in which one bone in the back , a vertebrae , slips forward slightly over the bone below it , thus narrowing the space available for the spinal nerve roots and potentially leading to sciatica .
There are also a number of less common causes of sciatic nerve compression . These include cysts or tumors that are either in or crowd into the spinal area and compression of the sciatic nerve by the piriformis muscle in the buttocks area .
Certain conditions can also develop that produce symptoms similar to those of sciatica , such as pain related to the joint ( sacroiliac ) that connects the spine to the pelvis or nerve damage in the legs due to peripheral neuropathy , a potential complication of diabetes .
The key to diagnosis is to determine whether the symptoms the patient is presenting are a result of sciatica and its most common causes or some other maladay . In a non-emergency situation , diagnosing sciatica includes identifying the patient ’ s symptoms , reviewing medical history , and performing a number of physical tests , such as moving the patient ’ s body in certain positions to determine whether it provokes pain , as well as testing for strength and reflexes .
If sciatica is suspected , additional diagnostic testing is usually not performed unless symptoms persist or don ’ t improve much after a couple of weeks of conservative therapy .
Conservative care Even without any treatment , sciatica symptoms will
Generally , the goal of conservative care is for the patient to stay as active as possible , but in a way that doesn ’ t worsen pain .
Symptoms
Sciatica results from pressure on the nerve roots that exit the spinal cord and then merge to form the sciatic nerve , which runs from the lower back all the way down the back of each leg . A herniated disk and narrowing of the spinal column ( spinal stenosis ) are two common causes .
Suggestive symptoms Symptoms that indicate pressure on the sciatic nerve roots include one or more of the following , usually in only one leg :
• Deep , aching pain that radiates from the lower back , down through the buttocks to the lower leg . When sciatica is caused by a herniated disk , the pain may become worse when sitting or straining .
• When sciatica is caused by spinal stenosis , pain may increase with walking or standing for a long time , and may diminish when bending forward .
• A burning , stabbing or tingling sensation that may be felt all the way down the leg .
• Development of muscle weakness , numbness , or difficulty moving the leg or foot .
• Sciatica pain usually isn ’ t an emergency , but if a nerve root becomes severely compressed , emergency surgery may be needed . Seek immediate medical attention if you experience any of the following signs and symptoms :
• Sudden severe or increasing pain .
• Sudden numbness , loss of feeling or weakness spreading to the groin area or to one or both legs .
• Loss of bladder or bowel control .
normally go away or greatly improve within about one to three months in about 75 percent of people . Because of this , the mainstay of early treatment is controlling pain and discomfort as the body heals .
This may be done with :
Medications Non-prescription pain relievers are generally the first choice for pain relief . Certain prescription medications may be considered on a trial basis for more severe pain .
Modified activity Generally , the goal of conservative care is for the patient to stay as active as possible , but in a way that doesn ’ t worsen pain . One or two days of rest are acceptable , but long periods of inactivity are not recommended as muscle strength and bone mass are diminished with extended bed rest . Patients should continue doing as much of their daily routine as can be tolerated . Gentle exercises , such as walking or swimming , are also beneficial . For those with spinal stenosis , use of a cane while walking is recommended .
There are also a number of less common causes of sciatic nerve compression . These include cysts or tumors that are either in or crowd into the spinal area and compression of the sciatic nerve by the piriformis muscle in the buttocks area .
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