Treatment For Sciatica | Spine 360, Bangalore

Image illustrates a woman is holding lower back with her hands due to pain.

Sciatica: An Overview

Sciatica is more popularly known as the radiating pain down your leg. The discomfort or pain is unique because it follows the path of the sciatic nerve, which originates from the lower back and branches out to the hip, buttocks, and down each leg.

Sciatica typically arises when excessive pressure is placed on a nerve due to either a herniated disk or an abnormal bone growth. This leads to an inflammatory response, causing pain and often resulting in partial loss of sensation in the affected leg.

Sciatica is of two types, and irrespective of the kind that affects you, the effects remain the same. The condition is classified as:

True Sciatica is a condition that occurs due to an injury that affects the sciatic nerve.
Sciatica-like conditions are similar to Sciatica but occur due to issues in the sciatica or other nerves.

Sciatica represents a more serious issue than just back pain. It indicates that your nerves are either compressed or irritated. While sciatica pain can be pretty intense, most cases can be effectively resolved within a few weeks with appropriate treatment.
An early investigation into the cause and initiation of treatment is of utmost importance in these cases. If neglected, Sciatica can cause permanent damage to the nerves. People with severe Sciatica, leg weakness, and bowel or bladder changes may require surgery.

Sciatica Risk Factors

Increasing age (peak 45 - 64 years)

Obesity / Overweight - mechanical stress on spine - degeneration of intervertebral disc

Strenuous physical activity - heavy manual labour, lifting heavy weights, sudden bending and twisting

Smoking - decreased pain threshold through sensitizing pain receptors from nicotine

Sedentary lifestyle

Wear and tear from sports and gyming

Sciatica: Causes, Symptoms & Warnings

Causes

When the sciatic nerve is compressed because of a bone spur or herniated disc, it results in Sciatica. In rare cases, Sciatica can also occur when bone tumours compress the sciatic nerve or if the nerves undergo damage due to uncontrolled chronic diabetes.

Following are some of the causes of Sciatica:

Image portrays a woman sitting on the bed, suffering from low back pain.

1. Herniated lumbar disc (slip disc)

Bulging or herniated disc – Disc are like jelly like soft substance covered by outer rim. Jelly - like inner material can come out of its confines and pinch or inflame the nearby nerve

2. Lumbar Degenerative disc disease

Tear and break down of disc leads to bulging disc with loss of height thereby compressing the nerve

3. Lumbar spinal stenosis

Narrowing of spinal canal – As a part ageing process the space for the nerve to pass become narrower leading to stenosis and leg pain

4. Lumbar Spondylolisthesis

When two vertebrae slip or slide over one another to produce the abnormal positioning of two vertebrae leading to compress the nerve

5. Tumors of spine

Spinal tumors are abnormal growth of cells that may be either benign or cancerous. However, when spinal tumor develops in the lumbar region it may compress the nerve producing sciatica

6. Synovial cyst of facet joint

Abnormal fluid filled sacs in facet joints of spine causing spinal stenosis and sciatica

7. Piriformis Syndrome

Piriformis muscle helps in hip extension and rotation of leg, attached sacral spine to the upper portions of the femur. Due to the proximity of the sciatic nerve, any injury or inflammation to the piriformis muscle can cause sciatica like pain

8. Pregnancy

Especially during third trimester – Obstetrical sciatic nerve compression

9. Pelvic floor tumours

Symptoms

We recommend you consult our doctors at Spine 360 if you feel any of the following symptoms:

Pain radiating down your legs.
Burning sensation when you urinate
Presence of blood in your urine
Bladder and bowel incontinence
High body temperature accompanied by back pain
Swelling or soreness in the back around the spine
Numb feeling in the upper pelvis, legs, buttocks, thighs, and legs

A man is standing in the office, experiencing low back pain.

Warnings

Presence of following warnings needs emergency consultation with a neurospine surgeon:

Weakness in the legs
Numbness around the genitals or around the anus
Difficulty in passing urine
Loss or difficulty in controlling when there is an urge pass urine (cauda equina syndrome)
Prolonged duration of pain (> 6 weeks)
Recurrent episodes of pain

Diagnostic Tests for Sciatica

At the outset, spine doctors will make you perform some activities to evaluate your reflexes and check your muscle strength. For instance, you may be asked to get up from a squatting position, walk on your toes or heels, or lift your legs one after the other while lying in a prone position. However, if your pain and discomfort do not improve within a stipulated time, our experts may suggest the following diagnostic tests to further the course of your treatment:

X-ray

Image of a person undergoing an MRI scan.

MRI scans

CT scans

Non-Surgical Treatments for Sciatica

It’s not life life-threatening conditions, but it’s always good a visit a doctor.There are various and non-surgical and surgical options, later being considered when abnormality is detected on imaging

Home remedies

Hot or cold compression packs for comfort and reduce the pain
Bed rest with minimal activity (sitting up, walking in the house, use of rest room) until the acute pain subsides, prolonged best red is not recommended; a few hours of bed rest may provide some symptomatic relief but does not result in faster recovery.

Pharmacological intervention

Analgesic – oral or injection (in severe cases) after consultation with doctor
Muscle relaxants will be of benefit, But no role of steroid

Non-surgical intervention

Local epidural steroid injection if not relieved by medications
Electrotherapy - Percutaneous electrical nerve stimulation (PENS) and transcutaneous electrical nerve stimulation (TENS)

Traction

Not effective; Not recommended for spinal tumours

Sciatica: Surgical Treatments at Spine 360

At Spine 360, our medical professionals assess the suitability of surgery for sciatica based on the specific underlying cause. It is important to note that sciatica is a symptom that may arise from various spinal pathologies. The surgical options are:

Endoscopic discectomy

Endoscopic discectomy stands as a minimally invasive surgical solution designed for sciatica resulting from herniated discs. This procedure entails a small incision and utilises camera guidance for the precise removal of disc material that exerts pressure on the sciatic nerve. Distinguished by a shorter recovery period and diminished complication risks in comparison to conventional surgery, it boasts a high success rate in alleviating symptoms.

Minimally invasive tubular discectomy(Keyhole)

Minimally invasive tubular discectomy, commonly referred to as keyhole discectomy, represents a surgical intervention for sciatica. This method incorporates a small incision and employs tubular retractors to eliminate herniated disc material that applies pressure to the sciatic nerve. The procedure is characterised by minimised tissue damage, expedited recovery, and quick relief from symptoms.

Open (conventional) discectomy

Conventional open discectomy for sciatica requires a larger incision and involves more extensive tissue dissection to address herniated disc material compressing the sciatic nerve. Although proven effective in symptom relief, this approach typically necessitates a more prolonged recovery period and may result in greater postoperative discomfort when compared to minimally invasive techniques.

Minimally invasive spinal fusion

Minimally invasive spinal fusion for sciatica encompasses the fusion of two or more vertebrae to eliminate painful motion, often executed through specialised instruments, small incisions, and imaging guidance. This approach aims to minimise postoperative pain, recovery time, and muscle disruption, providing an effective solution for alleviating sciatica symptoms attributed to spinal deformity or instability.

Open (conventional) spinal fusion

Conventional open spinal fusion for sciatica generally entails a larger incision and more extensive muscle dissection to achieve the fusion of vertebrae and stabilise the spine. While effectively addressing sciatica symptoms arising from spinal instability, this procedure typically leads to longer recovery times and increased postoperative discomfort when compared to minimally invasive methods.

Relief From Sciatica is an Appointment Away

Start your journey towards relieving your debilitating Sciatica pain! Book an appointment with our experts.

Sciatica