Is it sciatica?

Written by Cheng Bin
Orthopedics
Updated on September 04, 2024
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It should be noted that the incidence of sciatic nerve pain is still very high in clinical settings, and there are many causes which can lead to severe pain when it occurs. Common causes of sciatic nerve pain include conditions like sciatic neuritis, which can result in patient discomfort, as well as lumbar disc herniation, lumbar spondylolisthesis, lumbar spinal stenosis, and lumbar tumors. Compression of the spinal nerves can also lead to sciatic nerve pain. Additionally, piriformis syndrome can cause sciatic nerve pain in patients. Determining the specific cause requires a physical examination along with some auxiliary tests to make a clear diagnosis, after which active symptomatic treatment can be completely effective.

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Written by Zhang Hui
Neurology
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How is neuralgia treated?

Neuralgia can cause severe pain and significantly impact a patient's life. Treatment for neuralgia primarily focuses on the following aspects: First, treatment should be based on the cause of the pain. For instance, if the patient suffers from trigeminal neuralgia, antiepileptic drugs may be prescribed. Surgery may be necessary in some cases. If the neuralgia is caused by a viral infection, active antiviral treatment is required. If tumor cells invade and cause the neuralgia, tumor treatment should be administered. The second type of treatment involves symptomatic management. This mainly includes medications to relieve neuralgia, commonly comprising tricyclic antidepressants and antiepileptic drugs, which can be effective in alleviating the pain and should be taken under the guidance of a doctor.

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Written by Liu Shi Xiang
Neurology
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How to relieve neuralgia

Neuropathic pain can be relieved through treatments such as medication, physical therapy, and surgery. Medications used primarily include antiepileptic drugs and non-steroidal anti-inflammatory analgesics, such as carbamazepine, oxcarbazepine, gabapentin, pregabalin, sodium diclofenac, ibuprofen, and celecoxib. Physical therapy mainly involves localized heat application, massage, manipulation, and acupuncture. Surgical treatment is mainly suitable for patients who do not respond well to medication and physical therapy. Currently, the surgical approach mainly involves minimally invasive surgery to relieve nerve compression, thereby alleviating the symptoms of neuropathic pain. Beyond symptomatic treatment, it is important to identify and treat the underlying cause of the neuropathic pain, such as tumors, trauma, diabetes, etc. These causes can lead to neuropathic symptoms, so it is crucial to actively control these underlying diseases to potentially relieve neuropathic pain at its root. (Medications should be used under the guidance of a doctor.)

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Written by Liu Yan Hao
Neurology
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How to treat occipital neuralgia?

Occipital neuralgia is caused by cervical compression of the greater occipital nerve, leading to neuropathic pain. Thus, treatment of occipital neuralgia may involve oral pain relief medications to temporarily alleviate symptoms. Additionally, some nerve-nourishing medications can be used in treatment. Fundamental treatment involves addressing cervical spondylosis, which can include cervical physiotherapy and the use of medications that improve blood circulation and remove blood stasis to treat cervical spondylosis. It is also important to take care of the cervical spine by not sitting for too long; if sitting for extended periods, one should get up and move to stretch the muscles and bones. Performing the "little bird flying" exercise, where the head is leaned back and both arms are extended backwards, can effectively relieve cervical spondylosis and the pain caused by cervical compression of the greater occipital nerve. Additionally, the pillow should not be too high when sleeping at night.

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Written by Zhang Hui
Neurology
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Causes of Neuralgia

Neuralgia is extremely painful, with patients often experiencing severe, unbearable pain. The causes of neuralgia mainly include the following types. The first type to note is viral infection, such as herpes zoster virus infection, which can leave postherpetic neuralgia. In such cases, it is crucial to actively use antivirals and employ neuropathic pain medications for treatment. The second scenario may relate to nerve compression, such as trigeminal neuralgia, which may be associated with local vascular compression causing abnormal nerve discharges. Surgical treatment might be necessary to relieve the compression. Sciatica is also caused by compression of the sciatic nerve. The third case might be due to nonspecific inflammatory responses. For example, Guillain-Barre syndrome can also cause neuralgia, and treatment should be directed at the underlying cause.

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Written by Gao Yi Shen
Neurosurgery
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What is brachial plexus neuropathy?

Brachial plexus neuropathy occurs when certain pathological changes affect the brachial plexus, causing clinical symptoms such as pain, numbness, and weakness. The brachial plexus is composed of four nerves from cervical vertebrae 6 to 7, 8, and thoracic vertebra 1. The brachial plexus gives rise to the median nerve, ulnar nerve, and radial nerve, making it a central hub. If the brachial plexus is injured, for instance, through trauma such as stretching, tearing, tumor compression, or bone impingement, this can lead to clinical manifestations including pain, numbness, and weakness in the arms and hands, a condition known as brachial plexus neuropathy. If such symptoms occur, it is crucial to promptly complete the necessary examinations to clarify the changes in the condition.