- WHAT IS SCIATICA?
- Sciatica is a symptom caused by lumbar disc herniation and the pain generally affects the back, hip and leg. In such a case, the disc between two lumber vertebra compresses over existing nerve roots and causes radicular pain in one or both legs. It results in the patient experiencing tingling, numbness and stretching kind of pain in either one or both the legs. The pain can radiate up to toe, fingers and ankle however sometimes pain may only radiate up to the thigh and above knee.
- WHAT ARE SYMPTOMS OF SCIATICA?
Tingling and numbness in one or both legs
Ant walking sensation
Radicular pain in leg
Pain increase by walking and standing
Partially or completely relieved by rest or lying down position
Pain may provoke by coughing, sneezing or any kind of straining
- WHAT ARE CAUSES OF SCIATICA?
Sciatica is mainly caused by the irritation of sciatic nerve or its fibers
Lumbar disc herniation is the main cause of Sciatica
Degenerative vertebra can causes Sciatica
Muscle inflammation, injury or tumor can cause Sciatica
- HOW SCIATICA IS DIAGNOSED?
- History and physical examination can give clues to suspect sciatica. X ray and MRI of lumbar spine can help to diagnose sciatica as well as help to find out causes of it. MRI also guides a treatment plan.
- For acute and less severe pain, rest and medicine can help few of patients. Avoiding forward bending, lifting weight, avoiding sitting on floor will help. If patient feels improvement in pain we can continue a conservative approach with medicine and exercise for four weeks.
- As science advances treatment of sciatica is becoming less and less invasive. Now a day’s for sciatica minimally invasive treatments are widely available. Sciatica treatment in India is keeping pace with world. All advance and minimally back pain treatment also available in India.
If exercise and medicine are not working than your doctor might suggest you some intervetions. Pain Management treats such diseases with techniques called intervention. Intervention is a small injection technique which helps to get rid of root problem of Sciatica without surgery. Your doctor will see all reports and then suggest you best treatment options for you.
- Mild bulge (Slipped) Disc can cause a swelling on the existing nerve roots. Injecting a drug in to a foramen will reduce that swelling inside and help the patient by dissipating the pain.
PERCUTANEOUS DISC DECOMPRESSION / NUCLEOPLASTY
Transforaminal Block is given under local anesthesia. It is given under live X-ray (C arm) guidance. Here we numb a part of the back and insert a thin needle inside. The needle is guided with the help of a Live X-ray Machine.
- In this procedure we remove a part of the herniated disc through a needle. No incision or surgery is required for this procedure. We have latest equipments to do these procedures.
This procedure is recommended in Sciatica patients who have a significant disc herniation which is pressing on nerve roots and not responding to conservative treatment.
We numb the skin of the back. Under live X- ray (under IITV) guidance, we insert a needle like instrument called Disc dekompressor or nucleoplasty in the back. This instrument goes in between vertebra in to a disc. Once we confirm an instrument position with a live X-ray (IITV) machine, we turn on the machine and use latest techniques to remove a significant part of the disc which is called Nucleus Pulposus. Usually we do this procedure for three minutes. Once significant amount of material is removed we remove the instrument and put a small dressing at the spot from where needle was inserted in the back. (For this Proceudre we use stryker's decompressor).
- WHAT TO EXPECT AFTER THE PROCEDURE?
Mild aching back, which will be relieved with medicine
Improvement in pain will start after two to three days
It is recommended that patients apply ice on the back for three to four days
Patient must take rest for 1 to 2 days although no complete bed rest is required
- ADVANTAGES OF THIS PROCEDURE
Get rid of Sciatica problem without surgery
Remove a part of disc
Procedure done under local anesthesia so we can avoid general anesthesia
No bed rest needed
Less post-operative pain
Short recovery period
Get results equal to surgery
Provide a disc sample for biopsy if required
Intense rehabilitation not required
Avoids surgery and consequences of surgery
No scarring after procedure
Cost effective due to reduced hospital stay
Can be done on elderly patients also
- Sometimes due to severe Stenosis or loss of sensation in the leg / legs, the patient is required to go for an open surgery called Laminectomy. Laminectomy should be done under general anesthesia. Laminectomy is a surgery done to remove excessive pressure on the spinal cord and nerve roots. Laminectomy removes a portion of thin part of vertebra called lamina which forms a protective arch of vertebra. Laminectomy also removes a thick part of tissue around spinal cord on selected vertebra