Diagnosis of Sciatica

Sciatica nerve branches into the buttocks from the legs through the hips and the lower back. A sharp pain emanating along this nerve result in a condition called Sciatica and often affects one side of the body. When the bone spur and the herniated disk compress the Sciatica nerve, they cause pain, inflammation, and numbness in the area affected particularly in the leg. Most cases of the condition associated with pain resolve without treatment after some weeks except for severe situations where the patient experience weakness in the leg, changes in the bladder and the bowel. Surgery solves these critical cases.

The condition causes discomfort anywhere along the nerve. The pain, however, is experienced more through the calf, thigh, and buttock to the lower back. This pain that follows this type of pathway is called the Hallmark. The pain ranges from an excruciating sharp pain to a mild sensation. Sneezing and coughing can worsen the pain. Prolonged sitting increases the symptoms of Sciatica (Mathieson, 1111). The risk of acquiring the condition increases with age due to changes in the bone spurs and the herniated disks. Another factor is obesity as the situation adds more stress to the spine. The pressure results to changes in the spine triggering Sciatica. An individual’s job can trigger the condition especially when it involves lifting heavy load and back twisting the back (Mathieson, 1120).

However, there isn't a clear link between the condition and occupation. Active people are less likely to acquire the disease than people with a sedentary lifestyle or those who sit down for long. How the body of people with diabetes uses sugar is affected, and their nerves might be damaged which increases the risk of Sciatica. Imaging tests show the bone spurs and the herniated disks. These changes are visible under X-ray imaging among other imaging tests. These imaging tests are prescribed by the doctors when the patient is in deep pain which do not disappear after some weeks (Mathieson, 1124).

Diagnosis

Electromyography (EMG) is an example of the tests done to measure the muscle response and the electrical impulse produced by the nerves. The reduction of the spinal stenosis or the spinal canal or the herniated disks that causes EMG can measure nerve cell compression. A CT scan also applies in testing the condition where the patient is injected with an imaging dye in the spinal cord to differentiate between the compressed nerves that produce a white image (Euro, 4).

The Sciatica therapy includes Acupuncture applied when the lower back is painful. The procedure involves injecting the skin of the patient with thin needles at different points of the body. The practitioner must be an experienced individual with extensive training. Another form of therapy is Chiropratic used to treat restricted spinal movement. The function of the treatment is to reduce pain and restore spinal mobility. The CT scan or the Computed Tomography helps in the diagnosis of patients with damaged spinal columns or patients who have sustained injuries. The scan is painless, fast, accurate and non-invasive. In emergency cases, the method shows internal bleeding and injuries (Euro, 6).

Similar to other X-ray scans, the CT scan produces multiple scan images of the internal organs of the body. The computer monitor is then used to view the scanned picture, filed and saved in digital discs. The CT scan produces a clearer image of the bones, blood vessels, nerves and internal organs providing more details especially of the blood vessels and the soft tissues. With this technique, viewing the inter-vertebral discs is possible. The method is also used to look for potential fractures sustained in injuries (Euro, 8).

CT is also used to examine the spine after surgery and before any surgical procedure, diagnose pain in the spine, to measure the density of bones in the spine and predetermine fractures likely to be sustained in the Vertebral column in patients with Osteoporosis. CT is also used to measure Scoliosis anomalies in the Congenital area and to check for presence in the vertebral column of any tumors. The technique is used to look for cancer cells and biopsy diagnosis (Rasmussen-Barr, 587).

MRI or Magnetic Resonance Imaging of the spine is also applicable in the diagnosis of Sciatica. The MRI machine uses a computer, a magnetic field, and radio waves to come up with an image of the spine which is detailed. The technique is better when it comes to a highly accurate image of the affected area, the tissues and cells around the damaged cells. The method requires a contrast dye to differentiate between the target cells and the surrounding cells and tissues. The need for contrast dye is because MRI does not use ionization radiation in imaging.

The dye used in MRI imaging is called gadolinium which does not cause any allergic reaction with the patient. An MRI scan shows the anatomy of the tissues or cells. The image shows the gap between the vertebral discs where the nerves pass through (Rasmussen-Barr, 589).

MRI also shows the ligaments holding the discs. In clinical medicine, MRI remains the most sensitive test as far as spinal imaging is concerned. The condition is treatable with Epidural injections which can either provide a prolonged or temporary relief from the inflammation or pain. To accurately inject the injured part of the spine, imaging is needed. The image may help pinpoint the source of the pain.

Treatment

The Epidural injection is specific for spinal cord medication and for the infusion of the site around the spine. The epidural space is located posterior to the Dural membrane. During the procedure, anesthetic, steroids, and anti-inflammatory drugs are injected into the spine during this form of treatment. To place the needle at the right place, the doctor may use the CT scan or fluoroscopy to inject the drug at the correct source of the pain in the spinal cord. The treatment is used to lift the pain caused by the compressed nerve due to the bone spurs or the herniated disks. It is also used to treat the pain experienced after back surgery and spinal stenosis.

Non-invasive or nonsurgical treatments require chiropratic. It is an option that is drug-free where the objective is to bring back spinal cord mobility. Movement restoration reduces inflammation and pain. Patients with Sciatica may be treated with different Chiropratic plans. These may include heat or ice therapy, TENS, adjustment of the spine and various rehabilitation practices. The technique and manipulation of the spine are proven to have few side effects and effective (Rasmussen-Barr, 590).

Physical Therapy

Posture correction has proven to be an effective physical therapy where the patient is told to be keen with the core muscles especially those of the lower back and the abdomen which is essential for adjustment and proper posture. The patient passes through a series of exercise activities which alleviate the Sciatic pain than in bed patients. Patients who have the condition and do not work usually see a worsening of the state (Rasmussen-Barr, 594).

Work Cited

Euro, Ulla, et al. ""Risk factors for sciatica leading to hospitalization."" European Spine Journal (2017): 1-8.
Mathieson, Stephanie, et al. ""Trial of pregabalin for acute and chronic sciatica."" New England Journal of Medicine 376.12 (2017): 1111-1120.
Rasmussen-Barr, Eva, et al. ""Nonsteroidal Anti-inflammatory Drugs for Sciatica: An Updated Cochrane Review."" Spine 42.8 (2017): 586-594.