I. Concept
Sciatica is a painful condition resulting from damage to the sciatic nerve, which travels through the lower back and then through the buttocks to the legs. The sciatic nerve is composed of the 4th nerve root of the lumbar spine (L4, 5) to the 3rd nerve root of the sacral spine (S1, 2, 3), which is the largest and longest nerve in the body and extends through the lumbar and hip areas to the entire lower extremity. Therefore, patients with sciatica may experience severe pain and numbness in the lower back and buttocks, spreading from the buttocks to the posterior lateral thighs, calves and feet. Root sciatica is most often caused by a herniated lumbar disc pressing on the sciatic nerve root. In addition to compression, inflammatory reaction is also a cause of sciatica.
People at high risk of sciatica
1. People who sit incorrectly, such as sitting on their feet, sitting sideways, or putting their purse in the back pocket of their pants after sitting down.
2. Pregnant women.
3. People who have to sit or bend over for a long time at work.
4.People who have had trauma to the back.
Causes of sciatica
1.Protruding lumbar disc: the protruding disc will become inflamed when it is compressed, causing sciatica.
2.Degeneration of the lumbar vertebrae or excessive strain causing pressure on the nerves between the lumbar vertebrae.
3, inflammation of the soft tissues surrounding the lumbar spine.
4, spinal canal narrowing and pressure on the nerve.
5.Bone spur growth: because the bone spur grows at the back of the lumbar vertebrae, the nerve groove becomes smaller, so the nerve is compressed.
6.Sciatica caused by displacement of the lumbar vertebrae and pelvic bones, resulting in nerve compression.
7.Tumor: the nerve is compressed, causing pain.
8. Accidental impact: such as sports injury, fall, traffic accident, etc., resulting in displacement of the lumbar spine or pelvic bone, causing nerve compression.
Symptoms of sciatica
1. Usually, the patient will first feel pain and paralysis in the muscles of the lower back and buttocks. It takes a few days or weeks before the pain is felt in the back of the thighs, lower calves and feet.
2. The pain in the legs will exceed the pain in the lower back, and sometimes the pain in the lower back will disappear completely.
V. Classification of sciatica
1.Primary sciatica
Primary sciatica is pain caused by inflammation of the sciatic nerve, mostly unilateral, and can often occur simultaneously with myofibrositis. The main cause of primary sciatica (sciatica) is cold and damp and other inflammatory lesions such as tonsillitis, prostatitis, gingivitis, sinusitis, etc. Some of them are accompanied by myositis and myofibrositis.
2.Secondary sciatica
Secondary sciatica is caused by the compression or stimulation of adjacent lesions, and is divided into radicular and dry sciatica, referring to whether the site of compression is in the nerve root or in the nerve trunk, respectively. Root causes are most common, with disc herniation being the most common cause, and other causes include intravertebral tumors, vertebral metastases, lumbar tuberculosis, and lumbar spinal stenosis; dry causes can be caused by sacroiliac arthritis, intrapelvic tumors, uterine compression during pregnancy, hip arthritis, hip trauma, and diabetes mellitus.