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Sciatica
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.
What are the symptoms of sciatica?
Sciatica refers to the pain caused by the sciatic nerve due to various reasons, such as compression from spinal diseases or simply sciatica itself, and it is inherently a symptom. What are the characteristics of this symptom? Sciatica can occur on one side or both sides simultaneously. When it occurs, the pain is usually continuous and can have episodic exacerbations. The pain is often dull, stabbing, burning, or like a knife-cutting sensation. It radiates from the buttocks along the back of the thigh and the outer back of the lower leg toward the foot. Clinically, sciatica is divided into secondary and primary types. Secondary pain is due to compression of the sciatic nerve root, commonly seen in conditions like lumbar disc herniation and other spinal disorders. It often accompanies percussion pain in the lumbar spine, and the pain may worsen with coughing, sneezing, or bending, and severe cases may experience numbness in the skin of the lower limbs. Primary sciatica refers to simple inflammation of the sciatic nerve. This type generally presents pain in the buttocks and back of the thigh and usually does not involve percussion pain in the lumbar spine.
How to relieve sciatic nerve pain
How to alleviate sciatica pain. First, it is necessary to rest in bed absolutely, especially sleeping on a firm bed. While sleeping on a firm bed, you can also pad a soft pad in the lumbar area and place a soft pillow under the knee joints. The main purpose is to keep the knee and hip joints in a flexed state, allowing the muscles in the lower back to fully relax. Second, you can take some non-steroidal anti-inflammatory painkillers orally. Third, you can use traction therapy. Traction therapy is very effective for relieving sciatica pain as it can reduce the pressure inside the disc and expand the volume of the spinal canal, thus alleviating the stimulation and compression of the nerve roots. Fourth, you can consider undergoing physiotherapy, massage, and manipulation. However, aggressive massage is not recommended. Fifth, you can undergo intradiscal blockade or sacral canal injections. Sixth, you can perform nucleoplasty, which involves injecting collagenase into the intervertebral disc, or between the dura mater and the protruding nucleus pulposus. This often requires the intervention of a pain specialist. Therefore, after the aforementioned treatments, sciatica pain should generally be alleviated. If there is no relief or if symptoms worsen, then surgical treatment may be necessary.
Which department should I register for sciatica?
Sciatica is divided into primary and secondary types. Primary sciatica is caused by inflammation of the sciatic nerve itself, thus one should visit the Department of Neurology. Secondary sciatica is more common and usually stems from spinal conditions, so initially one should visit the Department of Spinal Surgery. Alternatively, one can visit the Department of Orthopedics, which deals with broader orthopedic issues. If experiencing severe acute pain, a visit to the Pain Management Department can provide rapid and effective pain relief. For frequent episodes of sciatica and interest in rehabilitation, the Rehabilitation Department can be considered. Additionally, traditional Chinese medicine has unique approaches to treating sciatica, so visiting the Department of Traditional Chinese Medicine to try treatments with Chinese herbs and methods is also an option.
What to check for sciatica
Sciatica is divided into primary sciatica and secondary sciatica. Secondary sciatica is very common and is mainly due to diseases of the spinal canal, including herniated lumbar discs, lumbar spinal stenosis, or spinal tumors compressing the spinal cord and nerve roots. Another condition is piriformis syndrome, where the sciatic nerve exits; if there is narrowing here, it can also cause sciatica. Therefore, clinically, one starts with secondary sciatica, conducting either a lumbar spine CT scan or an MRI, which can basically clarify the location causing the compression. Another type is called primary sciatica, which is caused by inflammation of the sciatic nerve, and is an internal medicine disease, not an orthopedic disease. This requires an electromyography (EMG). After completing the EMG, the diagnosis can generally be made based on the injured muscle or the muscle with abnormal electromotor conduction. Thus, the routine examinations for sciatica are X-rays, CT, MRI, and the non-routine examination is the EMG.
Is it sciatica?
It should be noted that the incidence of sciatic nerve pain is still very high in clinical settings, and there are many causes which can lead to severe pain when it occurs. Common causes of sciatic nerve pain include conditions like sciatic neuritis, which can result in patient discomfort, as well as lumbar disc herniation, lumbar spondylolisthesis, lumbar spinal stenosis, and lumbar tumors. Compression of the spinal nerves can also lead to sciatic nerve pain. Additionally, piriformis syndrome can cause sciatic nerve pain in patients. Determining the specific cause requires a physical examination along with some auxiliary tests to make a clear diagnosis, after which active symptomatic treatment can be completely effective.