Sciatica & Radiculopathy
SCIATICA
Sciatica refers to pain that radiates along the pathway of the sciatic nerve, typically from the lower back through the buttock and into one leg. It usually occurs due to irritation or compression of the nerve roots that contribute to the sciatic nerve. The pain may range from mild discomfort to severe, disabling pain and may be accompanied by tingling, numbness or muscle weakness.
Diagnosis,
1. Diagnosis usually begins with a detailed medical history & clinical examination,
- a. Location & nature of pain
- b. Duration & progression of symptoms
- c. Activities or movements that aggravate the pain
- d. Radiation of pain into the leg
- e. Numbness, tingling or weakness
- f. Reflexes, sensation & muscle strength
2. Radiological Investigations
- a. X-ray
- b. MRI of the spine
- c. CT scan of the spine
3. Pathological Investigations
Blood tests when infection, inflammatory condition or other systemic disease is suspected.
4. Additional Test
- a. Nerve Conduction Studies (NCS)
- b. Electromyography (EMG)
Treatment,
1. Medications -
Anti-inflammatory, analgesic & antispasmodic medicines having good role in acute stage. They reduce inflammation, pain & spasm in the back, help you to get to the daily routine.
2. Exercise & Physiotherapy -
In early stage, some back exercises are very helpful to maintain a muscle strength & tone. Targeted back & core strengthening exercises protect your back by building deep abdominal & lower back muscles that absorb daily loads & reduce pressure on the vertebrae and disc.
3. Spinal Blocks / Injections
If exercises & medications aren't effective, your doctor might suggest spinal blocks or injections. These are minimally invasive procedures, to block pain pathways & reduce inflammation. Pain relief typically beginning within a week.
At AREVA, we specialise in advanced interventional pain management for back & spine conditions, using precise, image-guided (C-ARM or IITV) procedures to target the source of pain, providing relief in back pain without the need for major surgery.
Many treatments are performed as day-care procedures, enabling patients to return home the same day & resume normal activities with minimal downtime.
Our goal: Precise treatment, faster recovery & lasting improvement in quality of life.
a. Facet Joint Block -
When pain originates from the facet joints (located between each vertebra), a specific type of injection called a facet joint injection, to diagnose & treat pain by reducing inflammation. The pain, commonly associated with facet arthritis & mechanical back pain.
b. Transforaminal Block / Selective Nerve Root Block -
A targeted image-guided injection delivered near an irritated spinal nerve root to reduce inflammation & pain, particularly in conditions such as sciatica, slipped or herniated disc & radicular pain.
Medications are injected into the neural foramen, the opening through which the spinal nerve exits the spine, & placed close to the affected nerve root. The medication spreads around the nerve root within the epidural/perineural space, helping to reduce inflammation & relieve pain.
c. Interlaminar Epidural Injection -
Medication is injected into the epidural space through an interlaminar approach to help reduce inflammation around spinal nerves. It may be considered for radicular pain, sciatica & selected spinal pain conditions.
d. Medial Branch Block -
A precise, image-guided injection around the small medial branch nerves that carry pain signals from the facet joints. It can help determine whether the facet joints are a significant source of back or neck pain & may also be used as part of the treatment pathway toward RF neurolysis.
e. Caudal Epidural Injection -
Medication is delivered into the epidural space through the sacral opening at the base of the spine. It may be used for lower back pain, sciatica & certain forms of nerve-root irritation
4. Radiofrequency Ablation (RF Neurolysis) -
A minimally invasive procedure that uses controlled radiofrequency energy to interrupt pain signals from selected nerves, most commonly the medial branch nerves supplying painful facet joints. It provides longer-lasting relief in appropriately selected patients.
At AREVA
At AREVA we evaluate sciatica to identify the likely source of nerve irritation and tailor treatment to each patient's needs. Depending on the diagnosis, management may include medication, rehabilitation, image-guided epidural injections and selective nerve-root procedures. Our goal is to reduce radiating leg pain, improve mobility and support recovery while avoiding unnecessary surgery whenever appropriate.