Sciatica, also known as lumbar sciatica, is a name we usually refer to Acute or subacute pain radiating from the lower back down the legs.
Age-related and common in pregnant women, Sciatica can occur at any point along the nerve pathwayfrom the spine to the feet and often continues its journey from the lumbar area, through the hips and back of the thighs to the calves.
Why does sciatica occur?
sciatic nerve Originates in the spinal cord from spinal nerve roots L4, L5, S1, S2 and S3arise from the spine in the lumbar and sacral areas and combine in the hip area to form the sciatic nerve.
When these nerve roots become irritated or compressed, symptoms of sciatica, or sciatica in the lower back, can occur, resulting in sciatica. Causes pain in the lower back and one or both legs.
Technically, sciatica is “A disorder involving radiculopathy caused by damage to the lumbar nerve roots, in which L5 and S1 are most commonly affected,” explains Dr. Juan Fernando Henares, Director of the Pain Unit at Quirónsalud in Alicante.
What is your reason? Are there any risk factors associated with its appearance?
One of the main causes of sciatica is a herniated disc., “This occurs when a disc herniates or ruptures, putting pressure on the nerve roots.”
Age is another common cause of this type of pain..
“As we get older,” Dr. Henares added, «The spine may develop a narrowing of the spinal canal, called stenosis. This compression affects the origin of the sciatic nerve. Some age-related degenerative diseases, such as osteoarthritis, can also contribute to the development of lumbar and sciatica pain.».
Likewise, spinal injury from trauma or tumors can damage the spine and compress the sciatic nerve.
The same thing happens with piriformis syndrome.: If the piriformis muscle is inflamed or too tight, it can irritate the sciatic nerve, producing what is called pseudosciatica (deep gluteal syndrome).
In this sense, adds the expert Quirónsalud of Alicante Being overweight and physically inactive increases the risk of lumbar sciatica, “By putting extra pressure on the spine.”
What are the symptoms of sciatica?
Although symptoms of sciatica vary from person to person, the most common are:
Stinging, burning, or persistent pain It radiates from the waist down into the legs and is often worse when sitting for long periods of time.
feeling abnormal. Or equally, abnormal sensations in the affected leg, such as tingling, numbness, or muscle weakness.
loss of muscle strength Making it difficult to move the legs or lift heavy objects.
On the other hand, while sciatica always affects the lower extremities (legs), there is a similar injury in the upper extremities called cervicobrachial pain.
«This condition involves the neck and arms and is classified as cervical radiculopathy. Due to the complexity of the cervical spine, treatment often requires more specialization,” Dr. Henares concluded.
What are your treatment options for sciatica?
The head of the Pain Unit at Quirónsalud in Alicante explains Sciatica treatment can be approached from three different angles:
Conservative management. «Recommended for most patients with herniated discs, as up to 90% of herniated discs will “reabsorb” on their own. “It includes rest, medications to treat pain and inflammation, and physical therapy to strengthen muscles and improve mobility.”
Minimally invasive management. «Percutaneous disc herniation treatment is a minimally invasive medical procedure designed to relieve the pain and symptoms caused by a herniated disc without the need for open surgery. The surgery is performed through small incisions in the skin Generally speaking, there are fewer complications and shorter recovery time than traditional surgery.
surgical technique. «These include discectomy or laminectomy, with or without instrumentation. Although effective, they carry greater surgical and anesthetic risks.
about tTechniques used in the treatment of sciatica at the Quirónsalud Pain Unit in Alicanteexperts list:
epidural injection. Medications are injected directly into the epidural space, usually corticosteroids and local anesthetics along with ozone or platelet-rich plasma (PRP). Treatment helps reduce inflammation and relieve painis symptomatic and effective and is conducive to the patient’s readjustment.
Nerve root or dorsal root ganglion (DRG) infiltration. This procedure locates the nerve root causing sciatica, often compressed by a herniated disc, and then injects corticosteroids, local anesthetic, or PRP into the area. The technology is associated with neuromodulation therapies such as pulsed radiofrequency.
nucleoplasty. Also called percutaneous disc decompression. This is a minimally invasive technique suitable for patients with herniated discs and lumbar spine or nerve root pain. Once the needles are precisely placed on the disc, different types of energy, such as radiofrequency, are used to cause damage for therapeutic purposes. Reduce stress and relieve patient pain. The goal is to alter the collagen of the annulus fibrosus and ablate pain receptors in the area.
Intradiscal regenerative medicine. It involves injecting stem cells (MSC) or concentrated plasma to relieve disc-derived pain. These types of therapies have been shown to improve water content at the disc height and increase cell proliferation due to growth factors and cytokines such as PDGF, IGF-1, TGF-β, and VEGF.
Intradiscal ozone therapy. It involves injecting a mixture of oxygen and ozone directly into the herniated disc. Ozone is thought to reduce inflammation and stimulate tissue regeneration, thereby relieving pain and improving function.
transcutaneous laser therapy.Use lasers of different wavelengths (usually 980nm or 1470nm) to vaporize or decompress the herniated disc tissue. The intervention is performed through a small incision, and recovery time is very quick compared to surgery.
Is there a definite treatment? What is the success rate of these interventions?
Pain Unit, Quirónsalud, Alicante Focus on minimally invasive treatments, primarily regenerative medicine.
Some of its advantages are its anti-inflammatory abilities, It has minimal adverse effects or preserves the intervertebral disc structure. and the biomechanical stability of that anatomical part.
“These treatments have similar success rates to open surgery (80-90%) but with fewer potential complications,” Dr. Juan Fernando Henares explains.
“The literature supports the effectiveness of these techniques, which provide considerable relief and assistance Improving patient quality of life with outpatient surgery. “Each case is evaluated individually and these approaches are prioritized before considering open surgery, which carries higher risks and longer recovery times.”
Request more information at Quirónsalud Alicante Pain Unit