Sciatica

Suffering with Sciatica? Arise Motion Furniture can help….

sciatica-nerve helped by electric adjustable beds and recliner chairsSciatica  is a set of symptoms including pain that may be caused by general compression or irritation of one of five spinal nerve roots that give rise to each sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves. Symptoms include lower back pain, buttock pain, and pain, numbness or weakness in various parts of the leg and foot. Other symptoms include pins and needles or tingling and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body. The pain may radiate below the knee, but does not always.

Although sciatica is a relatively common form of low back and leg pain, the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve, causing the pain. The treatment for sciatica or sciatic symptoms often differs, depending upon the underlying cause and pain levels. Causes include compression of the sciatic nerve roots caused by a herniated (torn) or protruding disc in the lower back.

Management

When the cause of sciatica is due to a lumbar disc herniation, most cases resolve spontaneously over weeks to months. Initially treatment in the first 6–8 weeks should be conservative. There does not appear to be a significant difference in outcomes between advice to stay active and recommendations of bed rest. Similarly, physical therapy (exercises) has not been found better than bed rest.

Medication

Although medications are commonly prescribed for the treatment of sciatica, evidence for analgesics is poor. Specifically NSAIDs do not appear to improve immediate pain and all NSAIDs appear about equivalent. Evidence is also lacking in use of opioids and muscle relaxants. In those with sciatica, believed to be due to piriformis syndrome, botulism toxin injections may improve pain, and or function.

Surgery

Surgery for unilateral sciatica involves the removal of part of the disc, known as a discectomy. While it results in short term benefits, long term benefits appear equivalent to conservative care.[5][18] Treatment of the underlying cause of the compression is needed in cases of epidural abscess, epidural tumors, and cauda equina syndrome.

Epidurals

Good quality of evidence to suggest short-term pain reduction with epidural steroid injections, long-term benefit is controversial. Other agents, ex: TNF inhibitors, have not shown efficacy in most randomized controlled trials.

Alternative medicine

Moderate quality evidence suggests that spinal manipulation is an effective treatment for acute sciatica. For chronic sciatica the evidence is poor. Spinal manipulation has been found to be generally safe for the treatment of disc-related pain however case reports have found an association with cauda equina syndrome and it is contraindicated when there are progressive neurological deficits.