How to treat sciatica

Written by Na Hong Wei
Orthopedics
Updated on September 21, 2024
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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.

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Written by Na Hong Wei
Orthopedics
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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.

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Written by Na Hong Wei
Orthopedics
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Sciatica obvious symptoms

Sciatica is divided into primary sciatica, which is sciatic neuritis, and secondary sciatica. This is due to other causes leading to swelling and pain. Clinically, it generally manifests in the following six aspects: First, pain that is primarily limited to the distribution area of the sciatic nerve, including the back of the thigh, the back of the calf, the outer side, and the sole of the foot, as well as the lateral side of the dorsum of the foot. Second, muscle strength governed by the sciatic nerve begins to diminish. Third, there are fixed tender points. Tender points are located at the ischial notch or could also be at the exit of the piriformis muscle. Fourth, there are symptoms of sciatic nerve traction, such as positive limb elevation, or positive straight leg raise test and enhancement test. Fifth, the Achilles tendon reflex is weakened or absent, while the muscle penetrative reflex is abnormally heightened due to stimulation. Sixth pertains to abnormal sensations in the areas governed by the sciatic nerve, including reduced or absent sensations, reduced absolute vibration at the external ankle, and some very mild sensory disturbances.

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Written by Guan Yu Hua
Orthopedic Surgery
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Where to massage for sciatic nerve pain?

Sciatica can be alleviated through massage and physiotherapy, which helps improve local muscle blood circulation and alleviate symptoms. Certainly, nerve issues can affect muscles, leading to varying degrees of muscle atrophy. Therefore, massage can stimulate local blood circulation and improve symptoms. Sciatica mainly presents as numbness and pain along the outer side of the thigh, the calf, and the dorsum of the foot. In the morning, there might be a feeling of short tendons when putting on shoes, and more effort is needed to wear pants and socks. The areas typically massaged are the thigh, calf, and dorsum of the foot, which are common areas of discomfort. Massage in these areas can help relieve symptoms. Additionally, treating with medications that invigorate blood circulation and relieve pain, along with medications that nourish nerves, can be beneficial. Usually, strict bed rest for half a month and appropriate therapies such as traction, hot compresses, massage, and cupping can also aid in alleviating symptoms.

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Written by Na Hong Wei
Orthopedics
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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.

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Written by Na Hong Wei
Orthopedics
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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.