Sciatica obvious symptoms

Written by Na Hong Wei
Orthopedics
Updated on September 18, 2024
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Sciatica is divided into primary sciatica, which is sciatic neuritis, and secondary sciatica. This is due to other causes leading to swelling and pain. Clinically, it generally manifests in the following six aspects: First, pain that is primarily limited to the distribution area of the sciatic nerve, including the back of the thigh, the back of the calf, the outer side, and the sole of the foot, as well as the lateral side of the dorsum of the foot. Second, muscle strength governed by the sciatic nerve begins to diminish. Third, there are fixed tender points. Tender points are located at the ischial notch or could also be at the exit of the piriformis muscle. Fourth, there are symptoms of sciatic nerve traction, such as positive limb elevation, or positive straight leg raise test and enhancement test. Fifth, the Achilles tendon reflex is weakened or absent, while the muscle penetrative reflex is abnormally heightened due to stimulation. Sixth pertains to abnormal sensations in the areas governed by the sciatic nerve, including reduced or absent sensations, reduced absolute vibration at the external ankle, and some very mild sensory disturbances.

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Written by Na Hong Wei
Orthopedics
1min 16sec home-news-image

Sciatica obvious symptoms

Sciatica is divided into primary sciatica, which is sciatic neuritis, and secondary sciatica. This is due to other causes leading to swelling and pain. Clinically, it generally manifests in the following six aspects: First, pain that is primarily limited to the distribution area of the sciatic nerve, including the back of the thigh, the back of the calf, the outer side, and the sole of the foot, as well as the lateral side of the dorsum of the foot. Second, muscle strength governed by the sciatic nerve begins to diminish. Third, there are fixed tender points. Tender points are located at the ischial notch or could also be at the exit of the piriformis muscle. Fourth, there are symptoms of sciatic nerve traction, such as positive limb elevation, or positive straight leg raise test and enhancement test. Fifth, the Achilles tendon reflex is weakened or absent, while the muscle penetrative reflex is abnormally heightened due to stimulation. Sixth pertains to abnormal sensations in the areas governed by the sciatic nerve, including reduced or absent sensations, reduced absolute vibration at the external ankle, and some very mild sensory disturbances.

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Written by Na Hong Wei
Orthopedics
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What to check for sciatica

Sciatica is divided into primary sciatica and secondary sciatica. Secondary sciatica is very common and is mainly due to diseases of the spinal canal, including herniated lumbar discs, lumbar spinal stenosis, or spinal tumors compressing the spinal cord and nerve roots. Another condition is piriformis syndrome, where the sciatic nerve exits; if there is narrowing here, it can also cause sciatica. Therefore, clinically, one starts with secondary sciatica, conducting either a lumbar spine CT scan or an MRI, which can basically clarify the location causing the compression. Another type is called primary sciatica, which is caused by inflammation of the sciatic nerve, and is an internal medicine disease, not an orthopedic disease. This requires an electromyography (EMG). After completing the EMG, the diagnosis can generally be made based on the injured muscle or the muscle with abnormal electromotor conduction. Thus, the routine examinations for sciatica are X-rays, CT, MRI, and the non-routine examination is the EMG.

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Written by Lv Yao
Orthopedics
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Can sciatica patients run?

The pain of the sciatic nerve is generally caused by degeneration of the intervertebral disc. The nucleus pulposus protrudes through the rupture of the fibrous ring of the degenerated disc, compressing the nerve root, which leads to symptoms such as sciatic nerve pain, numbness, and even restricted movement when walking. The intervertebral disc serves to absorb shocks and cushion the pressure on the lower back. During running, the load on the lower back increases, which could potentially exacerbate the symptoms of sciatic nerve pain. Therefore, it is best to avoid running exercises when sciatic nerve pain is caused by degeneration of the intervertebral disc.

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Written by Na Hong Wei
Orthopedics
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How to treat sciatica

Sciatica typically has two treatment methods. One is non-surgical treatment, which is currently the first and most commonly used approach. The first step is general treatment, meaning that once symptoms of sciatica occur, one should rest on a hard board bed. Second, one can combine this with some heat applications to the lumbar area, physical therapy, and acupuncture; all of these are options. The third is traction therapy, which is very effective for discogenic sciatica, as it can reduce the pressure on the intervertebral disc, thereby increasing the volume of the spinal canal and enlarging the area of the intervertebral foramen, thus reducing stimulation to the nerve. Fourth, one can consider undergoing sacral canal injections, or using papain or collagenase for chemical dissolution of the nucleus pulposus, which usually can also achieve a good effect. The fifth point is that when symptoms are reduced, one should start exercising the lumbar and back muscles to increase their strength and enhance the stability of the lumbar spine, thereby ensuring the stability of the intervertebral disc. It should be mentioned that massage and manipulation are quite effective for herniation of the disc nucleus pulposus, but if there is already obvious osteophyte formation, narrowing of the intervertebral space, or disorder of the facet joints, or even lumbar spinal stenosis, then massage and manipulation are not recommended. If the aforementioned treatments prove ineffective, the condition does not relieve or even worsens, or if there is central herniation of the lumbar disc, or if the patient shows significant cauda equina nerve stimulation symptoms, then surgical treatment is required.

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Written by Guan Jing Tao
Orthopedics
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Where to perform moxibustion for sciatica

Typical sciatica, in addition to soreness and numbness in the buttocks, is accompanied by sensory abnormalities in the back of the thigh, the back of the calf, the lateral muscles, and the foot. Thus, the location for moxibustion treatment spans from the buttocks to the thigh and calf, targeting corresponding traditional Chinese medicine acupoints progressively. This can alleviate, to some extent, the sensory abnormalities in the buttocks and lower limbs caused by sciatica. It is recommended to concurrently take oral medications that nourish the nerves to collectively reduce symptoms and shorten the duration of the illness. If there is no significant relief after two to four weeks of treatment, it is advised to revisit the hospital for further examination and treatment. Hospitalization for systematic treatment may be necessary.