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Sciatica

Sciatica is pain in the back or leg due to irritation of the sciatic nerve. This nerve is the thickest nerve in the body and starts in the lumbar and sacral part of the spinal cord and runs through the buttocks to the end of the leg. It is important to know that sciatica is not an actual disease or injury, but rather a symptom.

What is sciatica?

The sciatic nerve (nervus ischiadicus) is the longest and thickest nerve in our body, its nerve roots originate in the lumbar spine, running through the pelvis to the feet on both sides of the body. Sciatica is the term used to describe a cluster of symptoms caused by compression of the sciatic nerve (nervus sciatica).

Typical symptoms of sciatica are acute and stabbing pain that spreads from the lumbar spine across the buttocks to the back of one or both legs. There may also be isolated pain in the leg or legs. Sciatica usually affects only one side of the body.
 

How does sciatica occur?

Sciatica occurs when the nerve roots of the sciatic nerve are pinched or when the nerve is pinched by the piriformis muscle. Sciatica is often caused by various pathologies of the spine, e.g. disc herniation, spinal stenosis, spondylolisthesis, spinal arthrosis or osteoarthrosis, etc.

Severe sciatica can also be caused by piriformis syndrome, which occurs when the piriformis muscle, which is located in close proximity to the sciatic nerve, is severely shortened and becomes pinched. Symptoms of sciatica mean that the sciatic nerve is pinched at some level..

 

Preventive measures for sciatica

Preventive measures for sciatica When we talk about preventive measures for sciatica, we are talking in principle about proper maintenance of the spine. The spine must have developed an adequate loading capacity and stabilising muscles in all the main directions, e.g. anti-rotation, anti-flexion, anti-lateroflexion and anti-extension.

Sciatica occurs when the spine has poor support and is overloaded, in fact sitting is a great strain on the spine. Adequate physiotherapeutic exercise is the best preventive measure for sciatica.
 

When does sciatica usually appear?

Sciatica rarely appears before 20 years of age. It most commonly appears between 40 and 50 years of age.

Sciatica is often caused by various pathologies of the spine, e.g. disc herniation, spinal stenosis, spondylolisthesis, spinal arthrosis or osteoarthrosis, etc. Severe sciatica can also be caused by piriformis syndrome, which occurs when the piriformis muscle, which is located in close proximity to the sciatic nerve, is severely shortened and becomes pinched. Symptoms of sciatica mean that the sciatic nerve is pinched at some level.

Risk factors for sciatica

The main risk factors for sciatica are prolonged sitting combined with poor spinal musculature and inactive core stabilisers.

In reality, most people people do not know the correct techniques to strengthen anti-rotations and anti-latflexions of the spine, which are often problematic patterns.

If you sit a lot, have a history of sedentary work and do not maintain your spine with specific exercise you are likely to face sciatica in the near future.

Treatment

The treatment of symptoms of sciatica depends on the type of degeneration that causes it and its progression.

It is important to keep in mind that sciatica is not a disease, but only a term used to describe the symptoms that accompany degenerative changes of the spine which are treated with instrumental physiotherapy and therapeutic exercises in the initial stages.

Surgical treatment is performed when conservative therapies do not significantly improve the symptoms and the quality of life over the period of 3 to 6 months.

There are also some indications (cauda equina syndrome) that require rapid surgical intervention. Most patients improve symptoms of sciatica by following an adequate movement programme that aims to teach the correct exercise techniques, strengthen the core and control the movement of the pelvis.

Preventive measures for sciatica

When we talk about preventive measures for sciatica, we are talking in principle about proper maintenance of the spine.

The spine must have developed an adequate loading capacity and stabilising muscles in all the main directions, e.g. anti-rotation, anti-flexion, anti-lateroflexion and anti-extension.

Sciatica occurs when the spine has poor support and is overloaded, in fact sitting is a great strain on the spine. Adequate physiotherapeutic exercise is the best preventive measure for sciatica.

Frequently asked questions about sciatica

1) What kind of pain causes sciatica ?

Symptoms of sciatica (sciatica pain) occur suddenly, with a jolt on movement, with an aggressive pain response in the back, buttocks and legs, or gradually due to the progression of degenerative changes in the spine. Sciatica can also occur without pathology, in which case the pain diminishes rapidly

2) How does sciatica feel ?

Sciatica is caused by a strong acute irritated condition. The pain is intense and may be accompanied by neurological symptoms in the lower limbs, e.g. tingling in the legs and feet, as well as sensations of hot or cold feet. In advanced states of sciatica, sensory and motor disturbances of the legs may also occur.

Sciatica is distinguished from normal back pain by the pain spreading to the buttocks, hips and down the legs or feet. Sciatica is characterised by occurring on only one side of the body, although in rare cases it can occur bilaterally.

3) Can sciatica occur in both legs ?

Sciatica can occur in both legs, usually as a result of a compression at the level of the lumbar spine in the form of a broad-based disc herniation, where the sciatic nerve roots are affected bilaterally. Sciatica in both legs can occur when there are multiple associated pathologies of the lumbar spine, e.g. disc herniation at two levels of the spine on different sides, or disc herniation with arthritic changes on different sides. It is also common for sciatica to be felt bilaterally in an extremely acute condition.

4) Does sciatica occur immediately or gradually ?

Sciatica can occur when a movement is ”incorrectly” performed, although in reality it is not an incorrect movement. It is the poor activity of the muscle groups at the moment of the movement, with the probable presence of degenerative changes in the form of disc herniation or other pathologies. Often, the ”incorrect movement” is only the trigger of the sciatica symptoms, but the problem is broader than that.

5) How quickly does sciatica resolve ?

Sciatica can resolve quickly, within 1 week , in some cases, although in most cases the symptoms persist for several weeks. Sciatica can persist for months or years, depending on the approach of the individual. With proper physiotherapy and kinesiology, which is recommended for all sciatica patients, the pain usually resolves completely within a window of 6 – 12 weeks.

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