Sciatica is a painful condition caused by the irritation of the sciatic nerve. The sciatic nerve is the longest nerve in our bodies. It begins in the lower back and extends through the buttocks down the back of each leg to the thighs and feet. Sciatica can be acute (short term) lasting a few weeks, or chronic (long term) persisting for more than 3 months.
It is important to understand that most sciatica will resolve itself within a few weeks or months and rarely causes permanent nerve damage.
The sciatic nerve is the longest nerve in the body. Starting in the pelvic area and continuing through the buttock and hip areas down the back of the legs, the sciatic nerve enables you to feel sensation in your lower extremities. It is also responsible for the control of muscle movement in both legs.
Anyone can develop sciatica at some point in their lives; however there are certain risk factors that may predispose you to developing sciatica.
These include the following:
Increasing age causing degenerative changes in the spine is the most common risk factor for sciatica. These changes can cause pressure on the sciatic nerve.
It is important to know sciatica is a symptom not a medical diagnosis.
Some medical conditions that can cause sciatica include:
in the low back area are the most common cause of Sciatica. A herniated disc is a condition caused by a tear in a disc allowing the disc contents to bulge outside of the disc. Sciatica occurs when the disc contents put pressure on the sciatic nerve. Symptoms related to herniated discs in the lumbar region include sharp, continuous back pain, weakness in the legs, and some loss of sensation to the leg and foot.
The most common feature of sciatica is pain. The pain can vary by patient, from mild to debilitating, depending on the degree of pressure to the sciatic nerve.
Common symptoms of sciatica include:
Evaluating the source of sciatic pain is important in determining your treatment options for relief of the pain.
Dr Hsu or Dr Singh will perform the following:
Treatment for sciatica will depend on the cause of the pain and whether the pain is acute (short term) or chronic (long term). The goal of treatment is to alleviate pain and improve mobility.
Acute sciatic pain will usually get better on its own. Treatment guidelines for acute sciatic pain include:
Physical Activity: Continue your normal daily activities as much as possible, avoiding any activities that worsen the pain. Bed rest is not recommended and in fact can make your pain worse.
Over the counter medications: NSAIDS (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen, acetaminophen, can help ease the pain until it resolves.
Ice or heat packs are often used for 20 minute intervals and repeated every 2 hours. Some patients find alternating between heat and ice is helpful.
Exercise: Dr Hsu or Dr Singh may refer you to a Physiotherapist to instruct you on exercises to strengthen your trunk and back muscles. Stretching exercises done passively without jerking movements can also be helpful.
Prescription Medications: Your NSS spinal surgeon may prescribe anti-inflammatory medications such as steroids. For severe pain, you may be prescribed narcotic pain medications, or muscle relaxants.
Epidural Steroid Injections: Injections administered into the spine to deliver anti-inflammatory medications directly to the painful area around the nerve.
Therapeutic Massage by a trained therapist can decrease muscle spasms
Manual Manipulation: Spinal adjustments to straighten the spine can be performed by Chiropractors, Osteopathic Physicians, and appropriated trained Physiotherapists.
Dr Hsu or Dr Singh may consider surgical intervention if your sciatic pain persists for more than a few months, your pain is severe and interferes with your sleep and daily activities or if your pain does not respond to conservative treatment measures as described previously.
Some of the medical diagnoses that may need surgical intervention for sciatic pain include:
All surgical procedures involve risks. The information provided here is for general educational purposes only. For specific advice regarding lumbar spinal stenosis treatment, please book an appointment with one of our surgeons.