Sciatica: Understand the causes, symptoms, treatments, and prevention

Sciatica: Understand the causes, symptoms, treatments, and prevention

The simplest movements of the human body require great efforts from the joints. Even performing household chores with great intensity can lead to inflammation of the sciatic nerve, which is a pain that can be prolonged if the necessary care is not taken.

The sciatic nerve is the largest in the human body in terms of length and diameter. It originates in the lumbar spine and is responsible for the hip joints and the entire muscular region of the legs. Its path begins in the gluteal region and passes behind the thigh and knees until it reaches the feet.

When nerve roots become compressed or inflamed—a condition also known as sciatica—the act appears, a sign that it’s time to seek professional help.

the reasons

According to physical therapist Bernardo Sampaio, Clinical Director of ITC Vertebral (Institute for Spinal Spine Therapy), there are two causes of inflammation in the hip area: One is compression of one of the nerve roots in the lumbar spine. [a junção de algumas raízes compõe o nervo ciático]The other is compression of the nerve in the gluteal region by a muscle called the piriformis, causing piriformis syndrome.”

A physical therapist highlights that factors such as past lumbar crises, a sedentary lifestyle, smoking, and family history can increase a person’s chances of developing sciatica.

Orthopedic surgeon Rafael Marcon, Head of the Spine Group – Deformities and Lumbar Spine at HCFMUSP (Hospital das Clínicas, Faculty of Medicine, University of São Paulo) explains that the cause of inflammation depends on the age group.

“In youth, [a crise] It is usually associated with herniated discs that, in the elderly, cause compression of the nerve roots to a narrowing of the channel through which the nerves pass, due to degenerative processes of the spine. ”

Marcon also explains that sciatica can be accompanied by a loss of strength in the paresthesia of the affected limb [formigamento ou queimação do membro, por exemplo]. The doctor assures that in the acute second stage of the crisis, analgesic anti-inflammatory drugs are used to relieve symptoms.

Experts warn that everyone is exposed to this infection, including pregnant women, during pregnancy due to hormonal changes.

Pelvic and lumbar pain can affect pregnant women, because the weight of the abdomen burdens the spine, and can lead to inflammation of the sciatic nerve.


In addition to severe pain in the area from the buttocks to the feet, there may also be tingling, burning, numbness, weakness in the leg or foot, pain in the piriformis muscle, stabbing and shock sensations, and difficulty walking, as the MSD Diagnostic and Treatment Manual describes.

The pain can start in one place and travel to another place, usually along the path of the nerve, and is called radiating pain, according to medical evidence.

As the condition becomes more severe, the inflammation can cause a herniated disc, osteoporosis, and injuries.


And sciatica is not genetic, it is “related to degenerative processes that occur in the spine [tanto a hérnia quanto a estenose do canal no idoso]Orthopedic surgeon Rafael Marcon explains.

Physical therapist Bernardo Sampaio highlights that “the medical specialist or physical therapist should, at the first consultation, carry out the anamnesis [questionário com o paciente] Understand his complaint, signs and symptoms and conduct clinical examinations that prove his condition.”

It also states that, if necessary, an imaging test, such as an MRI, should be ordered to confirm the diagnosis.

Computerized tomography (CT) scans and electrodiagnostic (nerve and muscle) tests help identify abnormalities in the spine that cause sciatica, complements the MSD Handbook.

treatment or treatment

Once a person is diagnosed with sciatica, pain relievers, anti-inflammatories, and physical therapy can be used to relieve the crisis.

In extreme cases, there is a possibility of surgery when standard treatment does not respond to the expected results.

Marcon reiterates that surgery can occur “in root canal stenosis in the elderly or in cases of a herniated disc where pain does not improve after six to eight weeks of treatment or when the patient begins to lose strength gradually. Larger hernias can also, in Rare cases, to loss of sphincter control. [músculos da região anorretal]that characterizes urgency.”

“But only 5% of the proven cases of herniated discs do not improve with conservative treatment and require surgery,” the orthopedic surgeon adds.


Since it is not always possible to avoid sciatica, reducing the risk of its appearance is a positive alternative. Staying active with physical exercise is a good strategy not only for sciatic nerve pain, but also for preventing other conditions.

The physiotherapist advocates “three basic pillars” for those who want to avoid problems of this nature.

“Movement and flexibility, muscle strength and endurance, and motor control. This is of course related to staying active, seeking renewed sleep, hydration and healthy nutrition.”

Marcon also talks about the importance of physical activities. “Physical exercise is a protective factor for the spine, and it can prevent these conditions.”

* Trainee in R7 Under the supervision of Fernando Meles

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