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SCIATICA

Sciatica is caused due toirritation of sciatic nerve which causes pain radiating along the course of the nerve which runs from the lower back to buttock, back of thigh and into lower leg and foot.

Sitting may cause pain due to pressing of nerve

Pain is usually sharp, shooting, radiating to leg and foot, associated with burningsensation ,tinglingand numbness.

Pain is better during walking,lying down and the pain is more while standing.

Usually caused due to lumbar disc herniation. Most commonly affected level is L5-S1.

CAUSES of sciatica include herniated disc in spine,over growth of bone on vertebrae.

RISK FACTORS include elderly age, obesity, prolonged sitting, diabetes and occupation which involves carrying heavy loads,driving motor vehicle for long periods.

INVESTIGATIONS include Xray spine,MRIspine,CTspine,EMG

TREATMENT

1. NSAIDS
2. Muscle relaxants
3. Narcotics
4. Tricyclic antidepressants
5. Anti seizure medications.
6. PHYSICAL THERAPY-It includes strengthening,stretching and aerobic exercises.
7. Strengthen the spine and muscles of lower back,abdomen,buttocks and hip.
8. Stretch tight and inflexible muscles such as hamstring

Steroid injections – It involves injection of steroid around nerve root.Corticosteroid help reduce pain by suppressing inflammation around the irritated nerve.

Surgery is usually done when compressed nerve causes significant weakness,loss of bowel or bladder control, or when pain  progressively worsens or doesnot improve with other therapies.

Surgery involves removal of bone spur or the portion of herniated disc that is pressing the nerve

PREVENTION

1. Exercise regularly
2. Maintain proper posture while standing, sitting and even sleeping to minimize pressure on lower back.
3. Lose weight ,if overweight to lighten pressure on nerve
4. Stop smoking,which advance disc problems.
5. Avoid sitting for long stretches of time.