Sciatica:
Sciatica is a set of symptoms including pain that may be caused by general compression and/or irritation of one of five spinal nerve roots that give rise to each sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves.
Symptoms:
The pain is felt in the lower back, buttock, and/or various parts of the leg and foot.
In addition to pain, which is sometimes severe, there may be
-numbness
-muscular weakness
-pins and needles or tingling
-difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body.
-Pain can be severe in prolonged exposure to cold weather.
Cause:
Sciatica is generally caused by the compression of lumbar nerves L4 or L5 or sacral nerves S1, S2, or S3, or by compression of the sciatic nerve itself. When sciatica is caused by compression of a dorsal nerve root (radix) it is considered a lumbar radiculopathy (or radiculitis when accompanied with an inflammatory response). This can occur as a result of a spinal disk bulge or spinal disc herniation (a herniated intervertebral disc), or from roughening, enlarging, and/or misalignment (spondylolisthesis) of the vertebrae, or as a result of degenerated discs that can reduce the diameter of the lateral foramen through which nerve roots exit the spine.
Treatment
When the cause of sciatica is due to a prolapsed or lumbar disc herniation 90% of disc prolapses resolve with no intervention. Treatment of the underlying cause of the compression is needed in cases of epidural abscess, epidural tumors, and cauda equina syndrome.
-Analgesics to relieve pain and disability is lacking.
-Elective surgery is the main option for unilateral sciatica and focuses on removal of the underlying cause by removing disk herniation and eventually part of the disc.
-In a controlled study, surgical intervention was found to have better results after one year but after four and ten year follow ups no significant differences were found.
No comments:
Post a Comment