Where to treat sciatica?

Written by Chen Hui
Orthopedic Surgery
Updated on September 02, 2024
00:00
00:00

Sciatica is relatively common among the general population. Its symptoms manifest as numbness, swelling, and weakness in one leg. The most common cause is herniation of the lumbar intervertebral disc, which compresses the nerve roots resulting in these symptoms. Therefore, when such symptoms occur, it is necessary to seek treatment at a formal medical institution. One could visit the orthopedics department, or if the hospital has specialized departments, it is best to consult the department of spinal surgery.

Other Voices

doctor image
home-news-image
Written by Lv Yao
Orthopedics
43sec home-news-image

Where to go for sciatica treatment

The sciatic nerve is the largest nerve in the human lower limb. If symptoms of sciatic nerve pain occur, it is first necessary to determine the cause of this pain. Sometimes, the pain is caused by degeneration of the intervertebral disc, leading to a ruptured nucleus pulposus protruding from the annulus fibrosus, which compresses the nerve root canal, causing this nerve pain. In such cases, it is recommended to visit an orthopedic or spinal surgery department. If there is no degeneration of the lumbar intervertebral discs or the condition of spinal stenosis, and only this pain occurs, it is advisable to visit a pain management department.

doctor image
home-news-image
Written by Xie Yi Song
Orthopedics
1min 13sec home-news-image

What are the symptoms of sciatica?

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.

doctor image
home-news-image
Written by Lv Yao
Orthopedics
53sec home-news-image

How to relieve sciatic nerve pain

When experiencing sciatic nerve pain, it is important to first determine the cause. It may be due to a herniated disc compressing the nerve root, or it could be caused by piriformis syndrome. If the pain is caused by a herniated disc and it is the patient's first occurrence, a CT scan can be done. If the herniation is mild, conservative treatment may be chosen, such as wearing a lumbar support and performing some traction. Patients can also actively exercise their back muscles to alleviate the sciatic nerve pain. Additionally, it is recommended to sleep on a firm bed and spend more time lying down than sitting. If the herniation is severe, has been prolonged, or it recurs frequently, it is advised to seek professional treatment in orthopedics. If the pain is due to piriformis syndrome, a visit to a pain management clinic is suggested for symptomatic relief and pain alleviation.

doctor image
home-news-image
Written by Na Hong Wei
Orthopedics
1min 47sec home-news-image

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.

doctor image
home-news-image
Written by Na Hong Wei
Orthopedics
1min 10sec home-news-image

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.