Sciatica

Sciatica, also known as sciatica, usually presents as a sudden onset of sharp pain in the lower back. The complaint is triggered by inflammation of the so-called sciatic nerve. It can be caused by a variety of conditions, so it is always worth investigating the cause. It is a common complaint over the age of 40, and sitting may be a contributing factor. The concepts of lumbago and sciatica are often confused, as both are characterised by severe low back pain, but the former is muscular and the latter is neurological.

What is sciatica?

Sciatica is an inflammation of the longest peripheral nerve in the body, the sciatic nerve (sciatic nerve). This nerve is made up of nerve roots that exit the spinal cord at the lumbar spine and run down through the pelvis to the legs. It is also responsible for the movement of many muscles and the sensory innervation of the legs. Sciatica occurs when the sciatic nerve is under pressure or pinched and inflamed. This in turn usually causes severe, sharp pain in the lower back and often radiates to one or, less often, both legs.

Although many people think of sciatica as a disease in itself, it is actually a symptom that can be caused by a variety of conditions. That is why, if you notice the characteristic symptoms, you should see an orthopedics or rheumatology specialist as soon as possible, who will diagnose the condition accurately and recommend a personalised treatment. If the examination is delayed, the sciatic nerve can remain under permanent pressure, which can lead to permanent nerve damage or, in the worst cases, paralysis.

The risk of sciatica

In older age, the condition of bones, cartilage, joints and muscles is not what it was when you were young, so sciatica is more common over the age of 40-50 . In addition to age, other risk factors include a sedentary lifestyle, scoliosis, heavy physical work, lifting heavy weights and playing sports with unilateral loads. Being overweight, smoking and persistent anxiety can also contribute to the development of sciatica.

Symptoms of sciatica

The most common symptom of sciatica is severe, sharp pain in the lumbar part of the spine, which increases with standing and sudden movements. Lower back pain often radiates to the thigh and the foot. There may be pinprick-like sensations, numbness, tingling and, in more severe cases, loss of sensation. Sometimes the pain in the limb is more severe than the pain in the lower back. In very severe cases, paralysis or incontinence may develop.

Treatment of sciatica

Isias is also examined by a rheumatologist and an orthopedics specialist. At the Budapest Musculoskeletal Private Outpatient Clinic, we have developed a special patient journey protocol to ensure thorough examination and effective, targeted therapies.

Our mission is to help our patients regain their freedom of movement as soon as possible, and to permanently and long term relief from painful complaints.

Often, sciatica is caused by a serious musculoskeletal disorder – in order to clarify this, it is recommended to identify the underlying disease causing the pain and make a diagnosis. In its absence, only short-term symptomatic treatment is possible.

Medical treatment

The cornerstones of a successful investigation based on the BMM patient journey protocol:

• The medical history is half the diagnosis, and many diseases can be ruled out by detailed questioning.
• A thorough physical examination by a specialist. Based on the physical examination, a specialist will determine the need for any diagnostic imaging tests:
• X-ray examination can confirm bony lesions. X-rays are usually taken of the spine, hip joints, knees and feet. This is often necessary for isolating purposes related to diagnostics.
• The condition of the soft tissues, discs, articular cartilage, muscles and tendons is accurately assessed by the radiograph.
• In some cases, a CT (computer tomography) scan or MRI (magnetic resonance imaging) scan is also needed to make an accurate diagnosis.
• In the case of nerve involvement, neurophysiological testing, ENG or EMG is required to determine the extent of suspected nerve damage.

Treatment options for sciatica

In the case of sciatica, symptomatic treatment of acute pain is the first option. Spinal decompression, oral non-steroidal analgesics, possibly topical steroidal anti-inflammatory injections or medical collagen injection therapy are recommended. During symptomatic treatment, diagnostic tests recommended by a rheumatologist or specialist in orthopedics should be performed. The results of these tests will allow an accurate diagnosis to be made and the initiation of a course of outpatient therapy.

By treating the underlying cause, the pressure on the sciatic nerve can be permanently relieved to prevent the return of inflammation. Different underlying causes require different treatment protocols, but in most cases conservative therapy can avoid surgical intervention. With personalised, specific physiotherapy and therapeutic massage, and possibly physiotherapy treatments, spinal disorders can be well managed. If the underlying disease causing sciatica is advanced, paralysing or not responding to conservative treatments, a surgical intervention is an option. This requires a consultation with a neurosurgeon.

What is the difference between sciatica and lumbago?

The concepts of lumbago and sciatica are often confused in the public mind. In both cases, severe low back pain is the main complaint, but they are easily distinguishable by their nature.

Lumbar sprain is a muscular pain in the lower back that usually develops suddenly due to strain on the spine . In lumbar spondylolisthesis, there is no nerve involvement, no pain radiating to the limbs, no numbness and no loss of sensation.

Sciatica is a neurological complaint caused by a serious problem that has developed over a long period of time. Identifying the underlying cause is key to effective treatment, so it is advisable to see a rheumatologist or orthopedics specialist as soon as possible. Procrastinating a medical examination can lead to permanent damage to the nerve and paralysis if the nerve remains under pressure for a long time. Identifying and treating the spinal disease that is causing the pressure is necessary to treat sciatica and relieve painful symptoms.

Most Common Complaints Treated by Spine Medicine Center Specialists

• lower back pain
• lower back pain
• scoliosis
• nerve compression
• back pain
• neck pain
• stiff neck – neck stiffness
• osteoporosis
• spinal pain
• spinal stenosis
• back pain
• lumbar spine pain
• gluteal muscle pain
• poor posture
• sacrum pain
• shoulder blade pain
• morning lower back pain
• neck pain