Sciatica

The sciatic nerve begins in the lower back and extends through the buttocks, down the back of each leg to the thighs and feet. Sciatica refers to the pain caused by compression or irritation of the sciatic nerve. It typically occurs on one side of the body and can be acute, lasting for a few weeks or chronic, persisting for more than 3 months. In most cases, sciatica resolves within a few weeks or months and rarely causes permanent nerve damage.

Causes

Some medical conditions that can cause sciatica include:

• Herniated disc
• Lumbar spinal stenosis
• Piriformis syndrome
• Spondylolisthesis
• Degenerative disc disease
• Sacroiliac joint dysfunction
• Diabetes
• Tumor
• Trauma

Signs and Symptoms

Sciatica is the pain felt from a compressed sciatic nerve and typically occurs on one side of the body.  The pain can vary from mild to debilitating depending on the degree of pressure exerted on the sciatic nerve.

Patients with a compressed sciatic nerve often experience symptoms such as: 

• Pain in the lower back, buttock area,  and leg
• Sharp, intense, shooting pain down the leg
• Numbness, burning, or tingling sensations in the leg or foot
• Weakness of the leg or foot
• Pain that increases with coughing, sneezing, or straining
• Pain that increases with bending backward and with prolonged sitting or standing

Diagnosis

Your doctor will review your complete medical history and perform a thorough physical examination, along with an assessment of your neuromuscular function. Diagnostic procedures such as X-ray, MRI, discogram, CT scan with myelogram, electromyogram, and nerve conduction tests may also be ordered to determine the cause of the sciatica.

Treatment

Sciatica can be treated with conservative approaches such as physical therapy, exercise,  anti-inflammatory and pain medications, ice or hot packs, epidural steroid injections, back and leg massages, and manual manipulation. 

In some cases, surgery may be recommended to treat the underlying condition causing the sciatica such as a herniated disc, lumbar spinal stenosis, spondylolisthesis, or degenerative disc disease.

Microdiscectomy is the preferred surgery if sciatica is caused due to a lumbar disc herniation. In this procedure, portions of the herniated disc are removed to relieve pressure off the spinal nerve column.

Summary

Sciatica is a painful condition caused due to irritation of the sciatic nerve. Other symptoms include numbness or weakness in the lower back or leg. Sciatica pain may worsen with prolonged sitting, bending, or coughing. Treatment includes physical therapy, medications, hot or cold packs, injections, massages, and in severe cases, surgery. Talk to your specialist to learn more about sciatica and its treatment.