What are the symptoms of sciatica?

Written by Xie Yi Song
Orthopedics
Updated on September 07, 2024
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Sciatica refers to the pain caused by the sciatic nerve due to various reasons, such as compression from spinal diseases or simply sciatica itself, and it is inherently a symptom. What are the characteristics of this symptom? Sciatica can occur on one side or both sides simultaneously. When it occurs, the pain is usually continuous and can have episodic exacerbations. The pain is often dull, stabbing, burning, or like a knife-cutting sensation. It radiates from the buttocks along the back of the thigh and the outer back of the lower leg toward the foot. Clinically, sciatica is divided into secondary and primary types. Secondary pain is due to compression of the sciatic nerve root, commonly seen in conditions like lumbar disc herniation and other spinal disorders. It often accompanies percussion pain in the lumbar spine, and the pain may worsen with coughing, sneezing, or bending, and severe cases may experience numbness in the skin of the lower limbs. Primary sciatica refers to simple inflammation of the sciatic nerve. This type generally presents pain in the buttocks and back of the thigh and usually does not involve percussion pain in the lumbar spine.

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Written by Na Hong Wei
Orthopedics
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Symptoms of Sciatica

Symptoms of sciatica: First, sciatica often occurs in the lumbar 4 and lumbar 5, or between lumbar 5 and sacral 1 disc herniation. Second, the primary symptom of sciatica is pain, which typically originates in the lower back and can radiate to the buttock, posterior thigh, the lateral side of the calf, and the lateral edge of the foot sole. Pain usually has a triggering factor, such as coughing, sneezing, defecation, etc., basically any activity that increases abdominal pressure can cause radiating pain of the sciatic nerve. Third, the area innervated by the sciatic nerve may become hypersensitive, with some people feeling pain, others feeling heat, and still others feeling cold, until the later stages where it generally becomes numbness and dullness. Fourth, there are limitations in movement of the lower back or limbs, with many patients reporting a feeling as if there’s a shortened tendon at the back of the thigh, restricting movement. These are the primary symptoms of sciatica.

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Orthopedics
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What Chinese medicine is taken for sciatica?

Sciatica is categorized under "Bi Syndrome" in traditional Chinese medicine. There are several Chinese herbal formulas to consider for treatment. The first is Xuan Bi Tong Bi Tang, which has an overall effectiveness rate of about 96%. The second herbal formula is Wu Tou Xi Xin Tong Bi Tang, which also has good therapeutic effects and is statistically shown to be superior to non-steroidal measures. The third medication is Du Huo Ji Sheng Tang, which also has a high effectiveness rate and significant results, but lacks large-scale clinical data. Additionally, in terms of diet, it is advisable to consume dishes such as Sichuan Duan stewed pig tail and other traditional Chinese medicinal foods that include old mulberry branches like Sang Ji Sheng.

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Written by Na Hong Wei
Orthopedics
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Which department should I register for sciatica?

Sciatica is divided into primary and secondary types. Primary sciatica is caused by inflammation of the sciatic nerve itself, thus one should visit the Department of Neurology. Secondary sciatica is more common and usually stems from spinal conditions, so initially one should visit the Department of Spinal Surgery. Alternatively, one can visit the Department of Orthopedics, which deals with broader orthopedic issues. If experiencing severe acute pain, a visit to the Pain Management Department can provide rapid and effective pain relief. For frequent episodes of sciatica and interest in rehabilitation, the Rehabilitation Department can be considered. Additionally, traditional Chinese medicine has unique approaches to treating sciatica, so visiting the Department of Traditional Chinese Medicine to try treatments with Chinese herbs and methods is also an option.

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Sciatica belongs to which department?

Sciatica mostly falls under the category of orthopedics. It is a common orthopedic disease, with primary and secondary causes. The secondary type is often caused by compression at the exit point of the lumbar spine and sciatic nerve, so sciatica can be treated in orthopedics or spinal surgery. Primary sciatica, generally caused by inflammation of the sciatic nerve, is managed by neurology. To address sciatica, many hospitals now have departments of pain management. Therefore, sciatica can be treated by four departments: orthopedics, spinal surgery, neurology, and pain management.

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Which department should I go to for sciatica?

For sciatic nerve pain, it is recommended to first consult an orthopedic or spinal surgery specialist. Initially, it is important to determine the cause of the pain, such as whether it is caused by a herniated disc pressing on the nerve root. If it is confirmed that the pain is not caused by a herniated disc pressing on the nerve root, and it is purely sciatic nerve pain, you can then visit a pain management clinic to check for potential issues like piriformis syndrome. In essence, start with an orthopedic consultation to rule out orthopedic conditions. If no orthopedic issues are found, then consult a pain management specialist.