What is Sciatica?
What is sciatica?
Sciatica is pain in the lower extremity resulting from irritation of the sciatic nerve. The pain of sciatica is typically felt from the low back (lumbar area) to behind the thigh and radiating down below the knee. The sciatic nerve is the largest nerve in the body and begins from nerve roots in the lumbar spinal cord in the low back and extends through the buttock area to send nerve endings down the lower limb. The pain of sciatica is sometimes referred to as sciatic nerve pain.
What causes sciatica?
Sciatica might be a symptom of a "pinched nerve" affecting one or more of the lower spinal nerves. The nerve might be pinched inside or outside of the spinal canal as it passes into the leg.
Conditions that cause sciatica:
- A herniated or slipped disc that causes pressure on a nerve root — This is the most common cause of sciatica.
- Piriformis syndrome — This develops when the piriformis muscle, a small muscle that lies deep in the
buttocks, becomes tight or spasms, which
can put pressure on and irritate the sciatic nerve.
- Spinal stenosis — This condition results from narrowing of the spinal canal with pressure on the nerves.
- Spondylolisthesis — This is a slippage of one vertebra so that it is out of line with the one above it, narrowing
the opening through which the nerve exits
What are sciatica symptoms?
Sciatica causes pain, a burning
sensation, numbness, or tingling radiating from the lower
back and upper buttock down the back of the thigh to the back of the leg.
The result is leg pain. Sometimes the pain radiates around the hip or
buttock to feel like
hip pain. While sciatica is often associated with
lower back pain (lumbago), it can be present without low back pain.
Severe sciatica can make walking difficult if not impossible. Sometimes the
symptoms of sciatica are aggravated by walking or bending at the waist and
relieved by lying down. The pain relief by changing positions can be
partial or complete.
How is sciatica diagnosed?
Sciatica is diagnosed with a physical exam and medical history. The typical symptoms and certain examination maneuvers help the health-care practitioner to diagnose sciatica. Sometimes, X-rays, films, and other tests, such as CT scan, MRI scan, and electromyogram, are used to further define the exact causes of sciatica.
How is sciatica treated?
The goal of treatment is to decrease pain and increase mobility. Treatment most often includes limited rest (on a firm mattress or on the floor), physical therapy, and the use of medicine to treat pain and inflammation. A customized physical therapy exercise program might be developed.
Medicine — Pain medicines and anti-inflammatory drugs help to relieve pain and stiffness, allowing for increased mobility and exercise. There are many common over-the-counter medicines called non-steroidal anti-inflammatory drugs (NSAIDs). Muscle relaxants might be prescribed to relieve the discomfort associated with muscle spasms. However, these medicines might cause confusion in older people. Depending on the level of pain, prescription pain medicines might be used in the initial period of treatment.
Physical therapy —The goal of physical therapy is to find exercise movements that decrease sciatic pain by reducing pressure on the nerve. A program of exercise often includes stretching exercises to improve flexibility of tight muscles and aerobic exercise, such as walking.
The therapist might also recommend exercises to strengthen the muscles of your back, abdomen, and legs.
Spinal injections — An injection of a cortisone-like anti-inflammatory medicine into the lower back might help reduce swelling and inflammation of the nerve roots, allowing for increased mobility.
Surgery — Surgery might be needed for people who do not respond to conservative treatment, who have progressing symptoms, and are experiencing severe pain.
Surgical options include:
- Microdiscectomy — This is a procedure used to remove fragments of a herniated disc.
- Laminectomy — The bone that curves around and covers the spinal cord (lamina), and the tissue that is causing pressure on the sciatic nerve are removed.
Many people believe that yoga or acupuncture can improve sciatica. Massage might help muscle spasms that often occur along with sciatica. Biofeedback is an option to help manage pain and relieve stress, which can affect your ability to cope with pain. These are referred to as alternative therapies.
What complications are associated with sciatica?
Chronic (ongoing and lasting) pain is a complication of untreated sciatica. If the "pinched nerve" is seriously injured, chronic muscle weakness, such as a "drop foot," might occur.
What is the outlook for people with sciatica?
Sciatic pain usually goes away with time and rest. Most people with sciatica (80 percent to 90 percent) will get better without surgery. About half of affected individuals recover from an episode within six weeks.
Can sciatica be prevented?
Some sources of sciatica are not preventable, such as degenerative disc disease, back strain due to pregnancy, and accidental falls.
Although it might not be possible to prevent all cases of sciatica, you can take steps to protect your back and reduce your risk.
- Practice proper lifting techniques. Lift with your back straight, bringing yourself up with your hips and legs, and holding the object close to your chest. Use this technique for lifting everything, no matter how light.
- Avoid/ stop cigarette smoking, which promotes disc degeneration.
- Exercise regularly to strengthen the muscles of your back and abdomen, which work to support your spine.
- Use good posture when sitting, standing, and sleeping. Good posture helps to relieve the pressure on your lower back.
- Avoid sitting for long periods.
If you are suffering from sciatica or joint pain, please contact our office immediately to schedule an evaluation.
Dallas Orthopedics Institute
9330 Poppy Drive
Dallas , TX 75218