What to check for sciatica

Written by Na Hong Wei
Orthopedics
Updated on September 06, 2024
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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 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 Xie Yi Song
Orthopedics
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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.

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Written by Lv Yao
Orthopedics
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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 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 Chen Hui
Orthopedic Surgery
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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.