Mengenali Sciatica

Mungkin kita jarang dengar perkataan sciatica ini kerana ia adalah bahasa perubatan, tapi selalu dengar orang sakit belakang sehingga sampai ke betis.

Sebenarnya banyak penyebab kepada rasa sakit di belakang, terutamanya di bahagian bawah tulang belakang. Salah satunya adalah disebabkan oleh sciatica.

Apa dia sciatica?

Secara umumnya scantia adalah rasa sakit, lemah, lali, rasa tegang/cekang atau berdenyut-denyut di bahagian belakang kaki, termasuk peha dan betis. Ia disebabkan oleh kecederaan atau saraf sciatica yang tertekan atau rosak. Saraf ini memanjang bermula dari tulang spina turun hingga ke bahagian belakang betis. Saraf ini mengawal otot-otot di bahagian belakang lutut dan betis, dan kesan sakitnya dapat dirasai sehingga ke bahagian belakang peha, bawah betis sehingga ke tapak kaki.

Penerangan yang lebih terperinci dipanjangkan di bawah ini….

Sciatica

Medical Author: William C. Shiel Jr., MD, FACP, FACR

Medical Editors: Kenneth Kaye, MD, and Melissa Conrad Stöppler, MD

What is sciatica?

Sciatica is pain in the lower extremity resulting from irritation of the sciatic nerve. The pain of sciatica is typically felt from the low back (lumbar area) to behind the thigh and radiating down below the knee. The sciatic nerve is the largest nerve in the body and begins from nerve roots in the lumbar spinal cord in the low back and extends through the buttock area to send nerve endings down the lower limb. The pain of sciatica is sometimes referred to as sciatic nerve pain.

What are causes of sciatica?

While sciatica is most commonly a result of a lumbar disc herniation directly pressing on the nerve, any cause of irritation or inflammation of the sciatic nerve can reproduce the symptoms of sciatica. This irritation of nerves as a result of an abnormal intervertebral disc is referred to as radiculopathy. Aside from a pinched nerve from a disc, other causes of sciatica include irritation of the nerve from adjacent bone, tumors, muscle, internal bleeding, infections, injury, and other causes. Sometimes sciatica can occur because of irritation of the sciatic nerve during pregnancy.

Additional common causes of sciatica include:

Lumbar spinal stenosis (narrowing of the spinal canal in the lower back)

Degenerative disc disease (breakdown of discs, which act as cushions between the vertebrae)

Spondylolisthesis (a condition in which one vertebra slips forward over another one)

Pregnancy

What are sciatica symptoms?

Pain in the rear or leg that is worse when sitting

Burning or tingling down the leg

Weakness, numbness, or difficulty moving the leg or foot

A constant pain on one side of the rear

A shooting pain that makes it difficult to stand up

Sciatica causes pain, a burning sensation, numbness, or tingling radiating from the lower back and upper buttock down the back of the thigh to the back of the leg. The result is leg pain. Sometimes the pain radiates around the hip or buttock to feel like hip pain. While sciatica is often associated with lower back pain (lumbago), it can be present without low back pain. Severe sciatica can make walking difficult if not impossible. Sometimes the symptoms of sciatica are aggravated by walking or bending at the waist and relieved by lying down. The pain relief by changing positions can be partial or complete.

How is sciatica diagnosed?

Sciatica is diagnosed with a physical exam and medical history. The typical symptoms and certain examination maneuvers help the health-care practitioner to diagnose sciatica. Sometimes, X-rays, films, and other tests, such as CT scan, MRI scan, and electromyogram, are used to further define the exact causes of sciatica.

What are treatment options for sciatica?

Bed rest has been traditionally advocated for the treatment of acute sciatica. But how useful is it?

To study the effectiveness of bed rest in patients with sciatica of sufficient severity to justify treatment with bed rest for two weeks, a research team in the Netherlands led by Dr. Patrick Vroomen randomly assigned 183 such patients to bed rest or, alternatively, to watchful waiting for this period.

To gauge the outcome, both primary and secondary measures were examined. The primary outcome measures were the global assessments of improvement after two and 12 weeks by the doctor and the patient. The secondary outcome measures were changes in functional status and in pain scores, absenteeism from work, and the need for surgical intervention. Neither the doctors who assessed the outcomes nor those involved in data entry and analysis were aware of the patients’ treatment assignments.

The results, reported in the New England Journal of Medicine, showed that after two weeks, 64 of the 92 (70%) patients in the bed-rest group reported improvement, as compared with 59 of the 91 (65%) of the patients in the control (watchful-waiting) group. After 12 weeks, 87% of the patients in both groups reported improvement. The results of assessments of the intensity of pain, the aggravation of symptoms, and functional status revealed no significant differences between the two groups. The extent of absenteeism from work and rates of surgical intervention were similar in the two groups.

The researchers concluded that “among patients with symptoms and signs of a lumbosacral radicular syndrome, bed rest is not a more effective therapy than watchful waiting.” Sometimes, conventional wisdom is not as wise as research!

Other treatment options for sciatica include addressing the underlying cause, medications to relieve pain and inflammation and relax muscles, and physical therapy. A variety of low back conditioning and stretching exercises are employed to help people recover from sciatica. Surgery procedures can sometimes be required for persisting sciatica that is caused by nerve compression at the lower spine. Sometimes pain management specialists help with chronic sciatica conditions.

Sciatica At A Glance

* Sciatica is a nerve pain from irritation of the sciatic nerve.

* The sciatic nerve is the largest nerve in the body.

* Sciatica pain is typically felt from the low back to behind the thigh and radiating down below the knee.

* Treatments for sciatica depend on the underlying cause and the severity of the pain.

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