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Sciatica

Sciatica is an irritation of the sciatic nerve, causing dull, shooting, or aching pain that starts in the lower back and/or the buttocks and radiates down to one of the legs. Depending on its cause, sciatica can heal on its own over time. However, more serious causes may require medical treatments, ranging from non-surgical to surgical methods.

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

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 its normal position)
  • degenerative disc disease
  • pregnancy

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.

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.

Dr Chua Soo Yong is experienced in diagnosing and treating sciatica.

For a detailed evaluation, make an appointment at 6262 0555 today.

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?

Sciatica is a treatable condition, particularly when diagnosed early. 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. In certain cases, steroid injections may also be recommended to relieve nerve irritation and alleviate pain.
  • Physiotherapy – This can help reduce nerve pressure in the spinal joints and ease muscular tension in the lower spine, thereby helping you heal. These exercises can also strengthen the back, improve the flexibility of the spine, and reduce inflammation.
  • Sciatica surgery – Reserved for the most serious cases, surgery essentially involves removing the source of pressure on the sciatic nerve. This could entail removing bone growth, among others. Surgical procedures for sciatica include lumbar laminectomy, which is the partial or complete removal of the lamina in the lumbar spine to reduce pressure on the nerves. Another option is discectomy, where the damaged or herniated disc is partially or completely removed.

What are the Complications of Sciatica?

If left untreated, sciatica can sometimes lead to nerve damage resulting in chronic pain, loss of sensation and/or weakness in the affected leg and bowel or bladder dysfunction. When this happens, immediate medical attention is necessary.

Can Sciatica be Prevented?

While some causes of sciatica cannot be prevented, certain steps can be taken to reduce the risk of developing sciatica, such as:

  • Staying Active – Exercises and other physical activities can help strengthen the muscles and improve flexibility to reduce back pain. Furthermore, this helps maintain an optimal weight to prevent adding extra pressure to the spine due to excess weight.
  • Maintaining Proper Posture – Good posture can help reduce stress in the back and prevent pain. It is beneficial to choose a seat with adequate back support to prevent straining the back. Additionally, practising proper lifting positions helps prevent injuries and back pain.
  • Quitting Smoking – Nicotine decreases blood supply to the bones, making it weaker and more prone to developing problems.
  • Taking Sufficient Rest – If experiencing back pain, ensure to take adequate rest to prevent further pain and allow the body to recover. It is also helpful to refrain from performing high-impact or strenuous activities during this time.
FREQUENTLY ASKED QUESTIONS
Find answers to commonly asked questions here

For patients who have undergone surgical treatment, recovery depends on the procedure performed. Complete recovery from lumbar discectomy or laminectomy can take about 4-6 weeks, or longer when spinal fusion is required.

No. Sciatica is an irritation of the sciatic nerve, causing dull, shooting, or aching pain that starts in the lower back and/or the buttocks and radiates down one of the legs. Regular backache, on the other hand, can be caused by several factors, such as injuries, poor sleep, or sudden movements.

Most patients usually recover in around 4-6 weeks without treatment. However, for some patients with chronic sciatica (pain that lasts longer than 6 weeks), medical treatments, such as injections, physiotherapy, or surgery, may be required to treat the underlying condition that causes pain.

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

Dr Chua Soo Yong is an orthopaedic and spine surgeon at Atlas Orthopaedic Group, specialising in the management and treatment of back pain causes, including sciatica, herniated discs and more. He earned his medical degrees at the National University of Singapore and has attended specialist orthopaedic training in Singapore and Canada. Aside from his medical practice, Dr Chua is also an active researcher on spinal cord injury and regeneration and is a faculty member at AO Spine.

Make an appointment with our specialist, Dr Chua Soo Yong, at 6262 0555 today.
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Atlas Spine & Orthopaedic Surgery Centre provides subspecialty back and spine treatments tailored to each patient’s needs. For a detailed consultation, make an appointment with us at 6262 0555 today.