Our spinal cord connects the brain and the body. Sciatica pain is a serious condition that causes sharp, shooting, stabbing, burning or electric type pain in the spine. There are many conditions that cause sciatica pain including herniated or slipped disc, spinal stenosis and spondylolisthesis. Apart from that, other rare causes include pyriformis syndrome (spasm of pyriformis muscle), trauma, tumour and infection in the spine.
More than 90% instances of sciatica have a hernia or slipped disc as the primary cause. The disc acts as a cushioning pad between two vertebrae in the spine. A thick fibrous ring surrounds the interior, gel-like Nucleus pulposus of each disc (Annulus). Sciatica pain occurs when the inner nucleus bulges out (herniates) through a weakening in its outer wall and presses on a sciatic nerve root. Additionally, new research has demonstrated that the disc material’s associated inflammation (swelling) of the nerves is the primary cause of pain, in addition to mechanical compression.
Explaining the clinical diagnosis of sciatica pain, Dr. Hamza Shaikh, Consultant Spine Surgery, HCMCT Manipal Hospitals, Dwarka said “Clinical evaluation includes evaluation of the site of back and leg pain, neurological examination, and special clinical test for sciatica which includes- Straight leg raise test, also called Lasègue’s sign. With the patient lying down on their back on an examination table or exam floor, the examiner lifts the patient’s leg while the knee is straight. A positive straight leg test reproduces radiating leg pain.”
The treatment option of this condition includes:
• Non-Surgical – It includes rest for a short period of time, applying ice and/or hot packs, medication for pain management, stretching and walking
• Spinal injection- An injection of a corticosteroid with local anesthesia directly into the spine around the nerves have shown to reduce the pain and swelling around the affected nerve roots.
• Surgical- This includes discectomy which refers to the removal of the disc fragment in which includes open, microscopic and endoscopic discectomy. Another surgical option includes discectomy and instrumented fusion when associated with bony instability. In this type of surgery, the disc is removed and followed by inserting screws and rods to hold the spine steady.
(Dr. Hamza Shaikh, Consultant Spine Surgery, HCMCT Manipal Hospitals, Dwarka will be available for consultation on 20th November 2022 at Friends Hospital, Srinagar between 10 AM to 12 Noon)
