Which department should I visit for sciatica?

Written by Lv Yao
Orthopedics
Updated on September 21, 2024
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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
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How should one sleep with sciatica?

Sciatica is a very painful condition. Paying attention to some details when resting and sleeping can alleviate sciatica to a certain extent. Specifically, the first point is to sleep on a hard bed, preferably a solid wooden bed. If the bed is too soft, consider placing a wooden board on it. Second, lying on your back is better than lying on your side. This is because lying on your back can maintain the stability of the lumbar spine, thereby reducing the pressure on the discs. Third, maintain a moderate flexion of the hips and knees while sleeping. To do this, place a small soft pad under the lower back and a small soft pillow under the knee joints to keep the hip joints in a slightly flexed position. The purpose is to let the muscles of the lower back relax optimally, thus stabilizing the lumbar spine and reducing the burden on the lumbar discs. Therefore, for sciatica, if you sleep on a harder bed in a supine position, and maintain proper knee and hip flexion, it can be very beneficial for recovery.

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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.

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Written by Guan Jing Tao
Orthopedics
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Does sciatica cause numbness in the legs?

Sciatica can cause sensory abnormalities in one lower limb and even lead to muscle weakness. It can also cause numbness and sensory abnormalities on the dorsum or sole of the foot. However, foot numbness should first exclude causes like exposure to cold or poor blood circulation in the lower limbs. After excluding other causes of foot numbness, it can be diagnosed as sciatica-induced symptoms such as foot numbness. At this time, it is advisable to actively nourish the nerves and avoid certain postures that may aggravate sciatica. Additionally, sciatica can also be caused by lumbar disc herniation, or simply by the local compression of the sciatic nerve in its course.

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Written by Na Hong Wei
Orthopedics
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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.

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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.