The so-called sciatica is a typical pain that afflicts the lower back until it reaches the feet and derives from the inflammation of the sciatic nerve, the most complex and voluminous nerve of our body. The painful sensation usually originates in the lumbar area and descends along the sciatic nerve, passing along the buttocks and legs, until it reaches the foot. Generally, the pain affects only one side of the body and has an intensity that varies from mild to stabbing. Dr. Maurizio Fornari, Head of Neurosurgery at Humanitas, explained how to recognize and treat this problem.
The causes
In most cases, sciatica is related to a protrusion or hernia in the disc and the pain is alleviated with the resolution of the cause that determines it. As the specialist explains, there may also be symptoms such as tingling, numbness, lack of sensitivity or strength of the foot: in their presence, there is a suffering of the nerve root and not only its irritation. Among the causes of sciatica we can mention:
- Irritation or compression of a nerve root due to a herniated disc or a protrusion.
- Shrinkage of the lumbar spinal canal.
- Pyriform syndrome: a small muscle in which the sciatic nerve passes through its fibers; this can become irritated or compressed as a result of prolonged contractures.
How to understand if our sciatic nerve is inflamed?
As always, you should start with a specialist examination, which may be followed by other examinations, such as magnetic resonance imaging, radiography, CT scan and electromyography. During the examination the doctor may have to perform some maneuvers (such as the Lasegue and Wasserman maneuvers) to understand the origin of the disorder.
Is prevention possible?
“Although not all cases of sciatica can be prevented, leading an active life plays a major role in decreasing the risk of incidence,” the specialist commented.
Pain relief therapy or intervention?
During the acute phase of pain it is advisable to rest in bed with the legs flexed and to combat pain anti-inflammatory drugs, painkillers and muscle relaxants are recommended. Systemic analgesic and cortisone epidural infiltrations may also be useful. In the sub-acute phase, however, manipulation and postural gymnastics are indicated. Generally, sciatica resolves in about six weeks without the need for surgery. However, in some cases, for example in the presence of unresolved disc hernias, obstructive hernias that compress the nerve root or the endurance bag, or neurological deficits, surgery may be indicated as microdiscectomy or laminectomy.
