Sciatica is a condition that causes pain, numbness, or tingling in your leg. It is usually caused by compression, injury, or irritation of the sciatic nerve, the longest and thickest nerve in your body, which runs from your lower back down to your legs. Compression of the sciatic nerve can be due to various reasons such as a herniated disc, spinal stenosis, or bone spur.
The pain may range from mild to severe and can be aggravated by certain movements such as sitting or standing for long periods of time. The condition can also cause weakness in the affected leg and limit mobility.
What causes sciatica?
Sciatica is caused by compression or irritation of the sciatic nerve, this occurs as a result of:
Herniated or slipped disc: most common cause of sciatica, occurs when the discs in your lower back compresses the sciatic nerve.
Spinal stenosis: spinal stenosis is the abnormal narrowing of the spinal canal. This reduces the space available for the spine and nerves, causing them to be compressed together, thus resulting in sciatica.
Degenerative disc disease: natural wear and tear of the discs as we age, reducing the space between each vertebrae and eventually resulting in narrowed space for the nerves, leading to sciatica.
Osteoarthritis: osteoarthritis can cause bone spurs to grow and press against the sciatic nerve, causing sciatica.
Piriformis syndrome:piriformis syndrome can cause pressure on the sciatic nerve and result in sciatica.
Tumours: very rare occurrence but a tumour can put pressure on the sciatic nerve, causing sciatica.
Cauda equina syndrome:cauda equina syndrome is a very rare but serious condition that affects the nerves in the lower spinal cord, and can cause sciatica.
What are the symptoms of sciatica?
Symptoms of sciatica include:
Pain in your lower back or buttocks
Tingling or numbness in your legs or feet
Weakness or difficulty moving the affected leg or foot
Sharp or shooting pain that makes it difficult to stand or walk
Constant pain on one side of your buttocks
Pain that worsens when sitting or standing for long periods of time
Difficulty controlling bowel or bladder movements (severe cases)
If you notice any of the symptoms, make an appointment with an orthopaedic specialist to get an accurate diagnosis and treatment.
Dr Puah KL is our Senior Consultant Orthopaedic Surgeon at Artisan Sports & Orthopaedic Surgery. He used to serve the sports service of Singapore General Hospital - the highest volume trauma centre for orthopaedics in Singapore.
Sciatica can be very painful. The pain will usually start in your lower back and can spread down to one or both legs. The pain may feel like a sharp or burning sensation and it can be constant or come and go. It may also be accompanied by numbness, tingling, or muscle weakness.
The severity of the pain can vary between individuals and may be affected by factors such as the underlying cause of sciatica, the individual’s overall health, and level of physical activity.
Who is at risk of sciatica in Singapore?
Anyone in Singapore can develop sciatica, but some factors may increase the risk of developing the condition, these include:
Age: changes in your spine that come with age become more common (such as herniated disc and bone spurs).
Obesity: being overweight or obese can increase the stress on your spine, giving rise to increased pressure on the sciatic nerve, resulting in sciatica.
Occupation: jobs that require prolonged sitting, heavy lifting, or twisting of the spine, can increase your risk of developing sciatica.
Diabetes: individuals with diabetes are at an increased risk of nerve damage and sciatica.
Pregnancy: pregnant women may develop sciatica due to the pressure on the sciatic nerve from the growing uterus.
How is sciatica diagnosed?
Sciatica is diagnosed in the following ways:
Physical examination: your orthopaedist will start by taking a detailed medical history and performing a physical examination. Your symptoms will be assessed, including any pain and weakness or numbness you may be experiencing. You may also be asked to perform certain tests such as a straight leg test to accurately diagnose your condition.
Imaging tests:x-rays, computed tomography scans (CT-scan), and magnetic resonance imaging (MRI) will be performed to help confirm the diagnosis and identify the cause of your sciatica.
Nerve conduction test: conducted to investigate the receptivity of nerve signals and to identify if any alteration of sensation has occurred.
Electromyography (EMG): an EMG is often prescribed and would be necessary if an incidence of compressed nerves is suspected.
What are the treatment options for sciatica in Singapore?
Depending on your symptoms and the severity of the condition, treatment options may vary from person to person.
Physiotherapy: physiotherapy involves gentle and therapeutic exercises to reduce sciatic nerve pain, improve your flexibility, and increase your range of motion.
Hot and cold therapy: apply heat or ice packs to the affected area to reduce pain and inflammation.
Injections: epidural corticosteroid injections may be given directly to the area around the spinal cord and help reduce inflammation and pain.
Surgery: in some cases, surgery may be necessary to relieve pressure on the sciatic nerve if other treatment methods are unsuccessful.
Frequently asked questions
Can sciatica be cured without surgery?
How do you stop sciatica when it starts?
What exercises should you avoid when you have sciatica?
Is sciatica serious?
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