correct posture in which lower back is fully supported should be adopted.also frequent change in posture and avoiding long term sitting can be helpful in preventing sciatica symptoms. 

 

Prolong Sitting : our spine does not like sitting for long hours. jobs which involve sitting for very long time leads to loading of the spine and it becomes vulnerable for sciatic symptoms. frequent breaks from long sitting hours and adopting a good chair and a good posture is a key to avoiding spinal problems.

 

Complications in Sciatica

 

Sciatica is generally a self limiting disease which can be effectively treated by modifying lifestyle, some physical therapy and occasional use of some anti-inflammatory medications  ( Under the observance of your spinal doctor). However if left untreated, or if not taken proper  precautions as advised.

 

it may progress to a very serious condition which not only is highly painful and debilitating but may also lead to  Serious symptoms which include the following : 

 

    Weakness of legs.

    Extreme numbness and pain.

    Inability to work even few steps

    Loss of control of bladder and bowel movements

 

It is highly advised that if  one suffers from similar above-mentioned symptoms then he should immediately contact his spine specialist doctor.

 

Precautions for Sciatica

 

Certain precautions can be followed to avoid sudden appearance of sciatica symptoms.

 

1. Never lift any heavy object alone.  heavy object may be defined as an object which our body is usually not trained to pick up regularly.

2. Never bend too much forward by jerking forward.

3. Smoking should be avoided as already mentioned above.

4. Maintain healthy weight.

5. Stretching exercises & back pain exercises can be practised by anyone.Yoga (asanas) are excellent stretching and strengthening exercises if done under a trained yoga teacher.
sciatica treatment exercises & back pain exercises  are special exercises which can be learned from a physical therapist under the guidance of your spine specialist doctor. 

6. If you have had sciatic symptoms before avoid jerky movements or travel.

 

Treatment & Surgery for Sciatica:

 

Lower back pain treatment & sciatica treatment can be done at different levels.

 

Home Remedies for Sciatica: Many of the undermentioned  home remedies can provide sciatic nerve pain relief.

 

• Rest

• Cold packs and hot packs

• Stretching exercises

• Avoiding activities which lead to low back pain & Leg Symptoms.

• Example – lifting of a heavy object, forward bending,  sitting on an unsupported chair etc.

 

Medical Treatment for Sciatica : If you have had symptoms which are very strong in nature or all the above mention remedies are of no avail it is better to go for a professional consult with the back pain specialist or spine Specialist/Surgeon.

 

Generally, all the back pains sciatica are primary treated with conservative measures which include physiotherapy anti inflammatory drugs, Lifestyle modification and diet modification. 

 

Those patients who fail with the above mentioned conservative measures are given the option of Spinal Injection for blocks.These blocks are very good measures to give a targeted drug delivery at a spot where the pain is generating and gives a very significant relief in many patients.

 

Nowadays at some of the centres in India people have started using endoscopy instead of a traditional open surgery in which all the problems associated with surgery can be avoided. & disc problem or the lower back pain can be treated without the requirement of stitches.In Spinal Endoscopy, there is no need of anaesthesia in the procedure and the patient can go home the same day after the procedure also there is no pain associated with endoscopy.

 

However if all these measures then the question arises that how to cure sciatica permanently?

 

Patient is generally advised for spine surgery in which disc  which is offending the nerve area is cleared and the nerve is made free of the irritation.