Disease Index Musculo-Skeletal

Sciatica

The pain is caused by pressure on the sciatic nerve as it leaves the spinal column. Any pressure on the sciatic nerve causes sharp, stabbing pains in the buttock and down the leg.It is characterized by pain radiating down the back of the thigh that has been described as sharp, stabbing, electrical, and burning.

Sciatica, or sciatic neuritis, is pain along the large sciatic nerve that runs from the lower back down through the buttocks and along the back of each leg. It is relatively common form of back pain.

The pain is caused by pressure on the sciatic nerve as it leaves the spinal column. Sciatica can have a variety of causes, including a herniated (slipped) disk in the spinal column, arthritis, or a fall. In most people who have sciatic, the disks in the backbone have become weakened, either with age or as a result of excessive strain. The disks and vertebrae provide the necessary flexibility for people to stretch and bend. Each disk consists of a soft center, which acts as a shock absorber, and a tough fibrous outer layer. Sometimes, this outer layer weakens in parts, and the soft center bulges out. The resulting bulge puts pressure on the nerve to the leg and causes the pain of sciatica.

Any pressure on the sciatic nerve causes sharp, stabbing pains in the buttock and down the leg. It may happen suddenly when someone is bending or stretching or it may come on gradually. Even a slight movement, such as coughing or sneezing, can bring on the pain or make it worse. For anyone suffering from sciatica, walking and sitting can be painful and difficult. The most comfortable position is lying on the back with knees bent.

Causes of sciatica

The disks are pads of tissue that separate the vertebrae—the cylinder shaped bones that make up the spine. Together, the disk and vertebrae give the spine the necessary flexibility for people to stretch and bend.

Each disk consists of a soft center, which acts as a shock absorber, and a tough fibrous outer layer. With age or sometimes as a result of excessive strain being applied to the back, this outer layer weakens in part to allow the soft center to bulge out. This condition is rather inaccurately called a slipped disk. It is protrusion that puts pressure on the nerve to the leg and causes the pain of sciatica.

The same sort of pain can be caused by other disease in the region of the nerve roots as they leave the spinal canal. These diseases are uncommon but have to be considered by the doctor when diagnosing sciatica. For example, the nerve roots can be irritated by pressure from a tumor in the spine or from a collection of inflamed tissue, which may occur after spinal injuries or following surgery. These other causes can be indentified through examination and X-ray tests.

WHAT ARE THE SYMPTOMS OF SCIATICA?

When the sciatic nerve is irritated or compressed by any number of different conditions, aggravating pain can be felt along the nerve pathway. The pain can be constant or intermittent, sudden or progressive.

It is characterized by pain radiating down the back of the thigh that has been described as sharp, stabbing, electrical, and burning.

These symptoms can manifest in one or both legs. The pain may be distributed uniformly along the pathway but, often, specific and intense spots of pain are predominant. In many cases, the pain of sciatica is accompanied by sensations of numbness, tingling, weakness, and achiness.

Generally, the sharp, stabbing pain comes on suddenly, reaches a high intensity, then gradually fades away. The burning sensation, which suggests a pinched nerve, is often felt anywhere on the lower back, buttocks, legs, and/ or feet. The electrical sensation usually radiates pain from the specific area where the nerve is compressed and, from there, down the sciatic nerve pathway.

It comes on suddenly, then disappears, only to return and repeat the cycle. The tingling and numbness are further indications of nerve irritation along the pathway. Finally, the achiness is associated with strained or ever worked muscles. The symptoms of sciatica can be more severe when the individual bends forward, coughs, or sneezes.

Treatment of sciatica

Sciatica due to slipped disk, while very unpleasant on some occasions and often disabling when it occurs, will usually improve on its own if the proper measures are taken.

The initial problem is to relieve the pain, and this is most easily done by resting in bed in the most comfortable position. It may be helpful to have the shoulders raised a little with pillows, which will ease the curve on the lower back, since the muscles there will have gone into some spasms in response to the pain. All unnecessary movement must be avoided.

Continuous bed rest or two weeks, with the knees and the hip joints slightly flexed and sometimes with weight traction to the pelvis, is now the routine initial treatment for slipped disk. Such treatment will reduce the disk herniation in 90% of cases. If it does not, surgery may be required.

Painkillers may be prescribed if the sciatic pain is particularly bad, but ordinary analgesic drugs such as aspirin or acetaminophen are usually adequate enough back rest is given. The crucial thing is to stay in bed and to resist the temptation to be up and about when the disk is only half healed; otherwise the whole process will return to square one.

Often a hard bed is best because a soft bed encourages the spine to sag and puts more pressure on the interverterbral disks. Once the sciatica has improved, it is equally important to avoid straining the back and lifting heavy objects.

Surgical treatment of sciatica is a last resort, usually for those who have had repeated episodes that have not improved with ordinary rest in bed and for those who cannot afford to take time off work. However, surgery can be successfully performed only for certain types of disk problem, so special X-rays of spinal canal may need to be performed before a decision to operate can be made. In this test, called a myelogram, some special dye that shows up on X-ray is injected via a lumbar puncture into the fluid filled space around the nerve roots. The X-rays taken then show up the shadow of the spinal cord and its nerve roots, and reveal whatever is causing the symptoms. From these pictures, the doctor can see whether surgery is possible and how extensive the surgery needs to be in order to solve the problem. If the sciatica is caused by a single disk bulging out, the protrusion can be removed. If there are many disks producing pressure on the nerves, then more extensive surgery may be needed to relieve the pressure.

Homeopathic treatment of Sciatica – Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat sciatica but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to cure sciatica that can be selected on the basis of cause, sensations and modalities of the complaints.  For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of sciatica:

Colocynth, Arsenic Album, Spigelia, Rhus Tox, Aconite, Sulphur, Ignatia, Chamomilla, kalmia, Nux vom, Belladonna, Veratrum Album, Phytolacca, pulsatilla, lac can  and many other medicines.

Reference:

Encyclopedia of Health, Volume 15; 2005; 925

Larry P. Credit, Sharon G. Hartunian, Margaret J. Nowak- Relieving sciatica: using complementary medicine to overcome the pain of; 2000; 07

David B. Jacoby, R. M. Youngson- Encyclopedia of Family Health; 2007; 1886-87

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Ashish Sharma

Ashish Sharma

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