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CAUSES
OF SCIATICA
Siatica is a set of symptoms rather than a specific
disease
and is caused by abnormal pressure on the siatic nerve, either at its
root (bottom of the spine) as in a prolapsed disc or spinal tumour, or
somewhere along the upper part of the nerve such as in piriformis
syndrome or sacroiliac strain.
The causes of siatica include:
- Prolapsed
Disc:
Between each spinal
vertebra lies an intervertebral disc. In a young person
each disc consists of a ball of jelly surrounded by a tough casing
composed of a ring of fibres. It is possible for this disc to rupture
suddenly
as a result of lifting, twisting or bending and the jelly-like contents
to leak out. If this puts pressure on ligaments or nerves such as the
siatic nerve it can give rise to pain, and the person is said to have a
prolapsed disc. Symptoms include low back pain, muscle spasms, shooting
pains down the legs and into the buttocks and possibly numbness. The
symptoms tend to be one sided and usually lie in a particular part of
the leg depending on which disc has prolapsed. It tends to occur in
younger people because as we age the internal jelly hardens and
the thick casing becomes stronger so that a prolapse is less likely to
occur in older people. Treatment:
Acupuncture or
electroacupuncture is a safe and effective intervention for this type
of back pain, otherwise it is bed rest and pain killers. Do not alow
any physical manipulation as this may cause more damage. Your doctor
may recommend physiotherapy. If the pain remains severe after 6 weeks
then further investigations and surgical intervention may be necessary
in the form of a 'discectomy'.
- Spinal
Stenosis:
Occurs when the central
spinal canal through which the spinal chord travels begins to narrow.
This can be caused by compression of the intervertebral discs or
osteoarthritis. The symptoms include pain radiating down both legs and
into both buttocks and numbness when walking. Rest and bending forwards
often helps. Treatment:
Pain can be treated
by acupuncture or drugs (see your doctor). Surgical intervention may be
necessary to widen the canal in the case of unremitting pain.
- Piriformis
Syndrome:
The piriformis is a
muscle that lies deep within the buttocks and the siatic nerve has to
pass through this muscle on its way down the leg. The muscle can become
tight and so squeezes the siatic nerve resulting in shooting pains down
the leg. Treatment: This
type of muscular siatica is best treated with acupuncture or massage
(ostepath; masseur) and does not need manipulation.
- Sacroiliac
Strain:
The sacroliliac joint
lies at the base of the back between the sacrum and ilieum (hips) and
often gets strained with the wear and tear of life or as a result of an
injury. If this is strained it can aggravate the sacroiliac nerve and
cause pain. Treatment:
Acupuncture is the treatment of choice followed by massage by an
osteopath.
- Trigger
Points:
These are knots in the
muscles of the back or buttock that form as a result of strain or
injury and can cause muscle tightness surrounding the siatic nerve. Treatment:
Acupuncture is the best
treatment followed by massage.
- Intraspinal Tumour: This
is a very rare
cause of siatica. You should suspect this only if you have already had
cancer or believe you are at particular risk of getting cancer. Treatment:
Specialist hospital care. An MRI scan of the lower back is required to
confirm diagnosis followed by surgery and/or chemotherapy.
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