The sciatic nerve, the largest nerve in the body, starts from the lower part of the spine and reaches the leg. Sciatica, which regulates the sensory and motor functions of the leg, emerges from the 4th and 5th vertebrae, which are the last vertebrae of the waist, and passes through the hip and extends from the back of the knee to the bottom of the foot. Compression of this nerve, also known as the S1 nerve, is called sciatica or sciatica pain. Sciatica pain usually begins mildly and becomes more severe as time passes. The pain typically radiates to the leg area. It can be felt from the hip area to the calf, from below the knee to the lateral and front of the leg, and finally to the heel. Pain, which is usually unilateral, is more common in young adults, people who do heavy work, and people who do not exercise. Sciatica is a treatable disease, characterized by a feeling of pain, loss of strength, and sensation in the leg. Before moving on to the symptoms of sciatica, “What is sciatica?” Must answer the question.
What is sciatica?
The longest and thickest nerve in the body, sciatica, or as it is called in medical terminology, the nervus ischiadicus, emerges from the last vertebrae of the waist and ends just below the knee. In other words, the sciatic nerve, which is formed by the junction of the nerve roots L4, L5, S1, S2, and S3 in the lower region of the waist, passes through the perforated area in the pelvis located in the hip and defined as the coxa and extends to the posterior region of the leg. It divides into branches in the knee joint and reaches up to the foot and creates motor and sensory functions in this area. Sciatica is actually the name given to the pain caused by the compression of the nerve. Frequently wondered “What does sciatica mean?” The answer to the question can be given in this way. The compression or stretching of the roots of the sciatic nerve in the lumbar region causes a feeling of pain in the leg. In some cases, reasons such as vertebral slippage, inflammation, tumor, and cysts can also cause sciatic nerve pain. Sciatica pain, which starts with low back pain radiating to the hip, spreads along the nerve from the groin to the back of the leg and from there to the foot. In severe cases of sciatica, the leg becomes weak, knee and wrist reflexes decrease. The higher the person lifts his leg, the more severe the pain becomes.
What are the symptoms of sciatica?
Sciatica pain, which is characterized by pain that extends from the waist to the foot, causes the person to feel pulled from the hip to the heel. The pain, which is exacerbated by movement, causes a loss of sensation and strength in the leg and foot area along the area where the sciatic nerve passes. The severity of the pain may limit the person’s movements at times. The upper part of the body becomes difficult to bend, or the rotational movement may be limited. Often the person cannot stand upright and leans to one side. Foot drag problem can be seen on the side where the pain is felt during walking. In addition to pain, numbness, and tingling, a pinprick sensation can be felt on the underside of the feet and toes. In severe cases, loss of movement can be seen. In addition, complaints that require urgent intervention such as urinary incontinence due to the inability to control the bladder and intestines are among the symptoms of sciatica. If the disease is not treated, thinning and shortening of the painful leg muscles may be seen.
What causes sciatica?
Although sciatica pain is mostly caused by a herniated disc, it can occur for many different reasons. Sciatic pain, which is examined in three different groups, can be seen due to compression in the lumbar region, compression of the sciatic nerve in the hip muscles, trauma-induced injuries in the back part of the knee joint, or in the foot area. The factors that cause sciatica pain are listed below:
- Inactivity: Prolonged immobility and sitting can cause sciatic nerve pain. Sciatica is more common in occupational groups that require sitting for a long time and driving.
- Heavy Lifting: Sciatic nerve complaints are more common, especially in people who work in some professions and need to constantly lift heavy loads.
- Obesity: Being overweight or obese causes body weight to stress the spine. Therefore, this situation can trigger the formation of sciatica.
- Diabetes: Commonly known as diabetes, diabetes can cause damage to the nervous system.
- Advanced Age: Sciatic nerve pain may occur due to the weakening of the muscles, bones, and tissues around the bone due to aging.
- Trauma: Sciatic nerve pain may occur due to damage to the sciatic nerve and surrounding tissue after accidents and injuries.
- Pregnancy: The sciatic nerve may be suppressed due to the increased weight and enlarged uterus during pregnancy. In addition, the growth of the abdomen and breasts during this period may cause a change in the center of gravity and thus pressure on the sciatic nerve.
How to prevent sciatica?
It may be recommended to keep the back and waist muscles strong to prevent sciatica, which significantly reduces the quality of life of the person. A good posture is effective in preventing the formation of sciatica. In addition, it is among the measures to be taken to avoid wrong settings, to support the back, waist, and arms while sitting, and to prevent sciatica. Avoiding prolonged standing, immobility and heavy lifting can also prevent sciatica.
WHEN TO GO TO THE DOCTOR FOR SCIATIC?
The mild sciatica pain that occurs in the initial period may disappear spontaneously over time. However, if the pain intensity increases or the existing pain lasts longer than a week, it should be discussed with the physician. In addition, in case of sudden onset of severe pain in the back, hip, leg, or foot area, in the presence of numbness and weakness in the legs, and difficulty in bowel and bladder control, a physician should be consulted for diagnosis and treatment. The complaint of sciatica pain that begins after traumas such as falling from height or traffic accidents should also be examined by the physician.
How is sciatica diagnosed?
When a person applies to a doctor due to sciatica pain, the physician first takes the patient’s anamnesis. Therefore, pain description and history are very important. Often the presence of numbness, pain, or tingling sensation from the hip to the heel is important in the diagnosis of sciatica. The physician checks whether there is weakness in the muscles and the current state of the reflexes with a physical examination. It asks the person to raise their leg while lying in a straight position. It measures the severity of the pain by making some movements such as stretching. Likewise, it investigates the severity of complaints such as numbness and loss of sensation. When deemed necessary, the physician checks whether there is an abnormality in the sciatic nerve with nerve stimulation tests. In some cases, the physician may want to view the area where the sciatic nerve is compressed with radiological imaging methods such as CT and MRI. When it is understood what causes sciatica pain, the diagnosis is made and sciatica treatment is started.
How is sciatica treated?
Different types of treatment are applied depending on the patient’s complaints, general condition, the severity of sciatica, and why the sciatic nerve is suppressed. In some cases, analgesic drugs such as painkillers and muscle relaxants are used, while in others, methods such as epidural steroid injections may be used. In addition to physical therapy methods such as spinal manipulation and traction therapy applied by the physical therapy and rehabilitation department, surgical intervention may also be necessary for the treatment of sciatica. Sciatica pain can be treated by reducing the pressure on the nerve with lumbar laminectomy, removing the hernia formation, or by partial or complete removal of the disc, known as a discectomy.
If you think you have complaints related to the sciatic nerve, do not neglect to apply to the nearest health institution and have your checks done.
We wish you healthy days.
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