Sciatica or Lower back pain in Human Body. Sciatica Symptoms, causes, treatment, diagnosis, and Medication.

What is sciatica?
Sciatica is known as pain into the sciatic nerves which is form into your lower back region by five nerves roots, two from lumbar spine and three from sacrum spine are joints from hips to knee then further it branches other nerves roots and continue down into your toes on the both side of your body, it is the longest and thickest nerves. Sciatica pain is cause by when herniated disk, bone spur on the spine, spinal stenosis(narrowing spine) that cause pain, numbness, tingling, weakness in muscle, into hip, buttock, leg, foot, and toes.

What is the symptom of sciatica?
  1. Severe pain, numbness, stabbing, weakness, burning in lower back buttock, leg, feet
  2. Needle pins like pain in feet and toes
  3. Pain is worse when long time standing or sitting and cause lower mobility
  4. mostly occurs in one leg but sometimes occurs in both leg
  5. sudden body movement like sneezing, coughing can make the worsen pain

What is the causes of sciatica?
Sciatica occurs from various medical issues:
  • A herniated or slip disks is a condition in which cushioning Disk supporting between the vertebrae of spine but pressure from the vertebrae effect the center of gel of disk to destroy it outer layer, after herniated disk spinal vertebrae put pressure on your lower back nerves root that cause severe pain like hips legs foot.
  • Degenerative disk is a condition In which the natural degenerate disk between the spinal vertebrae cause shortness of height of disc happened and narrow the passage of nerves roots(spinal stenosis) which cause pinching sciatic nerves roots causes the severe pain In your lower back like hips buttocks legs foot toes.
  • Spondylolisthesis is a disease in which one of your vertebrae slipped out of spinal line by stress fracture or weakness, causes sciatic nerves roots pinch by outline vertebrae cause pain.
  • Osteoarthritis is a condition in which cartilage (supporting tissue between bones) is degenerate naturally which causes compress your lower back sciatic nerve.
  • Tumor inside the spinal canal of lumbar that compress your lower back nerves
  • Piriformis syndrome is a rare neuromuscular disorder in which a flat small muscle is located on the buttock, when it muscles become tight can put pressure on sciatic nerve
  • Cauda equina syndrome is a condition in which cauda equina the bundles of nerves roots after the end of spinal cord which used for your sensory, bladder, bowel, pelvic organs controls is dysfunction and cause pain in legs numbness around the anus, loss of bowel and bladder control.
  • Trauma injury is a sudden physical and shock injury both, this shock injury get immediate treatment since, patients loss muscles power on lower back by any bone fracture, stress fracture or cutting sciatica nerves.

What are the risk factors of sciatica?
Risk factor of sciatica include:
  • Age: In old age people bones start degenerating naturally by the time goes like bone spur, slipped disk are the common cause of sciatica
  • Obesity: obesity is the risk of almost all the disease, its put more pressure to your spine cause stress fracture
  • Occupation: your workplace where you put excess of pressure on your back spine may cause stress fracture like driving, carry heavy loads, etc.
  • Diabetes: increase in a blood sugar may cause your nerves affect
  • Pregnant women: pregnant women have risk of sciatica if your expanding uterus and growing baby put pressure on sciatic nerves can cause inflammation, pain

How to diagnose sciatica?
  • Your doctor first examines your leg asking you to lie down on your back and raise your leg straight, stretch muscles, to check the pinning pain on leg and back, and also ask you to walk on heel, and toes to check the strength of your calf muscles.
  • Depends on your severity of pain they give you test like imaging, X ray are includes:
    1. Magnetics resonances imaging (MRI) or Computed tomography (CT scan): doctors recommend MRI or CT scan to check the bones or soft tissues, usually they see herniated or slipped disk, pressure on nerves, by this test doctors confirm the sciatica
    2. X-ray: doctors ask you for spinal X- ray to check the spinal bone fractures, slipped disk, bone spur, tumor, etc.
    3. Electromyography: to check normal response of muscles and electric impulse travel through the sciatic nerves
    4. Myelogram: to check the vertebrae or disk is causing pain

What is the treatments of sciatica?
  1. There are some self-care treatment for acute sciatica, most cases get cures by these steps:
    • Icing packs or hot waters packs have reduce your pain
    • Some low impact stretching or walking
    • Some painkillers over the counter prescribe by your doctors:
      NSAID (Nonsteroidal anti- inflammatory drugs) are drugs that can relieve pain in a short term.
      Ibuprofen- Advil, Morin, Nuprin
      Amount: 200mg, 300mg, 400mg
      Dose: 1 (every 4 to 6 hours)
      Max Daily limit: 1200 mg
      Naproxen sodium- Alive, Naprosyn
      Amount: 220mg
      Dose: 1 (every 8 to 12 hours)
      Max daily limit: 440 mg
      Amount: 500 mg
      Dose: every 6 hours
      Max daily limit: 3 g
      Amount: 350- 650 mg
      Dose: every 6 hours
      Max daily limit: 500 mg

  2. In Server conditions or chronic sciatica treatment include these steps:
    • Physical therapy: cognitive behavioral therapy (CBT) therapist teach you different exercise according to your chronic pain and itís reduce pain
    • Surgery is the last option for your chronic pain, there 2 surgery includes:
      • Lumbar laminectomy: In this surgery doctors remove all parts of Lamina (posterior part of vertebrae) to make more space for compress sciatic nerve roots
      • Discectomy: surgeon removes the partial or fully removal of slipped disk, surgeon take risk in this surgery for chronic Patients
    • Stretching Exercise
      Stretching exercise also relieve the sciatic pain
      Stretching reduce your symptom and medication
      Long term relief in your hips, buttocks, legs, foot, and toes
    • Medication for chronic sciatica includes:
      • Cortosteroids: Steroids is given in the irritated nerves to reduce the severe pain
      • Stronger muscle relaxants (cyclobenzaprine (Amrix, Flexeril))
      • Tricyclic antidepressants
      • Amitriptyline (Elavil)
      • Anti sezure medications

Some alternative techniques are useful for some patient treatment but are not proved with scientist:
  • Acupuncture is techniques in which needles inserted at the specific points at some place making qi, there is flow of some energy qi is channel or meridians which is imbalanced or blockage cause pain, Acupuncture is removed those blockage to maintain qi and reduce pain.
  • Biofeedback is a technique that maintain the body processes like muscle tension, heart rate, blood pressure, the machines collect f data from your body processes, so we can find the specific problem, so patients should control consciously on their own body, mostly common to treat stress

Note: This is for education purpose only, all the medication should be taken under the prescription of Doctor only.