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Sciatica

What Is Sciatica?

Sciatica is defined as pain affecting the sciatic nerve, the longest nerve in the body that begins at the lower back, runs through the hips and buttocks, and further branches down to each leg and foot. It typically affects just one side of the lower body. Depending on the cause, sciatica treatment in Singapore ranges from medications to surgery.

What Are the Causes of Sciatica?

Sciatica occurs when there is an irritation, injury or compression of the sciatic nerve. The most common cause is a herniated disc , in which the spinal disc’s jelly-like core pushes against a weakness in the disc’s outer ring. This bulging can pinch part of the sciatic nerve, causing pain and numbness in the lower part of the body.

Other causes include:

  • spinal stenosis (narrowing of the spinal canal)
  • bone spurs (osteophytes) that form in the spine
  • spondylolisthesis (when a bone in the spine slips out of normal position)
  • degenerative disc disease
  • pregnancy

What are the Symptoms of Sciatica?

The main symptom of sciatica is pain that travels through the pathway of the sciatic nerve. The intensity of the pain can vary, ranging from a mild ache to debilitating pain. Many describe the experience as a stabbing pain, electric jolt or burning sensation that worsens when coughing, sneezing and sitting for a prolonged period.

Other symptoms include numbness, weakness and a tingling sensation in the lower limbs. For severe cases, pain may be accompanied by fever, inflammation in the spine, urinary and faecal incontinence, and so on. All of these should be immediately attended to by a medical professional or orthopaedic surgeon .

What are the Risk Factors of Sciatica?

Some of the things that can increase one’s risk of sciatica include:

  • Age – Individuals diagnosed with sciatica are typically between the ages of 30 and 50. Additionally, the spine and sciatic nerve can be affected by natural wear-and-tear from ageing.
  • Weight – Being obese or overweight adds stress to the spine, leading to structural changes that result in sciatic pain.
  • Sedentary lifestyle – Those who do not exercise regularly or sit for prolonged periods are more prone to developing this type of pain than those who have more active lifestyles.
  • Occupation – Apart from work that involves prolonged sitting, jobs that require constant heavy lifting, twisting the back or spine, and even driving for a long time can contribute to sciatic pain.

How Is Sciatica Diagnosed?

Sciatica can be diagnosed through a physical exam, in which the orthopaedic surgeon checks the patient’s muscle strength and reflexes. This may involve asking the patient to perform certain actions such as walking on their toes and heels, lifting each leg while lying on the back, standing from a squat position, and more.

If pain is severe and has not subsided after a few weeks, the doctor may require imaging tests such as:

  • X-ray, which can detect the presence of bone spurs that may be pinching a nerve
  • Computed tomography (CT) scan, which is used to create a clearer image of the spinal cord and nerves
  • Magnetic resonance imaging (MRI), which uses magnetic fields and radio waves to capture cross-sectional images of the bones and soft tissues of the back
  • Electromyography (EMG), which is used to measure how quickly electric impulses travel through a nerve, as well as how muscles react to these impulses

What Are the Treatments for Sciatica?

Conservative treatments like sufficient rest, activity and using safe lifting techniques can help mild cases of sciatica. For more serious cases, an orthopaedic surgeon may prescribe the following:

Medication

  • Certain non-steroidal or steroidal medications may be prescribed to reduce pain and inflammation.

Physiotherapy

  • This can help reduce nerve pressure in the spinal joints and ease muscular tension in the lower spine, thereby helping you heal.

Sciatica surgery

  • Reserved for the most serious cases, surgery essentially involves removing the source of pressure on the sciatic nerve. This could entail removing a bone growth, among others.

Sciatica is a treatable condition, particularly if help is sought early. Dr Chua Soo Yong is an orthopaedic and spine specialist at Atlas Orthopaedic Group, specialising in the management of back pain, including sciatica, herniated discs and more. For enquiries, please call 6262 0555.

Dr Chua Soo Yong Consultant Orthopaedic & Spine Surgeon
MBBS (S’pore), MRCS (Edinburgh), MMed (Ortho), FRCS (Ortho), FAMS (Ortho)

Dr Chua is an Orthopaedic and Spine Specialist with over 20 years of experience treating back and neck issues, which are commonly associated with the spine.

He is particularly passionate about treating conditions of the spine not only because it relieves pain, but because it also has the potential to reverse paralysis to a certain extent, which means a great deal to patients.

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