Sciatica or sciatic pain refers to the compression of the sciatic nerve that supplies the lower body with sensation of all kinds ranging from pain to burning or hot and cold. Sciatica pain generally refers to pain in the back radiating through the buttocks, thigh, leg and the calf. These symptoms can be on one leg or on both the sides of the body depending upon the compression of the neural structures. The neural structures can be compressed through the following reasons such as:
- Disc bulge
- Facet joint arthropathy
- Muscular tightness
- Nerve entrapment
- Muscular weakness
- Biomechanical compensations
- Osteophytes formation
Pathology of Sciatica
Sciatic nerve is the biggest and thickest nerve of our body. It arises from the L3, L4, L5 and S1 nerve root giving rise to the sciatic nerve supplying the entire back of the lower body. It also provides strength to our great toe extension, ankle dorsiflexion, ankle plantarflexion and hip extension. These actions are important to determine the extent to which the nerve has been compressed.
The sensory part of the sciatic nerve supplies the back from buttocks to leg and foot. The disc that is present between the L4-L5 and L5-S1 is the most vulnerable region where maximum mobility can be appreciated in the lumbar region hence maximum chances of disc causing compression of the following nerve roots hence maximizing the chances of sciatic pain. Once there is compression by the discal or the bony structures, there is inflammation of the neural structures that causes increased release of inflammatory substances such as histamine thus further enhancing the process of inflammation to be continued.
This in turn causes the transference of signals to be altered thus causing generation of stimuli such as pain. There is also altered oxygenation at the site of inflammation followed by release of noxious agents. Depending upon the degree of compression, the nerve can present with pain followed by burning sensation followed by tingling and lastly numbness hence seriously altering the sensation of the affected area.The process of inflammation needs to be altered by adequate bed rest followed by slow and sustained recovery to functional activities once the inflammatory phase subsides.
Symptoms of Sciatica:
- Pain is the prime symptom that is present in around majority of the cases. The initial complaints of pain are followed either by a sudden jerk or may be insidious in nature.
- Pain can be followed by burning and tingling and numbness that seriously affect the sensorium of the patient giving complaints of unable to perceive sensations adequately.
- Patients can also complain of weakness in the lower body or unequal weight bearing on one side of the body in comparison to the other side thus affecting their walking pattern causing them to limp.
- Patients can also complain of difficulties in performing certain specific activities such as bending as the nerve gets stretched or prolonged sitting or walking or standing as the load increases on the disc and thus further causing neural compression.
Sciatica pain is treatable given the chance that one follows the ergonomic advice and works on improving the efficiency of the muscles with improving the mobility of the nerves.
Shanewastson is the heath care advisor at QiSpine Clinic. QiSpine clinic offers Back Pain Remedies successfully by the best Spine Specialist in India.