What is Sciatica?
Sciatica (pronounced sigh-at-eh-kah) has quickly gained infamy as a very common condition, affecting over 3 million people per year in the United States. However, by understanding the various symptoms and causes of sciatica, as well as the available treatments, you can make confident and knowledgeable decisions about this generally manageable complication.
The sciatic nerve runs from the lower region of the spine down the back of each leg. As the longest nerve in the body, the sciatic nerve provides sensation to the backs of the thighs, parts of the legs and the feet. Additionally, it controls the muscles around the backs of the knees and the lower legs. When the sciatic nerve is pressured or damaged in any way, sciatica occurs. Pain can vary widely, sometimes appearing as a light tingling, a dull aching or even a burning feeling known as lumbar radiculopathy. Rarely, the pain can become so severe that a patient is immobilized. Other symptoms include, but are not limited to:
- Lower back pain
- Pain in the rear or leg that intensifies when standing or sitting
- Hip pain
- Weakness, numbness or difficulty moving the leg or foot
- A constant pain on one side of the rear
- Sensations that make it difficult to stand from a sitting position
- A “pins-and-needles” feeling
Pain located in one side of the body and not in the other is usually a good indicator of sciatica as each sciatic nerve operates independently of the other. Some distinct symptoms, such as pain bending the body forward or backward, may appear depending on the origin of your sciatica.
The underlying causes can be as various as its symptoms. However, some of the most common instigators are:
- Degenerative disc disease
As discs in the spine age, they begin to show wear and tear. This process can be accelerated by other factors and may cause sciatica as your spinal makeup begins to change.
- Herniated disc
Also known as a “slipped” or ruptured disc, a herniation occurs when a tear in the disc’s hard outer layer, known as the annulus, allows the inner liquid-like nucleus to leak into the spinal canal. Pressure results and, if located near the sciatic nerve, can lead to sciatica. Herniated discs usually happen because of strenuous labor or everyday tasks that are physically straining.
- Spinal stenosis
Sciatica may be caused by spinal stenosis, or the narrowing of the spinal canal. When spinal stenosis occurs, tension is placed on the spinal cord and may irritate and strain local nerves.
- Piriformis syndrome
The slim piriformis muscle is located in the buttocks, near the hip joint, and helps people move their thighs, maintain balance and walk. The sciatic nerve travels closely to this muscle and can easily become pressed or irritated when the piriformis spasms or contracts. Runners and other athletes are especially susceptible to this type of trigger.
Occasionally, a vertebra in the spine can slip forward and slide over the bone beneath it. This condition is known as spondylolisthesis and is most common in the lower back, where straining nearby nerves can cause sciatica.
- Sudden injury or accident
Some unexpected traumatic events, such as a car accident, can lead to sciatica. Injuries sustained and new scar tissue can place stress on the sciatic nerve.
During pregnancy, pain in the back of the thighs spurred by shifts in the pelvic region can be misdiagnosed as sciatica. However, there are situations in which the sciatic nerve is actually being pressed as a result of these changes. Speak to your doctor if you think you are suffering from sciatica or pelvic groin pain.
Rarely, an infection in the spine may cause sciatica.
- Other health issues, such as tumors
Growths and related health issues may irritate the sciatic nerve and lead to chronic sciatica.
Symptoms often include:
- Mild tingling sensations throughout the leg, calf or foot
- Dull, aching pain throughout the leg, calf or foot
- Burning sensations, known as lumbar radiculopathy
- Sharp pain in parts in the leg or hip
- Weakness and numbness in the affected leg
Sciatica Non-Surgical Treatment Options
How you address sciatica depends largely upon the root cause. Luckily, there are many methods that may lessen the pain of sciatica or remove it entirely. Many treatment plans involve one or more of the following:
- Physical therapy and massage therapy
Strengthening exercises, aerobic conditioning and targeted massage provide remedies to many men and women suffering from sciatica. Empowering the spinal column and abdominal core as well as related muscles, ligaments and tendons through purposeful exercise can reduce pressure on the sciatic nerve. Massages from licensed professionals may relieve tension and reduce inflammation.
- Anti-inflammatory medications
Some anti-inflammatory medications may help mitigate the pain and severity of sciatica, but be sure to discuss all potential pharmaceuticals with your doctor before using them. Failing to do so may result in an even worse case of sciatica or other serious consequences.
- Lifestyle changes
Altering your behavior and environment in certain ways can help the body deal with sciatica and may keep your condition from worsening. Drink lots of water and eat a diet high in healthy proteins and Omega 3 fatty acids, which have anti-inflammatory properties. Avoid prolonged periods of bed rest, as they tighten your muscles and can lead to even greater irritation. Maintain proper posture and stretch regularly. Do not smoke, as doing so can heighten your risk for disc degeneration and sciatica relapses.
- Epidural steroid injections
Epidural steroid injections (ESIs) can significantly reduce pain and will likely be used in tandem with a rehabilitation program to treat sciatica. Although ESIs provide only temporary relief, some people who have acute sciatic episodes may find them beneficial until a more permanent solution is reached.
Sciatica Surgical Treatment Options
If conservative treatments do not ease your sciatica-related pains, you may consider undergoing minimally invasive surgery. Minimally invasive procedures focus on removing the condition instead of only treating the symptoms. These approaches also prioritize extremely small incisions and shortened recovery times.
Common minimally invasive surgeries are:
During a discectomy, an expert removes herniated disc material that is pressing on the sciatic nerve.
A microdiscectomy or microdecompression involves removing fragments of intervertebral discs that have broken away and are pressing on the sciatic nerve or spinal cord. Microdiscectomies may also extract bulging or protruding disc material that is causing sciatica.
Sometimes, a portion of the vertebral bone called the lamina can be ousted to curtail sciatica.
At Laser Spine & Orthopedics®, our team of expert physicians can work with you to develop a sciatica treatment plan that fits your unique needs and preferences. With state-of-the-art facilities and advanced techniques, our highly trained spine experts are dedicated to helping you find pain relief and reach long-term solutions that will give you back your quality of life.
Get in touch today by filling out the ‘Contact a Spine Specialist’ form on this page or visiting one of our nearby locations.