SCIATICA

Sciatica is a term given to the pain felt caused by irritation or compression of the sciatic nerve. This is often caused by a herniated or “slipped” disc. Less common causes include spinal stenosis (narrowing of the nerve passages in the spine), spinal injury or infection, or a growth within the spine (such as a tumor).

Sciatic nerve compression (sciatica) causes:

  • Pain (may be mild to moderate, or worsened by sneezing or coughing)
  • Numbness
  • Tingling sensation that radiates to the lower back and travels down to legs, feet and toes

Some may also experience muscle weakness in the affected leg.

Diagnosis

The diagnosis of sciatica is centered around the identification of its clinical symptoms and/or warning signs. Physician may request to do a passive straight leg raise test to test for pain on the affected leg, which is an indication for sciatica.

Warning signs include:

  • Tingling or numbness of lower extremities
  • Muscle weakness of leg and foot on the affected side
  • Age over 50 years or under 20 years
  • Sudden severe pain when lying down
  • Recent trauma or injury
  • Patient has a structural deformity of spine

Other tests a physician may request are:

  • Blood tests to rule out infection
  • CT scan or MRI scan
  • X-ray

 

Recommended Management

Treatment for sciatica is not always necessary, as the condition often improves naturally within six weeks. If symptoms persist, a number of treatments are available.

  • Medical treatment
    • Analgesics, ie. NSAIDs, paracetamol, ibuprofen
  • Exercise or Physiotherapy
  • Compression packs
  • Surgery (rarely necessary; only indicated in severe cases where symptoms are not relieved by conservative methods)

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