SCIATICA

1. WHAT IS SCIATICA?

Sciatica is a term used to describe nerve pain in the leg that is caused by irritation and/or compression of the sciatic nerve. Sciatica originates in the lower back, radiates deep into the buttock, and travels down the leg.

Traditional medicine has also described this disease for several thousand years with the illnesses such as Yaojiao tong (back and leg pain) ...

2. CAUSES OF SCIATICA

2.1. Disc herniation. A herniated or slipped disk that causes pressure on a nerve root. This is the most common cause of sciatica

2.2. Degenerative disk disease is the natural wear down of the disks between vertebrae of the spine. Osteoarthritis, trauma injury to the lumbar spine or sciatic nerve, tumors in the lumbar spinal canal that compress the sciatic nerve. Spinal stenosis can pinch the sciatic nerve roots as they leave the spine.

 2.3. Other causes: lead and alcohol poisoning, diabetes mellitus, cold neuritis, occupational disease….

3. SYMPTOMS OF SCITICA

3.1. Clinical symptoms

- Mechanical function: Pain spread along the path of the sciatic nerve, dull or severe pain, increased pain with movement, coughing, sneezing ... reduced when resting, pain naturally or after excessive spinal movement.

-        Entity:

+  Spine syndrome: Lumbar spine deformity, spasticity of the spinal muscles, corresponding point pain pressures, anti-pain posture, decreased lumbar spinal elongation, limited range of the lumbar spine , ringing signal (+).

+ Nerve root syndrome: Lasègue sign, Bonnet test, Neri test (+), Walleix (+) pain points, sensory disturbances, tendon reflex disorder, movement disorder, dystonia muscle force, vegetative neurological disorders ...

3.2. Subclinical symptoms

- Spinal X-rays to look for spinal fractures, disk problems, infections, tumors and bone spurs.

- Magnetic resonance imaging (MRI) or computed tomography (CT) scans to see detailed images of bone and soft tissues of the back. An MRI can show pressure on a nerve, disk herniation and any arthritic condition that might be pressing on a nerve. MRIs are usually ordered to confirm the diagnosis of sciatica.

4. DIAGNOSIS OF SCITICA

- Definitive diagnosis: Functional symptoms (pain along the path of the sciatic nerve). Physical Symptoms: spinal syndrome and root syndrome.

- Diagnose the cause by subclinical.

- Differential diagnosis: pelvic arthritis, hip arthritis, pelvic myositis.

5. TREATMENT DISEASE OF SCIATICA

5.1. Internal medicine treatment

- The acute stage: Motionless. Epidural (Vitamin B12, Corticoid). Anti-inflammatory pain reliever. Muscle relaxants. High dose vitamins B1, B6, and B12.

- Subacute and chronic stage: Drug treatment as combined acute phase: Physiotherapy, exercise of the back muscles, stretching the lumbar spine.

5.2. Surgical treatment: indicated in the presence of horsetail syndrome; have a compressed tumor; recurring painful disc herniation many times, seriously affecting living and working; did not respond to internal therapy for 3 to 6 months.

New treatments: Percutaneous disc removal surgery, laser surgery

5.3. Traditional medicine treatment:

-  Electric acupuncture

-  Tuina- massage reflexology; spinal chiropractic

- Cupping