What is Sciatica?
Sciatica, is a term used to describe pain along the course of the Sciatic Nerve, which runs from your lumbar spine down each leg before branching into smaller nerves that actually innervate each of your legs. It results from irritation of the Sciatic Nerve, most commonly caused by compression of the nerve root. This disorder is a very common problem and can be treated with surgical and nonsurgical interventions.
Symptoms
Common symptoms are often described as:
- Pain – radiating from the lumbar spine into the buttocks and down the back of your legs
- Tingling
- Numbness
- Weakness
People will present with different symptoms depending on what branch of the sciatic nerve gets compressed or irritated. There might be one specific symptom, or multiple symptoms throughout the course of Sciatic nerve.
Possible causes for symptoms include:
- Herniated disc
- Spinal stenosis
- Degenerative disc disease
- Tumor pressing on sciatic nerve (rare)
Another possible cause of Sciatica symptoms is a result of Spinal Stenosis – narrowing of the spinal canal that can occur in some people (mostly older individuals) who have arthritis or a worn-out spine associated with degenerative disc disease.
When to See a Doctor
Mild sciatica may resolve on its own over a period of time. Cases of persistent, worsening symptoms may require specialized treatment by a neurologist.
You should seek immediate medical care if you experience:
- Sudden pain, numbness or weakness after a traumatic injury
- Severe numbness or weakness in your legs
- Lose control of your bowel or bladder
Diagnosis
Diagnosis begins with a thorough history and physical examination. Our team of neurosurgeons may examine your sciatic nerve by testing skin sensation on either side of your outer thigh. If your symptoms are a result of a compressed or irritated Sciatic nerve, you will feel reduced sensation or no sensation at all, in the areas innervated by this sciatic nerve branch.
Diagnostic tests for Sciatica include:
- MRI or CT Scan – Imaging that can show both soft tissue as well as bony structures of your pelvis and lumbar spine. This testing allows the neurosurgeons to see what is happening inside the Sciatic nerve, Sciatic foramen and Sciatic canal.
- X-Ray – Used to eliminate the possibility of compression fractures or bone tumors pressing against Sciatic nerve and sciatic foramen.
- Sciatic Nerve Block – An injection of anesthetic into the affected area to help differentiate Sciatica from other conditions.
Treatment
Symptoms can be treated in a variety of ways and treatment will depend on what is causing the sciatic nerve itself to become compressed or irritated. Sciatica back pain, leg pain, and neuropathy in the lower extremities may remain even after compression of sciatic nerve root or sciatic nerve itself is relieved. This is a result of the scar tissue formation and inflammation. Our neurosurgeons will work with you to outline the best course of treatment.
Initial Sciatica treatment options include:
- Anti-inflammatory drugs
- NSAIDs
- Physical therapy
- Therapeutic injections
- Neurosurgery