Chủ Nhật, 13 tháng 10, 2013

Sciatic Nerve Pain – Symptoms, Causes, Treatment, Relief, Medications, During Pregnancy

Sciatic Nerve Pain – Symptoms, Causes, Treatment, Relief, Medications, During Pregnancy

What is Sciatic Nerve Pain?


This is also known as sciatica and denotes the pain radiating along the track of the sciatic nerve as well as its divisions – from the back down the leg and buttocks. This sciatic nerve is the lengthiest nerve in the body running from the spinal cord to the hip and buttock area and down each leg’s back.








Sciatic nerve pain is actually a symptom, not an actual disorder. The pain radiating from the sciatic nerve is an indicator of some other difficulty which involves this nerve, for instance a disk that is herniated. Dependent on the cause of the sciatic nerve pain – which can be quite painful – it usually goes away on its own within several months.


Meanwhile, self-care procedures might help ease this pain. Often, your physician will suggest some other treatment.


Sciatic Nerve Pain Symptoms


Any pain that radiates from the lower spine or lumbar region to the buttock and down the back of the leg is the mark of sciatic nerve pain. An individual might feel this discomfort anywhere along the pathway of this nerve but it is likely to follow the path from the low back to the buttock and the back of the thigh and calf.


This pain may be widely various, from an ache that is mild to a burning, sharp sensation or excruciating pain. Often it might feel like an electric shock or jolt. It might be worse when the individual sneezes or coughs as well as sitting prolonged amount of time may aggravate symptoms. Normally only one lower leg is involved.


Sciatic nerve pain symptoms consists of:



  • Pain – It is especially likely to happen along a path from the lower back to the buttock as well as back of the calf or thigh.

  • Muscle weakness or numbness along the pathway of the nerve in the foot or leg. In many cases, the individual might have pain in one part of the leg and numbness in another.

  • Pins-and-needles or tingling feeling, often in part of the foot or toes

  • A loss of bowel or bladder control. This is a sign of cauda equina syndrome, which is a rare but serious problem requiring emergency care. If an individual experiences either of these symptoms, seek help medically immediately.


Sciatic nerve pain that is mild normally goes away given enough time as well as patience. Call the physician if self-care remedies fail to ease the symptoms or if the pain lasts much longer than a week, is severe or if it becomes increasingly worse. Get immediate medical assistance if:



  • There is severe, sudden pain in the lower back or leg as well as numbness or weakness of the muscle in the leg

  • Pain follows an injury that is violent, such as a traffic wreck

  • There are problems controlling the bladder or bowels


Sciatic Nerve Pain Causes


The sciatic nerve runs from the spinal cord thru the buttocks and hips area as well as down the back of each leg. This nerve has control over many of the muscles in the lower legs as well as provides feeling to the legs, thighs and feet. Sciatic nerve pain can develop when a nerve root is compacted in the lower spine – usually because of a disk that is herniated in the lower area of the back.


Disks in the back are cartilage pads that separate the vertebrae or bones in the spine. They are filled with a gel-like material and keep the spine flexible as well as act as shock absorbers to pad the vertebrae when moving.


If the outer cover of a disk tears or herniates, gel can seep out and press on a nerve root, causing pain in the back, leg or both. If the damaged disk is in the lower area of the back, the individual can as well feel numbness, weakness or tingling in the buttock, foot or leg.


Even though a disk that is herniated is a frequent cause of sciatic nerve pain, there are other conditions that also can apply pressure on this sciatic nerve, including:


Lumbar spinal stenosis
Spinal stenosis is the narrowing of one or more areas in the spine – most often in the upper or lower back. When the narrowing occurs in the lower spine, the lumbar as well as the sacral nerve roots can be affected.


Spondylolisthesis
This is a condition, normally caused by degenerative disk disease, occurring when one vertebra slides a little forward above another vertebra. This displaced bone can pinch the sciatic nerve where it leaves the spine.


Piriformis syndrome
The piriformis muscle begins at the lower spine and is connected to each femur or thighbone. Piriformis syndrome happens when this muscle becomes tight or goes into a spasm, putting more pressure on the sciatic nerve. Sitting that is prolonged, auto accidents as well as falls can add to the piriformis syndrome.


Tumors on the spine
In the spine, tumors can develop inside the spinal cord, within the meninges or membranes that cover the cord or in the spaces between the cord and the vertebrae. As these tumors grow, they compress the cord or the nerve roots.


Trauma
An auto accident, blow to the spine or fall can all injure the sacral or lumbar nerve roots.


Sciatic nerve injury or tumor
Often the sciatic nerve can be affected by an injury or tumor.


Other causes
There are some cases where the physician may not be able to find a cause of sciatic nerve pain. There are a number of problems that can affect the bones, muscles as well as joints, all which can potentially cause sciatic pain.


Risk factors for sciatic nerve pain include lifestyle options, health problems as well as inherent qualities such as race or age that can make it much more likely an individual will develop a certain condition. Major risk factors for sciatic nerve pain consist of:


Prolonged sitting
Individual who sit for long periods of time or have a very inactive lifestyle are most likely to develop sciatic nerve pain than active individuals are.


Age
Changes that are age-related in the spine are common causes of sciatic nerve pain. Most individuals are likely to have some wear in the disks of the back by the age of 40.


Diabetes
This disease, that affects the way the body uses blood glucose, increases the risk of nerve damage.


