Pre-symptoms of sciatica

Written by Cheng Bin

Orthopedics

Updated on January 21, 2025

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For the early symptoms of sciatica, it is usually manifested as obvious pain in the area where the sciatic nerve enters and distributes. The main symptom is radiating pain, especially under circumstances such as catching a cold, strenuous exercise, fatigue, or suffering from trauma, where the pain will be more pronounced. There are many causes of sciatica in clinical practice. Common causes include issues with the lumbar spine, such as disc herniation, lumbar spondylolisthesis, and spinal stenosis, which can compress the spinal nerves and result in symptoms of sciatic nerve pain.

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Written by Na Hong Wei

Orthopedics

1min 10sec

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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 Li Jin

Orthopedics

40sec

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What foods should be avoided with sciatica?

Patients with sciatic nerve pain should be cautious with their diet in daily life. Avoid consuming spicy and stimulating foods such as chili peppers and black pepper. Avoid high-fat, high-calorie foods such as fatty meats, barbecued and fried foods. Also, reduce the intake of foods high in sugar like various pastries and sweets, as these foods are detrimental to health. Patients with sciatic nerve pain should eat more foods rich in high-quality protein and vitamins such as milk, eggs, beans, chicken, fish, fresh vegetables, and fruits. These foods are beneficial to health.

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Written by Na Hong Wei

Orthopedics

59sec

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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 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.

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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.