Sources of Information
EBSCOhost
http://eds.b.ebscohost.com.ezproxy.unwsp.edu
PubMed
http://www.ncbi.nlm.nih.gov/pubmed/26005262
PubQuest
http://search.proquest.com.ezproxy.unwsp.edu
http://eds.b.ebscohost.com.ezproxy.unwsp.edu
PubMed
http://www.ncbi.nlm.nih.gov/pubmed/26005262
PubQuest
http://search.proquest.com.ezproxy.unwsp.edu
Definitions and Analysis of Medical Terms
Word analysis of Neuralgia
neur- (P) = nerve
-algia (S) = formation
Definition- intense, typically intermittent pain along the course of a nerve, especially in the head or face.
Word analysis of Radiculopathy
Radicul/o (CF) = spinal nerve root
-pathy (S) = disease
Definition- A disease of the root of a nerve, such as from a pinched nerve or a tumor.
Word analysis of Peripheral
peri- (P) = around
pher (R) = invovling
-al (S) = pertaining to
Definition- of, relating to, involving, forming, or located near a periphery or surface part.
Word analysis of Stenosis
sten- (P) = narrowing
-osis (S) = condition
Definition- the abnormal narrowing of a passage in the body.
Word analysis Lumbar
lumb (R) = loin, lower back
-ar (S) = pertaining to
Definition- Pertaining to the loins (lower back).
neur- (P) = nerve
-algia (S) = formation
Definition- intense, typically intermittent pain along the course of a nerve, especially in the head or face.
Word analysis of Radiculopathy
Radicul/o (CF) = spinal nerve root
-pathy (S) = disease
Definition- A disease of the root of a nerve, such as from a pinched nerve or a tumor.
Word analysis of Peripheral
peri- (P) = around
pher (R) = invovling
-al (S) = pertaining to
Definition- of, relating to, involving, forming, or located near a periphery or surface part.
Word analysis of Stenosis
sten- (P) = narrowing
-osis (S) = condition
Definition- the abnormal narrowing of a passage in the body.
Word analysis Lumbar
lumb (R) = loin, lower back
-ar (S) = pertaining to
Definition- Pertaining to the loins (lower back).
Summary
Low back pain poses a significant problem in clinics and public health. It presents one of the main problems with adults, since 70-80% of adults experience it at least once in their lifetime (Ibrahimi-Kaçuri, 2015). The estimated annual incidence of sciatica in Western countries is 5 cases per 1000 adults. (Peul, 2007). Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from the lower lumbar spine through the hips and buttocks and down each leg. This lumbar radiculopathy involves at least one of the nerve or nerve roots associated with the lumbar spine. Several nerve roots at the bottom end of the lumbar spine join together and form the sciatic nerve, which helps supply sensation in the lower back and buttocks, the rear of your upper and lower legs, and your feet. When radiculopathy affects these roots, sciatica symptoms develop (Types of Radiculopathy, 2015). Typically, sciatica affects only one side of the body. ("Sciatica", 2015) The most common cause of sciatica is caused by a herniated disc when the sciatic nerve becomes pinched, A herniated disc is a condition in which part or all of the soft, gelatinous central portion of an invertebral disk is forced through a weakened part of the disk. Compression on the nerves can cause siatica or severe lumber back pain that radiates down one or both legs; also called herniated intevertebral disk, ruptured disk, herniated nucleous pulposus (HNP), or slipped disk. (Rice, 498). More rarely, the nerve can be compressed by a tumor or damaged by a disease such as diabetes. ("Sciatica", 2015) This neuralgia can be caused by several other conditions: -Piriformis syndrome — This develops when the piriformis muscle, a small muscle that lies deep in the buttocks, becomes tight or spasms, which can put pressure on and irritate the sciatic nerve. -Spinal stenosis — This condition results from narrowing of the spinal canal with pressure on the nerves. -Spondylolisthesis — This is a slippage of one vertebra so that it is out of line with the one above it, narrowing the opening through which the nerve exits (clevland clinic) ("Sciatica", 2015) |
Diagnosis and Treatment
A complete medical history, including a review of symptoms, and a physical exam can help to diagnose sciatica and determine its cause. Other diagnostic tests might be performed to look for other causes of sciatic pain. Such testing might include:
The goal of treatment is to decrease pain and increase mobility. Treatment options include:
Nonsteroidal anti-inflammatory drugs (NSAIDs)- are the most frequently prescribed
medications worldwide and are widely usedfor patients with low-back pain (Cochrane Database, 2007). NSAIDs such as aspirin, ibuprofen (Motrin, Advil), and naproxen (Naprosyn, Aleve) help to relieve pain and stiffness, allowing for increased mobility and exercise.
