Sciatica or sciatic radicular syndrome, is a pathology that causes pain and weakness of the legs and lower back. It is a common disorder in middle-aged people with a sedentary lifestyle.
The vertebral column is formed by a set of vertebrae, small bones joined to each other by gelatinous tissue (intervertebral discs). The nerve roots coming from the spinal cord pass through the spaces between these vertebrae and form the different nerves that reach the muscles, glands or other places of the body. The nerve roots that make up the sciatic nerve are the largest and longest nerve in the body. It is responsible for the innervation of almost the entire leg. In some cases, the roots that form the sciatic nerve (L4, L5 and S1) are compressed, producing what is known as sciatica.
The compression of the roots can be due to different causes. One of the main ones are herniated discs. It may also be due to tumors around the spine, osteoarthritis of the vertebrae or malformations.
The compression of the sciatic nerve produces pain in the lumbar area (lumbago) and give rise to symptoms such as:
ifficulty to move the leg. Depending on the root that is affected, some movements will be altered since each root controls a certain group of muscles.
Alteration of the sensitivity in the leg, which also depends on which nerve root is compressed.
Affectation of reflexes, which are automatic responses to a stimulus. If they are affected, they will be diminished or absent. The reflexes that are altered because of sciatic radicular syndrome are the patellar or ankle.
To recover from a radicular syndrome, the first thing to do is to treat what compresses the nerve root. Depending on the evolution of recovery, rehabilitation may be needed to strengthen the muscles.
When sciatica is caused by a herniated disc the treatment can be conservative, since the symptoms remit after a few days. The non-surgical approach to sciatica can be done in different ways. Treatment usually involves oral analgesics (such as ibuprofen) and application of heat and cold in the lower back to reduce inflammation and relieve pain. If the pain is very intense or does not respond to analgesics, it may be useful to apply corticoids, a more powerful anti-inflammatory drug. They are commonly injected into the painful area. However, you should not abuse of these injections, so they should be reserved for times when pain is very intense.
On the other hand, when there is severe compression, surgical intervention may be necessary. This option is recommended in approximately one out of every ten patients with a herniated disc.
Rehabilitation and physiotherapy are essential to recover from sciatica with greater speed. It consists of exercising the lumbar muscles to strengthen the area. Aerobic exercise is also recommended to improve general health, endurance and circulation.