What Is Sciatica?
Sciatica is pain somewhere in the leg that originates in the back. Many people never even have any back pain and that is why it is sometimes hard to understand the diagnosis. The sciatic nerve emerges from the lower spine, goes down the leg and stimulates the muscles and skin of the thigh, leg and foot.
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What causes Sciatica?
Injury or inflammation of the sciatic nerve can cause pain to travel down the leg from the thigh and into the foot and toes. Sciatica may be caused by a back injury, an irritation from arthritis of the spine, or from pressure on the nerve at various points along the nerve pathway.
Sciatica pain may also be caused by an abnormal bulging or protrusion of a disc in the lower back. The discs are jelly-like pads which act as elastic cushions to separate the vertebrae (spinal bones). The affected disc(s) may press on the spinal nerve root of the sciatic nerve. This condition is known as a herniated or “slipped” disc and the pain may be felt all along the lower back. ARTHRITIS in the back is the most common cause of sciatica. An enlargement on one of the joint processes, called an arthritic spur, irritates the nerve. It can also be caused by a slippage of two vertebrae bones which pinch the nerve.
Sciatica may arise when a muscle goes into a spasm, contracts abnormally and puts pressure on the nerve. Injury occurs as a result of weak back muscles, by prolonged or improper use of the back or as a result of being overweight.
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How you can ease your pain?
If you have low back pain or have reason to believe you have sciatica, apply a heating pad to the lower back to help reduce inflammation and swelling and decrease the pain. Use the heat for periods of 20 to 30 minutes, with at least a 30 minute interval between each application. Avoid sitting for any length of time, even for as little as 10 to 15 minutes. Sitting puts the weight of the body on the lower discs of the spine, which may aggravate disc problems related to sciatica.
You may be most comfortable when lying on your back or walking. A word of caution: these are temporary remedies and not a substitute for seeking immediate professional care. If you have sciatica, consult your doctor as soon as possible.
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What your orthopedic doctor can do for you?
Orthopedic doctors are educated and trained in the detection and treatment of problems affecting the joints. Many cases of sciatica lend themselves to correction through Epidural Steroid Injection (E.S.I.). Physical therapy also can be helpful.
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What is epidural steroid injection?
It is a procedure in which a cortisone-like drug is injected on top of the spinal canal. The anti-inflammatory properties of the medication are intended to give long term, sometimes permanent relief of symptoms.
The procedure is painless and the risk of complication is very low.
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How is E.S.I. Done?
E.S.I. is an outpatient procedure, really no more than an office visit. A small area in the lower back is numbed with a local anesthetic. A very small needle is then placed through the skin into the epidural space, an area adjacent to the affected nerves. The medications are painlessly injected through the needle and spread to the nerves. The procedure is performed by our doctors, who are skilled in this technique.
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Physical Therapy After E.S.I.
Your doctor may believe you can benefit from physical therapy after your ESI.
Physical therapy after an ESI injection is designed to strengthen the muscles of the lower back, abdomen, buttocks and legs, in order to promote good posture and enhance your treatment.
Physical therapy treatment includes ultrasound, moist heat and massage.
The education portion of the program teaches you how to minimize recurrence of sciatica. Topics include exercises, medications and proper body mechanics. You will also learn which exercises you should avoid.
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