Occupation
Any job that requires an individual to twist the back, drive a motor vehicle for long time periods, or carry heard loads can make an individual more prone to develop sciatic nerve pain.
Even though many individuals will fully recover from sciatic nerve pain, often without any precise treatment, sciatica may cause potentially nerve damage that is permanent. Depending on what is the cause of the nerve being compressed, other complications can occur, these include:



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  • Feeling loss in affected leg

  • Movement loss in the affected leg

  • Function loss of bladder or bowel


Treatment for Relief


For the majority of individuals, sciatic nerve pain does react well to measures of self-care. These can include using alternating hot pack and cold packs, exercise, stretching as well as using “over the counter” or OTC medicines. The primary care physician can endorse the following:


Physical therapy
If an individual has a disk that is herniated, physical therapy may contribute a vital aid in the individual’s recovery. As soon as acute pain gets better, the physician as well as a physical therapist may design a rehab program in order to aid in the prevention of recurrent injuries.


Rehabilitation normally involves exercises to aid in strengthening the muscles which support the back as well as improve flexibility and correct posture. The primary care physician will have an individual begin exercise, physical therapy or both together as soon as possible. It is the foundation of any treatment program as well as needing to become a part of permanent management plan for home.


When these conservative methods do not alleviate the pain within several months, any one of the below can be a preference for sciatic nerve pain treatment:


Epidural steroid injections
The physician can recommend injections of a corticosteroid drug into the area that is affected. These injections suppress any inflammation surrounding the nerve that is irritated, thus aiding in relieving the pain.


The usefulness of these injections in treating sciatic nerve pain is still up for debate. Research has discovered that corticosteroids may provide only short-term relief of symptoms and are not a long-term resolution. Additionally, corticosteroids may have side effects; therefore the total number of injections a person may receive is restricted. If the primary care physician recommends corticosteroids, she/he will decide on a safe number of these injections for the patient.


Surgery
Normally surgery is only reserved for those periods when the nerve compression causes substantial weakness, bladder or bowel incontinence or if the pain progressively gets worse or does not improve with any other therapies.


Surgical preferences include:



  • Diskectomy

  • Microdiskectomy


Diskectomy
Surgeons take away a part of a herniated disk that is pressing on the nerve. Idyllically, the majority of the disk remains complete to reserve as much of the usual structure as is possible. Often a surgeon will accomplish this surgery thru a very small incision while watching thru a microscope – microdiskectomy


Rates of success of normal discectomy as well as microdiskectomy are fairly equal, but the patient can have a lesser amount of pain and gets better faster with microdiskectomy.


Medications


The primary care physician will first suggest over the counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen (Advil, Motrin, others), and acetaminophen (Tylenol, others) can both be helpful for sciatica.


When these are not effective, the physician can prescribe anti-inflammatory drugs along with muscle relaxants. Narcotics can also be prescribed but only for short-term pain relief. Tricyclic anticonvulsant and anti-depressants medications can also aid in helping chronic pain. They also can aid by obstructing the messages of pain that go to the brain or by enhancing endorphin production which is the body’s natural painkillers.


Sciatic Nerve Pain Management


For the majority of individuals, sciatic nerve pain reacts well to measures of self-care. You will heal rapidly if you carry on with daily activities but need to avoid what caused the pain originally. Resting for several days can offer some relief; bed rest that is prolonged is not a great idea. Inactivity will make the symptoms and signs only worse.


As well as resuming normal activities, attempt the following:


Cold packs
Use initially to decrease inflammation and get rid of discomfort. Wrap the ice pack or a pack of frozen vegetables in a towel and put on the areas which are painful for about 20 minutes numerous times a day.


Hot packs
After 2 to 3 days, put on heat to the area that hurts. Use hot packs, a hot pad or a heating lamp on the low setting. If pain continues, try alternating cold and warm packs.


Stretching
Exercises for stretching of the lower back may help and may be able to release nerve root that is compressed. Evade jerking, twisting, or bouncing while stretching as well as try to hold the stretch for at least 30 seconds.


Over-the-counter medications
These fall into 2 categories – some diminish pain and inflammation and other treat only pain. See above for further information. Although they may deliver real relief, there is a limit to exactly how much pain they may control. Also, NSIDs may cause side effect such a stomach bleeding, ulcers, as well as nausea and acetaminophen such as Tylenol can cause problems with the liver when taken in excess.


Regular exercise
It can seem wrong to exercise when an individual is in pain but exercise on a regular basis is one of the best methods to battle any chronic discomfort. Regular, sustained exercise prompts the body to issue endorphins which are the body’s natural painkillers.


Early in course of sciatic nerve pain, water exercise as well as other low-impact exercise, for example a stationary bike, will help the individual to remain active devoid of causing any worsening of symptoms. As the individual improves and the pain diminishes, a program of strength training, core stability and aerobic exercises can aid in limiting the properties of back problems that are age-related.


Sciatic Nerve Pain during Pregnancy


Sciatic nerve pain can occur when a woman is pregnant. But there are several simple changes that often can provide relief. The American Pregnancy Association has recommended the below:



  • Lie on the side of the body that is not in pain

  • Do not lift heavy objects

  • Avoid standing for long periods of time

  • Try some exercises that make you feel lighter, for instance swimming


Do not hesitate to speak with your healthcare provider for some medications to ease the pain. Most over the counter medicationa such as acetaminophen will not harm the unborn baby and normally will help with the discomfort.













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