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Sciatica
How to relieve sciatic nerve pain
When experiencing sciatic nerve pain, it is important to first determine the cause. It may be due to a herniated disc compressing the nerve root, or it could be caused by piriformis syndrome. If the pain is caused by a herniated disc and it is the patient's first occurrence, a CT scan can be done. If the herniation is mild, conservative treatment may be chosen, such as wearing a lumbar support and performing some traction. Patients can also actively exercise their back muscles to alleviate the sciatic nerve pain. Additionally, it is recommended to sleep on a firm bed and spend more time lying down than sitting. If the herniation is severe, has been prolonged, or it recurs frequently, it is advised to seek professional treatment in orthopedics. If the pain is due to piriformis syndrome, a visit to a pain management clinic is suggested for symptomatic relief and pain alleviation.
What causes sciatica?
The causes of sciatica generally fall into two categories. The first is primary sciatica, which is usually caused by inflammation of the sciatic nerve and is relatively rare in clinical practice. The second category is secondary sciatica, which occurs when the tissues and structures around the sciatic nerve undergo pathological changes, leading to stimulation and compression of the sciatic nerve, thus causing secondary sciatica. The majority of secondary sciatica cases are associated with lumbar spine disorders, such as lumbar disc herniation, tumors in the lumbar spinal canal, or degenerative joint disease of the lumbar spine, as well as sacroiliitis. A hospital examination is necessary to make a definitive diagnosis.
What should I do about sciatica?
For sciatica, absolute bed rest is initially required, ideally lasting three weeks. If three weeks is not possible, at least one week is necessary. Secondly, continual traction is used, which can widen the intervertebral space, reduce the internal disk pressure, and potentially expand the spinal canal, thereby alleviating stimulation and compression of the nerve roots. Thirdly, you can take some non-steroidal anti-inflammatory drugs, or some traditional Chinese medicines, many of which contain pain-relieving ingredients. Fourthly, consider undergoing physical therapy, including physiotherapy, acupressure, and massage. Fifthly, intradiscal injections, intradiscal blockade, or catheter blockade can be considered. Sixthly, chemical dissolution of the nucleus pulposus can be considered. Thus, these are the basic treatment methods for sciatica.
How to treat sciatica?
For sciatica, conservative treatment methods should first be adopted, which include the following five points: The first is general treatment; as soon as sciatica appears, immediately rest in bed, and the bed should be relatively hard. Second, you can apply heat to the lumbar area, use physical therapy, or acupuncture. Third, lumbar traction can be performed, which has a very clear effect in alleviating sciatica. Fourth, consider performing an intradiscal injection or sacral injection therapy, and chemical nucleolysis can also be performed. After the above treatments, if the symptoms and pain are reduced, you can start functional exercises for the lower back muscles. Functional exercises of the lower back muscles play a significant role in enhancing the stability of the lumbar spine. If the effect of the aforementioned treatments is not significant, or if the symptoms worsen, then surgical treatment may be necessary at this time.
Which department should I visit for sciatica?
Pain in the sciatic nerve first requires a visit to orthopedics or spinal surgery to look into whether the pain is caused by a herniated disc compressing the nerve root. If examinations or imaging studies find no abnormalities, we might consider the possibility of piriformis syndrome, or other reasons causing the nerve pain. You can then consult the pain management department to determine the cause and receive appropriate treatment, primarily involving orthopedics and pain management.
