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What is it?
The sciatic nerve is the largest nerve in the human body. It originates from several nerve roots that come out of the end of the lumbar spine, more precisely from the L4, L5, S1, S2 and S3 roots. He is responsible for controlling hip joints, knees and ankles, plus leg and foot muscles.
Pressure on this nerve can cause inflammation and consequently the so-called sciatica pain. The most common cause of pain in this nerve is a herniated disc (problem with a cartilaginous disc between the vertebrae).
Another less common cause of compression of the sciatic nerve is when it passes through the piriformis muscle (gluteus). This compression occurs mainly in athletes and runners who tend to increase the volume of this muscle.
- Pain in the back of the leg and buttocks;
- Little back pain;
- Pains in the leg in the form of a burning shock;
- Usually in just one of the lower limbs;
- In the most severe cases, there may be a decrease in strength in the lower limb;
- Usually the pain improves lying down;
- The pain is worse sitting or standing;
- It may be worse when sneezing or coughing.
Physical exam: o Lasègue test, as it is sensitive, it can detect pain in cases of compression of the sciatic nerve. It is performed with the patient lying down and the leg extended, causing very strong and irritating pain down to the foot. In addition, weakness or loss of sensation in some part of the lower limb may also occur.
Imaging exams: tomography or MRI of the lumbar spine can assess the presence of disc herniation.
- Analgesic and anti-inflammatory medications;
- Local ice or heat;
- Relative rest for short periods of time;
- Pain procedures such as corticosteroid injections, guided by radioscopy or tomography.
When there is no improvement with clinical treatment, the objective of the surgeries is to remove the herniated disc and, for this, a microscope or endoscope is used. These surgeries are currently minimally invasive with the early return of the patient to their activities.
- Regular physical exercises;
- Avoid being overweight;
- Muscle strengthening with guidance respecting your limits;
- Ergonomics at work or at home such as suitable chairs and mattresses;
- Avoid carrying weights inappropriately.
Pain in the sciatic nerve and back has a very high incidence and prevalence rate in our setting. More than 60% of the population is subject to this type of pain. This percentage increases due to the sedentary lifestyle, the daily movement of cities and long hours sitting.
Source: Dr. Luciano Miller Reis Rodrigues, physician at the Einstein