Sciatic Nerve - DEALING WITH IT

Sciatic nerve

The sciatic nerve is the main nerve of the lower limbs.
It controls the hip, knee and ankle, and also the hamstrings and the muscles of the leg and foot. The sciatic nerve is the longest in the human body - connects the big toe to the lower back - but fame does not come from its length, but the pain caused by it, the "sciatica", which affects about 15% population and can cause very desconforto.Como the sciatic is responsible for the innervation of the lower limbs, pain can occur in several places, but the most common are the posterior gluteal region, the big toe and the lateral aspect of the thigh and leg.
sciatic nerve inflammation (sciatica)

What is Sciatica

Sciatica is leg pain due to irritation of the sciatic nerve. This pain usually goes from the back of the thigh to the back of the calf, and may extend to the hips and feet. In addition to pain, there may be numbness and difficulty moving and controlling the leg.
Although sciatica is a form of relatively common pain, the true meaning of the term is often misunderstood. Sciatica is the number of symptoms, not a diagnosis for what is irritating the nerve and causing pain.

Causes of Sciatica

Sciatica is usually caused by nerve root compression in the lumbar spine, and less common by compression of the sciatic nerve itself. Thus, the "true sciatica" is caused by compression of the nerve roots by a bulging disc,  thickening and / or misaligning the vertebra. The "pseudo-sciatica" is caused by the compression of most peripheral nerve sections, usually through soft tissue tension in the piriformis or other related muscle. Unhealthy postural habits, such as staying too long sitting in chair or sleeping in the fetal position, along with stretching and insufficient exercise of the relevant myofascial areas, can cause spinal problems and soft tissue associated with sciatica. Other causes include infections and tumors sciatica.
Sciatica can also occur during late pregnancy, whether as a result of the uterus pressing on the sciatic nerve, or secondarily due to muscle tension or vertebral compression associated with extra weight and posture changes.

Treatment of Sciatica

Since various conditions may compress the sciatic nerve roots and cause sciatica, treatment options generally differ. Treatment of the underlying cause of the compression is usually the most efficient practice. When the cause is due to lumbar intravertebral disc prolapsed or herniated, research has shown that with the treatment of support for relieving pain in 90% of cases, recovery without specific intervention. Most cases of sciatica can be treated effectively with physiotherapy and massage therapy (specifically neuromuscular therapy), and appropriate changes of behavior and environment (for example alcochoamento, the chair and table height, exercises, stretching). Other treatment options include conservative therapy Somatic Movement of the anti-inflammatory and analgesic. Around 10-20% of cases surgery is needed to correct the problem.

Description and Diagnostic

Pain in the Sciatic Nerve is a disease or symptom?

The pain expression in sciatic nerve is commonly used to describe pain that propagates along the sciatic nerve. The sciatic nerve pain is a symptom caused by a disease that occurs in the lumbar spine. The sciatic nerve is the largest nerve in the body, having the approximate diameter of a finger.
The fibers of the sciatic nerve starts in the 4th and 5th lumbar vertebrae (L4, L5) and the first and few segments of the sacrum. The nerve passes through the sciatic foramen just below the Piriformis muscle (lateral rotation of the thigh), passes through the posterior extension of the hip and lower Gluteus Maximus (muscle of the buttocks, thigh extension). Then, the sciatic nerve extends vertically downward from the back of the thigh, behind the knee, branching in the muscles of tendons (calf) followed down to the feet.

Symptoms of pain Sciatic Nerve

The Sciatica usually affects one side of the body. The pain may be dull, sharp, burning or as an intermittent shock accompanied by acute pain, starting at the bottom and extending downward behind or from the side of the thigh and / or leg. The pain in the sciatic nerve extends to below the knee and can be felt in the feet. Sometimes symptoms include tingling and numbness. Sit back and try to get up can be painful and difficult. Coughing and sneezing can intensify the pain.

The Cause: Nerve Compression

The sciatic nerve compression can cause any of the symptoms mentioned above. The nerve damage is rarely permanent and paralysis is a rare risk, since the spinal cord ends before the first lumbar vertebra. However, an increase in the torso or leg weakness, incontinence or bladder and / or bowel is an indication cauda equina syndrome, a serious disease that requires emergency treatment.
Diseases of the lumbar spine that usually cause sciatic nerve compression include: • Herniated Disc, the most common cause of sciatic nerve pain in the lumbar spine. • Degenerative Disc Disease, a natural biological process associated with aging, often causing weakness to disk, may be the precursor of a herniated disc. • Stenosis of the Lumbar Spine, a narrowing of one or more passages nerve, due to disc degeneration and / or arthritis in facets. The sciatic nerve may be under pressure as a result of these changes. • The Isthmus spondylolisthesis resulting from a stress fracture, typically in the 5th lumbar vertebra (L5). The fracture, combined with the collapse of the disc space can cause the vertebra to slip forward toward the first segment of the sacral region (S1). The slip may cause nerve root impingement L5 out of the column.
Tumors of the Spine and infections are other diseases that can compress the sciatic nerve, but are rare.
There are other conditions that may occur and may look like a sciatic nerve pain, but are difficult to diagnose.

Diagnosis of Pain Sciatic Nerve

The medical examination includes the patient's medical history, a review of current medications, physical and neurological examination and, if warranted, x-rays, CT and / or MRI. A proper diagnosis requires an analysis of the patient's pain. Usually, the patient is given a headache diagram to illustrate the distribution and sensation of pain (eg., Numbness and burning).
doctor's questions may include: • "As the pain began?" • "On a scale of 1 to 10, with 10 being the worst pain imaginable, rate your pain." • "The pain gets worse if you go up or down a slope?" • "pain affects your daily activities?" • "What kind of treatment has been tried and which had some effect?"
Note the extent of patient motion. Test the reflexes and muscle strength. The doctor may use one or more motion tests to determine the source or cause of the pain.
Treatment and Recovery Treatment Non-Surgical
The sciatic nerve pain usually responds well to non-operative forms of treatment and there is hardly any indication for surgery as the primary form of treatment. Time, non-steroidal anti-inflammatory drugs (NSAIDs), short-term use of narcotic drugs for acute pain, lumbar injections and physiotherapy are beneficial.
Although rest is recommended in bed for a short period during the acute phase, it is good to perform some activity. In this context, "activity" is set to remain standing for periods of time that do not cause severe pain. The exercise prescription may include stretching, walking and aerobic exercise.

Surgery

The surgery is not recommended for all patients. However, in some cases, surgery may be indicated. Patients who followed the guidance of a non-surgical treatment for four to six weeks without relief certainly need to be re-evaluated by your doctor. If an MRI exam revealed herniated disc or spinal stenosis, surgery can provide relief to the pain in the legs. The type of procedure depends in part upon the condition and patient diagnosis.

Recovery

If the treatment for sciatica is non-operative or if surgery is always good to follow the instructions given by the doctor and / or physical therapist.
Look relieve unnecessary mechanical stress of the column. For example, when you stand, rest one foot on a stool, alternating with the other leg. When driving, place a small pillow or rolled towel back to maintain the natural curvature of the spine. Time to go to bed, lie on your back with a pillow under your knees or between the legs side sleeping.
Try to eat healthy way, trying to maintain your ideal weight and avoid smoking. This lifestyle makes all the difference to the health of the spine.