How to treat sciatica
Sciatica typically has two treatment methods. One is non-surgical treatment, which is currently the first and most commonly used approach. The first step is general treatment, meaning that once symptoms of sciatica occur, one should rest on a hard board bed. Second, one can combine this with some heat applications to the lumbar area, physical therapy, and acupuncture; all of these are options. The third is traction therapy, which is very effective for discogenic sciatica, as it can reduce the pressure on the intervertebral disc, thereby increasing the volume of the spinal canal and enlarging the area of the intervertebral foramen, thus reducing stimulation to the nerve. Fourth, one can consider undergoing sacral canal injections, or using papain or collagenase for chemical dissolution of the nucleus pulposus, which usually can also achieve a good effect. The fifth point is that when symptoms are reduced, one should start exercising the lumbar and back muscles to increase their strength and enhance the stability of the lumbar spine, thereby ensuring the stability of the intervertebral disc. It should be mentioned that massage and manipulation are quite effective for herniation of the disc nucleus pulposus, but if there is already obvious osteophyte formation, narrowing of the intervertebral space, or disorder of the facet joints, or even lumbar spinal stenosis, then massage and manipulation are not recommended. If the aforementioned treatments prove ineffective, the condition does not relieve or even worsens, or if there is central herniation of the lumbar disc, or if the patient shows significant cauda equina nerve stimulation symptoms, then surgical treatment is required.
Which department should I go to for sciatica?
When experiencing sciatic nerve pain, we first need to analyze the cause of such pain symptoms, such as a herniated disc compressing the nerve root leading to sciatica. In this case, we recommend visiting an orthopedic or spinal surgery department. If there is no disc herniation or nerve root compression, consideration should be given to whether the pain is caused by piriformis syndrome, in which case a visit to the pain management department is suggested.
What Chinese medicine is taken for sciatica?
Sciatica is categorized under "Bi Syndrome" in traditional Chinese medicine. There are several Chinese herbal formulas to consider for treatment. The first is Xuan Bi Tong Bi Tang, which has an overall effectiveness rate of about 96%. The second herbal formula is Wu Tou Xi Xin Tong Bi Tang, which also has good therapeutic effects and is statistically shown to be superior to non-steroidal measures. The third medication is Du Huo Ji Sheng Tang, which also has a high effectiveness rate and significant results, but lacks large-scale clinical data. Additionally, in terms of diet, it is advisable to consume dishes such as Sichuan Duan stewed pig tail and other traditional Chinese medicinal foods that include old mulberry branches like Sang Ji Sheng.
Sciatica obvious symptoms
Sciatica is divided into primary sciatica, which is sciatic neuritis, and secondary sciatica. This is due to other causes leading to swelling and pain. Clinically, it generally manifests in the following six aspects: First, pain that is primarily limited to the distribution area of the sciatic nerve, including the back of the thigh, the back of the calf, the outer side, and the sole of the foot, as well as the lateral side of the dorsum of the foot. Second, muscle strength governed by the sciatic nerve begins to diminish. Third, there are fixed tender points. Tender points are located at the ischial notch or could also be at the exit of the piriformis muscle. Fourth, there are symptoms of sciatic nerve traction, such as positive limb elevation, or positive straight leg raise test and enhancement test. Fifth, the Achilles tendon reflex is weakened or absent, while the muscle penetrative reflex is abnormally heightened due to stimulation. Sixth pertains to abnormal sensations in the areas governed by the sciatic nerve, including reduced or absent sensations, reduced absolute vibration at the external ankle, and some very mild sensory disturbances.
How to completely cure sciatica?
Treatment methods for sciatica include several approaches. First, resting on a hard board bed; typically, this rest period lasts three to four weeks, during which many patients experience symptom relief. Second, pharmacological treatment is recommended, usually involving non-steroidal pain relievers, as well as vitamins B1, B6, and B12. Short courses of corticosteroid hormones are also used. However, it is important to use hormones minimally and to stop their use correctly if possible. Third, traditional Chinese medicine and herbal treatments are preferred. Many cases of sciatica may be alleviated or even cured with the proper application of traditional Chinese medicine and herbs. Common remedies include Xuanluo Tongbi Decoction, Wutou Xixin Tongbi Decoction, and Duhuo Jisheng Decoction. Local injection treatments are also available, but it is crucial to ensure precise and successful injection on the first attempt. Fourth, exercise therapy is essential as inactivity can lead to muscle atrophy, so proper rehabilitation is necessary. Sixth, dietary therapy should focus on nutritious foods while avoiding junk food and spicy, stimulating dishes.