What does sciatica cause?

Written by Na Hong Wei
Orthopedics
Updated on September 12, 2024
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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.

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Written by Na Hong Wei
Orthopedics
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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.

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Written by Lv Yao
Orthopedics
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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.

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Written by Guan Jing Tao
Orthopedics
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Where to perform moxibustion for sciatica

Typical sciatica, in addition to soreness and numbness in the buttocks, is accompanied by sensory abnormalities in the back of the thigh, the back of the calf, the lateral muscles, and the foot. Thus, the location for moxibustion treatment spans from the buttocks to the thigh and calf, targeting corresponding traditional Chinese medicine acupoints progressively. This can alleviate, to some extent, the sensory abnormalities in the buttocks and lower limbs caused by sciatica. It is recommended to concurrently take oral medications that nourish the nerves to collectively reduce symptoms and shorten the duration of the illness. If there is no significant relief after two to four weeks of treatment, it is advised to revisit the hospital for further examination and treatment. Hospitalization for systematic treatment may be necessary.

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Written by Lv Yao
Orthopedics
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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.

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Written by Na Hong Wei
Orthopedics
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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.