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Sciatica Herniated Disc Treatment Clinic .pdf

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Sciatica, Herniated disc (Or slip disc)


What we Treat

Sciatica, Herniated disc (Or slip disc)

Sciatica, Herniated disc (Or slip disc)
What Is Sciatica?

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Our spine consists of the vertebral column through which spinal cord runs. From the spinal cord various nerves comes
out and supply sensations to the peripheral parts of the body. Sciatic nerve is large nerve that runs from the lower back
down the back of each leg. When something injures or puts pressure on the sciatic nerve, it can cause pain in the lower
back that spreads to the hip, buttocks, and leg. Up to 90% of people recover from sciatica without surgery. In brief,
Sciatica refers to back pain caused by a problem with the sciatic nerve.

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Symptoms of Sciatica

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Lower back pain
Many a times pain extends through the hip and buttock and down one leg
Usually on one side
Usually worse when you sit, cough, or sneeze
The leg may also feel numb, weak, or tingly at times.
The symptoms may remain for few days to weeks, but the good news is that pain subsides in 95% of
cases with conservative treatments and pain management procedures.

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How to differentiate sciatica from other causes of back pain?
Not all back pain are sciatica. Every individual in their life time suffers from back pain. As per literature up to 85% of
Americans experience some type of back pain during their lives. But this doesn't always involve the sciatic nerve.
Muscle and ligament sprain and strain are common reason of back pain. One of the easiest character to differentiate
these pain from sciatica pain is – In Sciatica, pain radiates to leg and / or foot (Shooting, shock like, cramp like or
aching) in one particular band.

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Doctors at PCI

Who Gets Sciatica?
Age 30-50
Females during pregnancy (pressure on sciatic nerve) from full size uterus
Commonest cause is a herniated or slipped disc and degenerative arthritis of the spine

Who Gets Sciatica?

Eligibility - Post graduation in Anesthesiology,
Orthopedics, Neurosurgery, and Radiology

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Herniated Disc –
The most common cause of sciatica is a herniated disc. Discs act like cushions between the vertebrae of your spine.
Aging makes these discs weaker. They are easy to get damaged by minor injuries. Herniated disc means the central gel
leaks out and compress the sciatic nerve. About 1 in 50 people will get a herniated disc at some point in life.
Spinal Stenosis –
Aging, minor injuries over time causes natural wear and tear of the vertebrae can lead to a narrowing of the spinal
canal. This narrowing, called spinal stenosis may put pressure on the roots of the sciatic nerve. Spinal stenosis is more
common in adults over age 60.
Spinal Tumors –
In rare cases, sciatica may result from tumors growing inside or along the spinal cord or sciatic nerve. As a tumor
grows, it may put pressure on the nerves that branch off from the spinal cord.
Piriformis Syndrome –
The piriformis is a muscle found deep inside the buttocks Sciatic nerve runs between 2 heads of the muscle belly. If
this muscle goes into spasm, it can put pressure on the sciatic nerve, triggering symptoms of sciatica. Usually women
suffer more from this syndrome. Keeping a fat wallet in the back pocket may also cause piriformis syndrome (FAT
Sacroiliitis –
Sacroiliitis is an in ammation of one or both of the sacroiliac joints. Sacroiliac joint is a joint between sacrum and hip
bone ilium. It causes pain in the buttocks, lower back, and may even extend down one or both legs. The pain is more on
prolonged standing or climbing stairs. Sacroiliitis can be caused by arthritis, injury, pregnancy, or infection.
Injury or Infection –
Other causes of sciatica include muscle in ammation, infection, or injury, such as a fracture. In general, any condition
that irritates or compresses the sciatic nerve can trigger symptoms. In some cases, no speci c cause of sciatica can
be found.

Diagnosis of sciatica
Examination –

Pain is a way your body reacts to injury or illness.
Everybody reacts to pain differently. Schedule an
appointment for the pain you suffer.  
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history, speci c examination by the doctor will guide him to the cause of sciatica.
Imaging –
X-ray, MRI, CT Scan
Complications Related to Sciatica –
If you develop a loss of bladder or bowel control, contact your doctor right away. This can be a sign of a medical
emergency that requires surgery to avoid permanent damage.
Fortunately, this complication is rare.

Sciatica Treatment
Ice and Heat –
These are home remedies to relieve pain caused by sciatica. Heating pad or ice pack may be especially helpful. Apply
the heat or ice for about 10 – 15 minutes every 4 hours. You can choose any one, once you see which is more effective.
Never keep the heating pad on body and sleep as it can cause accidental burns.
Medication –
Commonly used medications (Over-the-counter pain relievers ) can provide short-term relief from sciatica.
Acetaminolihen and nonsteroidal anti-in ammatory drugs (NSAIDs), such as asliirin, ibulirofen, and naliroxen are
options. Muscle relaxants and other adjuvant medications are also useful.
Physiotherapy –
Physiotherapists at pain clinic of India use different methods like manual therapy, electomodalities, Kinesiology
(Taliing), McKenzie treatments for sciatica along with various exercises to strengthen, stretch, and developing core
muscles of the back.
Pain Management injection –
At pain clinic Of India various pain management injections are performed to relieve sciatica pain. Image guided Lumbar
epidural injection is very very popular and effective in treating sciatica pain. It can resolve symptoms in few hours to
days and many times 2-3 injections can cure the condition. It is very effective slip disc treatment option to avoid
surgery in most cases. We do recommend taking 1-2 epidurals before taking surgical decision very strongly.
Surgery –
If your sciatica is due to a herniated disc, and it's still causing severe pain after four to six weeks, if pain management
injection is not helping, surgery may be an option. The surgeon will remove a portion of the herniated disc to relieve the
pressure on the sciatic nerve. About 90% of patients get relief from this type of surgery. At pain clinic of India we do
offer various minimally invasive discectomy procedures for sciatica pain. We also offer endoscopic discectomy (stitch
less) under local anaesthesia. Other surgical procedures can relieve sciatica caused by spinal stenosis.
Rehabilitation therapy –
After back surgery, you will generally need to avoid driving, lifting, or bending forward for about a month. Your doctor
may recommend physical therapy to help you strengthen the muscles in the back. Once recovery is complete, there's
an excellent chance you'll be able to get back to all your usual activities.

Prevention is better than cure
If you've had sciatica once, there's a chance it will return. But there are steps you can take to reduce the odds:
Exercise regularly.
Maintain good posture.
Bend at the knees to lift heavy objects.
These steps can help you avoid back injuries that may lead to sciatica.

Dr. Kailash Kothari
info@painclinico ndia.com

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