Which department should I go to for sciatica?

Written by Lv Yao

Orthopedics

Updated on September 14, 2024

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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.

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Written by Na Hong Wei

Orthopedics

55sec

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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.

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Written by Chen Hui

Orthopedic Surgery

44sec

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Sciatica can heal on its own in a few weeks.

Lumbar disc herniation compressing the nerve roots in the lower back can cause pain in the buttocks and popliteal fossa, which we can refer to as sciatica. The underlying cause is still due to lumbar disc herniation. Generally, over 95% of patients experiencing initial pain can self-heal and find relief from the pain. In terms of sciatica, statistical and evidence-based medical research shows that most patients, especially those who initially exhibit symptoms, generally experience significant symptom relief within three months. However, if symptoms do not improve within three months, surgery is definitely indicated.

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Written by Lv Yao

Orthopedics

29sec

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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.

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Written by Na Hong Wei

Orthopedics

1min 24sec

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What is sciatica?

Sciatica refers to severe pain caused by various reasons that result in the compression and irritation of the sciatic nerve. The typical pain of sciatica radiates from the lower back to the buttock or the back of the thigh and the lateral side of the leg down to the foot. The pain can intensify during coughing or increased abdominal pressure. Additionally, this condition is often accompanied by dullness or numbness, and in a minority of cases, it can cause bilateral sciatica. Generally, there are three main causes of sciatica: The first is chemical irritation, mainly when the disc tissue comes into contact with the sciatic nerve, releasing chemical substances that stimulate and trigger an autoimmune response, resulting in neuritis. The second cause is mechanical compression, primarily from protuberance and nucleus pulposus compression or traction on the already inflamed nerve root, leading to obstructed blood flow and worsening edema. The third cause follows chemical stimulation and mechanical compression, leading to ischemic symptoms in the injured nerve, which then results in pain. Therefore, sciatica typically has primary and secondary causes. The primary cause is sciatic neuritis, while secondary causes are usually associated with lumbar spinal stenosis, lumbar disc herniation, lumbar tumors, and piriformis outlet syndrome.

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Written by Na Hong Wei

Orthopedics

1min 47sec

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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.