Sciatica is not painful when lying down but painful when standing. Most of the time it is caused by nerve compression caused by lumbar spinal disease. When lying down and resting, the weight of the lumbar spine is reduced. Nerve compression will be significantly relieved, and when standing, the load on the lumbar spine will increase. The symptoms of nerve compression will also be aggravated, so the above situation will occur.

1. The cause of sciatica

Sciatica is a clinical symptom of many diseases. Common diseases that cause sciatica include lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis, piriformis syndrome, etc. Sciatica caused by lumbar disc herniation, lumbar spondylolisthesis, and spinal stenosis is often accompanied by waist pain that worsens when walking or moving. A lumbar MRI or lumbar disc CT examination can confirm the diagnosis and guide the choice of treatment. . Piriformis syndrome causes sciatica, which is manifested as swelling and pain in the lower limbs while walking. It is obvious during activities, but there is no obvious waist pain symptom. There is no obvious abnormality in the lumbar spine MRI examination. During the physical examination, there is often obvious tenderness in the piriformis muscle of the buttocks, and the piriformis muscle tension test is positive.

2. Treatment of Sciatica

The most common cause of sciatica is compression of the sciatic nerve by lumbar disc herniation. The preferred method for sciatica caused by lumbar disc herniation is Conservative treatment requires bed rest. It is very strict and requires the patient to stay in bed as much as possible. Except for eating and going to the toilet, he must lie down on the bed, which can reduce the compression of the lumbar disc on the sciatic nerve. If the effect is not good after being completely bedridden for two weeks, you can go to the hospital for infusion treatment, including nerve nutrition and dehydration treatment. If it still doesn't work, you should take an MRI to see if surgery is needed. Some lumbar discs that severely compress the sciatic nerve can only be solved through surgery. There is another situation, which is peripheral sciatic nerve entrapment, which needs to be confirmed by MRI or B-ultrasound. This situation can only be solved through surgical release, and other treatments are often less effective.

3. Precautions for sciatica

Ask the patient to rest in bed, avoid weight-bearing, and wear a waistband when walking. When patients have severe pain, they can take oral non-steroidal anti-inflammatory drugs for pain relief.