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Sciatica
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.
Which department should I go to for sciatica?
For sciatic nerve pain, it is recommended to first consult an orthopedic or spinal surgery specialist. Initially, it is important to determine the cause of the pain, such as whether it is caused by a herniated disc pressing on the nerve root. If it is confirmed that the pain is not caused by a herniated disc pressing on the nerve root, and it is purely sciatic nerve pain, you can then visit a pain management clinic to check for potential issues like piriformis syndrome. In essence, start with an orthopedic consultation to rule out orthopedic conditions. If no orthopedic issues are found, then consult a pain management specialist.
What does sciatica cause?
Sciatica generally causes changes in six aspects. The first is pain, which mainly occurs along the distribution area of the sciatic nerve, including the back of the thigh, the posterior and lateral sides of the calf, and the lateral side of the foot and sole. I have seen a patient with severe sciatica who had to stay in bed with his head down and buttocks up to minimize spinal canal pressure, finding some relief only in this position. The second change is a decrease in muscle strength, which can even lead to muscle atrophy. The third aspect involves the pathway of the sciatic nerve, including the exit of the piriformis muscle, with tenderness and percussion pain along the course of the nerve. The fourth aspect includes symptoms of sciatic nerve traction, which involves positive results in straight leg raise tests and cross-legged tests. The fifth point is a weakened or absent Achilles reflex, due to the sciatic nerve's innervation of the muscles on the back of the thigh, leading to a decrease or disappearance of the Achilles reflex. The sixth point is abnormal sensations in the area innervated by the sciatic nerve, including reduced or lost sensations or mild sensory disturbances.
Can you drink alcohol with sciatica?
Can people with sciatica drink alcohol? This question comes up often. In fact, sciatica is unrelated to drinking alcohol; people with or without sciatica can drink alcohol. However, it is best to drink less if you are suffering from sciatica. The reason is simple. After consuming alcohol, it might trigger an exacerbation of sciatica symptoms. Secondly, after drinking, the body's coordination and stability decrease, which may lead to uneven walking. At this time, if the sciatica has a specific cause, drinking may aggravate the factors that induce sciatica. Thirdly, excessive drinking is genuinely torturous and also harmful to health. Therefore, it is imperative to drink alcohol in moderation, and it is best to avoid excessive drinking. Otherwise, it is not good for the condition or the person.
Sciatica belongs to which department?
Sciatica mostly falls under the category of orthopedics. It is a common orthopedic disease, with primary and secondary causes. The secondary type is often caused by compression at the exit point of the lumbar spine and sciatic nerve, so sciatica can be treated in orthopedics or spinal surgery. Primary sciatica, generally caused by inflammation of the sciatic nerve, is managed by neurology. To address sciatica, many hospitals now have departments of pain management. Therefore, sciatica can be treated by four departments: orthopedics, spinal surgery, neurology, and pain management.
Symptoms of Sciatica
Symptoms of sciatica: First, sciatica often occurs in the lumbar 4 and lumbar 5, or between lumbar 5 and sacral 1 disc herniation. Second, the primary symptom of sciatica is pain, which typically originates in the lower back and can radiate to the buttock, posterior thigh, the lateral side of the calf, and the lateral edge of the foot sole. Pain usually has a triggering factor, such as coughing, sneezing, defecation, etc., basically any activity that increases abdominal pressure can cause radiating pain of the sciatic nerve. Third, the area innervated by the sciatic nerve may become hypersensitive, with some people feeling pain, others feeling heat, and still others feeling cold, until the later stages where it generally becomes numbness and dullness. Fourth, there are limitations in movement of the lower back or limbs, with many patients reporting a feeling as if there’s a shortened tendon at the back of the thigh, restricting movement. These are the primary symptoms of sciatica.