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Do you know what sciatica is?

A limiting pain that could be the result of questionable postural hygiene: Do you know what sciatica is? What are the symptoms that define it?

Is your big toe numb? It could be sciatica, that one lumbar pain which radiates to the back or side of the leg and is caused by the pinching of a nerve.

EFEsalut has interviewed the doctor Juana Sánchez, head of the Pain Working Group of the Spanish Society of General and Family Physicians to learn more about the pathology: What are the defining risk factors? Which profiles are more likely to suffer from it? What is the treatment?

Why does it occur?

According to the doctor, sciatica, like pinching of the sciatic nerve, can have many causes: posture, age, obesity, sedentary lifestyle and, although it is less common, it can also be for inflammatory cause.

Illustration by Nuno Afonso provided to EFEsalut

Although the most frequent, yes, is the mechanical degenerative painwhat we know for osteoarthritis.

The range of age and the profile of the same patient are, in this sense, the factors that will condition the cause.

For example, in the case of womenthis pathology usually occurs during postmenopause, in the face of the loss of calcium in the vertebrae, which sometimes leads to a osteoporosis.

But, in addition to this, sciatica can also occur due to the continued use of drugs such as corticosteroids.

And the fact is that the use of corticosteroids can lead to vertebral collapse, due to accidental trauma or simple effort, because they can produce loss of bone mass.

“Corticosteroids are very useful. But the fundamental problem is the treatment time and the dose”, says Juana Sánchez.

The doctor insists that it is not appropriate to demonize this type of drug, since, although their use can lead to a weakening of the bone mass, they are also the most effective in severe cases of sciatica

Pay attention to risk factors

Ultimately, the expert lists how risk factors:

  • posture: the posture and the fact of doing mechanical work makes suffering from this pathology very likely.
  • age: when is it are over 50 years old, there is a loss of muscle tone, a decrease in the vertebral bodies and intervertebral discs. The degeneration of the vertebra narrows the areas of the spinal canal and this pinching can occur.
    • If it occurs in young peoplethe fact of suffering from sciatica makes it very likely that we are faced with a case of scoliosis
  • obesity
  • Sedentarism
  • Personal and family background: we cannot forget the fact that you have had treatment with corticosteroids, chemotherapy or radiotherapy, as well as a history of infectious diseases such as tuberculosis, because this can play a fundamental role when diagnosing the disease.

Symptoms of sciatica

The symptoms of sciatica are the same as those that define it: Pain that goes from the lower back to the gluteus and radiates either through a lower limb to the big toe or bilaterallyby the two lower limbs.

If you have these symptoms, watch out

However, there are occasions when the symptomatology goes further and the alarm signs that accompany it can make us think of a secondary cause. If accompanied by…

  • fever
  • Weight loss
  • Very bad pain at night that gets better when you get up
  • Involuntary loss of sphincters, either in urine or deposition
  • Low compression, the so-called cauda equina syndrome

It can be one tumoral pathology, acute infectious and they make us suspect dunesecondary acute umbosciatica. Although less common, it is important to know these symptoms.

A limiting pathology

Sciatica, in the eyes of the expert, is a disease that remaining quality of life and that largely affects the patient functionality.

And the fact is that the patient with lumbosciatica has a pain that prevents walkingwhat can produce lameness and makes him adopt one antialgesic posture.

“That’s why they often go to the emergency room or the doctor promptly, because they can’t even put on their socks or tie their shoes,” says Sánchez.

Is it reversible?

The lumbosciatalgia it usually gets better, though it totally depends on the cause.

One thing that is always emphasized is the importance of correct the risk factors: if the patient is obese, he must lose weight; if you are sedentary, you need to exercise.

The doctor indicates that correcting these factors is the most important part and, precisely for this reason, exercises such as pilates or tai chi are often prescribed to improve functionality and restore muscle tone of the spine.

EFE/David Aguilar

How is sciatica treated?

Generally speaking, the way sciatica pain is usually treated is by…

  • Repose: it is always recommended that it be a maximum of 72 hours, depending on the situation.
  • dry heat in the painful area
  • small rehabilitation: small exercises as the patient can tolerate.
  • Symptomatic treatment with analgesics, such as paracetamol, or anti-inflammatories, taking into account their gastrointestinal toxicity, for the shortest possible time
    • As previously mentioned, if we have a high suspicion of a herniated disc leading to muscle atrophy, it is usually prescribed corticosteroids to lower inflammation.

After menopause

On the other hand, the doctor specifies that in the case of postmenopausal womento avoid sciatica pain, two more points are added:

  • Good calcium contributionthat compensates for the deficiency.
  • Vitamin D or sunbathe responsibly.

Anyone can suffer from it

Juana Sánchez, as spokesperson for the SEMG, makes it clear that anyone can suffer from sciatica. Being aware of risk factors and trying to avoid them whenever possible is the most important thing.

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