Physical therapy —The goal of physical therapy is to find exercise movements that decrease sciatic pain by reducing pressure on the nerve. A program of exercise often includes stretching exercises to improve flexibility of tight muscles and aerobic exercise, such as walking.
The therapist might also recommend exercises to strengthen the muscles of your back, abdomen, and legs.
Spinal injections — An injection of a cortisone-like anti-inflammatory medicine into the lower back might help reduce swelling and inflammation of the nerve roots, allowing for increased mobility.
Surgery — Surgery might be needed for people who do not respond to conservative treatment, who have progressing symptoms, and are experiencing severe pain.
Surgical options include:
- X-ray to look for fractures in the spine
- Magnetic resonance imaging (MRI) or computed tomography (CT) scan to create images of the structures of the back
- Nerve conduction velocity studies/electromyography to examine how well electrical impulses travel through the sciatic nerve
- Myelogram using dye injected between the vertebrae to determine if a vertebra or disc is causing the pain (Cleveland Clinic, 2015).
The goal of treatment is to decrease pain and increase mobility. Treatment options include:
Nonsteroidal anti-inflammatory drugs (NSAIDs)- are the most frequently prescribed
medications worldwide and are widely usedfor patients with low-back pain (Cochrane Database, 2007). NSAIDs such as aspirin, ibuprofen (Motrin, Advil), and naproxen (Naprosyn, Aleve) help to relieve pain and stiffness, allowing for increased mobility and exercise.
Physical therapy —The goal of physical therapy is to find exercise movements that decrease sciatic pain by reducing pressure on the nerve. A program of exercise often includes stretching exercises to improve flexibility of tight muscles and aerobic exercise, such as walking.
The therapist might also recommend exercises to strengthen the muscles of your back, abdomen, and legs.
Spinal injections — An injection of a cortisone-like anti-inflammatory medicine into the lower back might help reduce swelling and inflammation of the nerve roots, allowing for increased mobility.
Surgery — Surgery might be needed for people who do not respond to conservative treatment, who have progressing symptoms, and are experiencing severe pain.
Surgical options include:
- Microdiscectomy — This is a procedure used to remove fragments of a herniated disc.
- Laminectomy — The bone that curves around and covers the spinal cord (lamina), and the tissue that is causing pressure on the sciatic nerve are removed.
Works Cited
Cleveland Clinic, 2015. "Diseases and Conditions- What is Sciatica". Retrieved October 20, 2015, from
https://my.clevelandclinic.org/health/diseases_conditions/hic_What_is_Sciatica
Cochrane Database of Systematic Reviews. (2007). "Non-steroidal anti-inflammatory drugs for low back pain". retrieved on October 20, 2015, from http://eds.b.ebscohost.com.ezproxy.unwsp.edu/ehost/detail/detail?vid=13&sid=1e363e75-a76f-4aaa-ab1d-71286bdabcf0%40sessionmgr111&hid=108&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=CD000396&db=chh
Ibrahimi-Kaçuri D, Murtezani A, Rrecaj S, Martinaj M, Haxhiu B. (2015). "Low back pain and obesity". PubMed. Retrieved October 21, 2015. from http://www.ncbi.nlm.nih.gov/pubmed/26005262
Mayo Clinic Staff. (2015, August 14). "Sciatica". Mayo Clinic. Retrieved October 20, 2015, from
http://www.mayoclinic.org/diseases-conditions/sciatica/basics/definition/con-20026478
Peul, Wilco C, MD; van Houwelingen, Hans C, PhD; van den Hout, Wilbert B, PhD; Brand, Ronald, PhD;Eekhof, Just AH, MD, PhD; et al. (May 31, 2007). "Surgery versus Prolonged Conservative Treatment for Sciatica". ProQuest. Retrieved October 20, 2015. from
http://search.proquest.com.ezproxy.unwsp.edu/docview/223919753/C40DBA59989B4767PQ/6?accountid=12915
"Types of Radiculopathy", (2015). North American Spine. Retrieved on October 21, 2015, from https://northamericanspine.com/conditions/radiculopathy/types/
Image Credit
Inman Chiropractic- http://paragouldspines.com/wp-content/uploads/2015/03/sciatica.jpg
Mayo Clinic Health-
http://www.riversideonline.com/source/images/image_popup/mcdc7_herniated_disk.jpg
Mayo Clinic Health-
http://www.riversideonline.com/source/images/image_popup/mcdc7_herniated_disk.jpg