Sciatica is a term often given to the sensation of pain going down one or both legs. The term refers to irritation of the Sciatic Nerve, which travels down the buttock and back of the thigh. "Sciatica" is a misnomer, as the pain is typically cause by irritation of nerve root of the spine, rather than the sciatic nerve. The medical term for a pinched nerve of the spine is radiculopathy and is characterized by pain, numbness, tingling, or weakness that radiates along the path of the nerve affected. It typically occurs when a nerve root in the spine becomes compressed or irritated, leading to symptoms that can affect various parts of the body. In the low back a herniated disc may cause low back pain and/or radiculopathy in one or both legs. In the neck a herniated disc may cause neck pain and can affect the arm(s), but also can cause pain in back of head, neck, upper back and chest.
Causes.
Radiculopathy can occur due to various factors that put pressure on the nerve roots in the spine. Common causes include:
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Herniated Disc: A herniated disc occurs when the soft inner core of a spinal disc leaks out and presses against a nearby nerve root.
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Degenerative Disc Disease: Wear and tear on the spinal discs over time can lead to disc degeneration, resulting in disc height loss, decreased cushioning, and potential compression of nearby nerve roots.
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Spinal Stenosis: Narrowing of the spinal canal or the openings through which nerves exit the spinal cord can compress nerve roots, leading to radiculopathy symptoms.
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Bone Spurs: Overgrowth of bone, typically due to osteoarthritis, can develop in the spinal canal or around the neural foramina (the openings through which nerves exit the spine), causing nerve compression and radiculopathy.
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Spondylolisthesis: This condition involves the forward slippage of one vertebra over the one beneath it, which can compress nerve roots and lead to radiculopathy symptoms.
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Facet Joint Hypertrophy: Enlargement of the facet joints in the spine, often due to arthritis or degeneration, can encroach upon the space for nerve roots, resulting in radiculopathy.
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Trauma or Injury: Acute trauma, such as a car accident or fall, can cause fractures, dislocations, or other injuries to the spine, potentially leading to radiculopathy if nerve roots are affected.
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Tumors: Growths or tumors within the spinal canal or along the nerve pathways can compress nerve roots, causing radiculopathy symptoms. Tumors can be benign or malignant.
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Infections: Infections affecting the spine, such as spinal epidural abscesses or vertebral osteomyelitis, can lead to inflammation and compression of nerve roots, resulting in radiculopathy.
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Other Causes: Less common causes of radiculopathy include spinal cord lesions, inflammatory conditions like rheumatoid arthritis, and rare congenital abnormalities.
Symptoms.
The symptoms of radiculopathy can vary depending on the location and severity of nerve compression. Common symptoms include:
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Pain: Patients may experience sharp, shooting pain that radiates along the path of the affected nerve, often into the arms or legs.
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Numbness and Tingling: Numbness, tingling, or a pins-and-needles sensation may occur in the areas supplied by the affected nerve.
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Muscle Weakness: Weakness or difficulty controlling muscles may develop, particularly in the arms or legs.
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Loss of Reflexes: Reflexes controlled by the affected nerve may be diminished or absent.
Treatment.
Treatment for radiculopathy aims to alleviate symptoms, reduce inflammation, and improve function. Depending on the severity of the condition, treatment options may include:
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Conservative Management: Initially, conservative treatments such as rest, physical therapy, and anti-inflammatory medications may be recommended to relieve symptoms.​
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Epidural Steroid Injections: Corticosteroid injections delivered into the epidural space around the affected nerve can help reduce inflammation and provide temporary pain relief.​​
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Minimally Invasive Procedures: Minimally invasive procedures such as epidural nerve root blocks or percutaneous discectomy may be recommended to relieve pressure on the nerve root.​
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Surgery: In severe cases or when conservative treatments fail to provide relief, surgery may be considered to decompress the affected nerve root and stabilize the spine.