Dealing with Sciatica: Main Solutions
What is sciatica?
Sciatica is one of the most frequent pains of the nervous system and can seriously affect the quality of life. It is not a disease in itself, but a set of symptoms caused by irritation or compression of the sciatic nerve, the longest and widest nerve in the human body.
The sciatic nerve originates in the lumbar area (lower back), crosses the buttock and the back of the leg until it reaches the foot. When this nerve is compromised, it can cause discomfort in a wide region of the body, causing pain, numbness, weakness or a tingling sensation in the areas it passes through.
It is important to note that sciatica is not a specific pathology, but refers to the symptoms caused by damage to this nerve.
Due to its long course, when this nerve is affected, it causes discomfort that spreads through a large part of our body, affecting our mobility and causing considerable pain, numbness, weakness or an annoying tingling in the areas where this nerve passes.
Causes of sciatica
The main cause of sciatica is compression of the sciatic nerve at the level of the spine, which can occur in different areas, although most commonly in the lumbar region. This compression can occur in different vertebral segments, such as the cervical, dorsal or lumbar regions, depending on where the nerve is affected.
The most frequent causes include herniated discs, disc protrusions, osteoarthritis, vertebral disc degeneration, muscle spasms in the lumbar or gluteal region, bone spurs (abnormal bone growths caused by joint wear or arthritis), spinal canal stenosis (narrowing of the canal through which the nerves pass), tumors that pinch or compress the nerve (less frequent), and diabetic neuropathy in cases of poorly controlled diabetes.
There are some risk factors that may favor the onset of sciatica, such as changes in the spine caused by age (such as bone spurs or herniated discs), overweight and obesity, which increase the load on the spine, diabetes, especially if poorly controlled, because it can cause nerve damage, and also work-related factors, especially those that require spending too much time sitting or performing movements that involve twisting the back or lifting heavy loads.
Knowing the exact cause and degree of involvement is essential to decide on the appropriate treatment, since compression at one vertebral level is not the same as compression at several levels simultaneously.
Symptoms of sciatica
The most characteristic symptoms of sciatica include radiating pain from the lower back that runs down the back of the leg, and can reach the foot. This pain can vary in intensity and frequency, being a constant or intermittent discomfort. Numbness in specific areas of the nerve pathway, tingling, burning, sensation of electric shock or hypersensitivity, and weakness in the affected leg may also appear. The pain may affect one or both legs, and its intensity may range from mild to disabling.
The pain is usually aggravated by prolonged sitting, coughing or sneezing, or certain movements. If we suspect that we may have an injury to the sciatic nerve, or if we have suffered a strong blow causing these discomforts, it is important to consult a doctor to evaluate the situation.
How is it diagnosed?
Early diagnosis is key to effective treatment. It is essential to identify the exact cause and the degree of nerve involvement. Compression at a single vertebral level is not the same as compression at several levels at the same time.
The medical evaluation includes clinical history, physical examination and, in many cases, imaging tests such as MRI or CT, which allow visualization of the nerve compression and rule out other pathologies.
How to prevent and relieve sciatica?
We have seen some risk factors that can cause sciatic nerve injuries, but some of them are factors that we cannot control, such as deterioration of the spine due to age or some previous condition.
Even so, there are measures that can reduce the risk, such as avoiding a sedentary lifestyle and keeping active, performing regular physical exercise adapted to our physical condition, controlling body weight, protecting the back when lifting heavy objects using appropriate load techniques, and avoiding intense efforts that overload the lumbar area.
Be careful when performing certain activities that place a load on the lumbosacral area (either at work or at the gym, for example), avoid gaining weight so as not to overload our back, stay active and stay away from a sedentary lifestyle… These are general recommendations, but they can help us prevent the onset of sciatica.
If we already have pain caused by sciatica, it will first be a medical professional who will have to assess the situation and the possible causes. The important thing, once we have reached this point, is to try to minimize the impact of the injury until it disappears or, at least, we do not aggravate it further.
Treatments can range from non-surgical treatments for milder cases, in which we find pharmacological or physiotherapeutic treatments, to surgical treatments for chronic or severe cases.
The pain caused by sciatica is quite disabling the first few days after the injury, so it is necessary to be careful and rest to prevent it from getting worse. It is good to start recovering mobility little by little, without making great efforts; and if possible, start our physical activity gradually to alleviate the pain.
If you have to take any medication to reduce pain, such as anti-inflammatory drugs or muscle relaxants, do not do it on your own. A medical professional should prescribe the most appropriate for your situation. What you can do is apply heat and cold to the affected area.
Treatments for sciatica
Treatment of sciatica may include a combination of medical, interventional and physical therapy options. The choice depends on the origin of the pain and its intensity.
Among the most common treatments are analgesic and anti-inflammatory drugs, and muscle relaxants, always under medical prescription.
In terms of minimally invasive treatments, the following stand out:
Epidural injections: local anesthetics, corticosteroids or regenerative therapies are administered directly into the area of inflammation, providing fast and effective pain relief.
Dorsal root ganglion radiofrequency: this technique uses a needle that transmits electricity to modulate pain transmission in the central nervous system, which helps to significantly reduce pain intensity.
Intradiscal treatments: consist of the application of radiofrequency techniques, laser or active substances directly on the injured disc to reduce the volume of the herniation or protrusion and reduce the pressure on the nerve.
These procedures often offer significant pain relief, with results that can last more than six months. In addition, they are minimally invasive treatments, which means they do not require surgery or long recovery periods.
To achieve lasting relief, it is essential to combine these treatments with a rehabilitation and physiotherapy program. These exercises help strengthen the muscles in the affected area, reducing pressure on the nerves and improving spinal stability. Physical therapy helps reduce pressure on the nerves, improves function and prevents future injuries.
Medical Director of MIVI Salud
Director MIVI Salud Valencia