Sciatica (technically known as lumbar radiculopathy) refers to pain in the area of the sciatic nerve, the largest nerve in the body, which is about the width of a finger. If you have sciatica, you will probably experience pain beginning in your lower back and running down your buttocks and legs.Sciatica is usually caused by a protruding disc that presses on the sciatic nerve.
Sciatic pain can be dull, sharp, or burning. You might also experience off-and-on shocks of shooting pain in the low back, thighs, and calves. Your pain might extend below the knee, sometimes all the way to your feet. You might feel weak, numb, or have a pins and needles sensation. Sneezing or coughing may intensify the pain. Typically, sciatica affects just one side of the body.
Sciatica most often results from general wear and tear or sudden pressure on the discs that cushion the vertebrae of the lower spine. A herniated disc may press directly on the nerve roots that lead into the sciatic nerve. The damaged disc can also leak fluid, which may inflame and irritate the nerve. Other less common causes of sciatica include degenerative disc disease, lumbar spinal stenosis, isthmic spondylolisthesis, sacroiliitis, lumbar facet joint syndrome, piriformis syndrome, and iliolumbar syndrome. In rare cases, it can also be caused by an infection or tumor.
To diagnose your condition, we begin by taking your medical history, reviewing your current medications, conducting a physical and neurologic examination, and if needed, by ordering X-rays, magnetic resonance imaging MRI), and a computerized tomography (CT) scan.
We design sciatica treatment to help you manage your pain without long-term use of medications. We may recommend a few days of bed rest during the acute phase, with some light activity such as standing and walking to help reduce inflammation. Applying gentle heat or cold on the painful muscles may help soothe the pain. We may also recommend injecting the spine area with a cortisone-like drug. Physical therapy and short walks may also help.Most of the time, this conservative approach will help you feel better within a few weeks.
If these conservative methods don’t do the trick, we may recommend surgery. Laminotomy is the most common surgical treatment for sciatica caused by a herniated disc. Surgery for disc herniation is almost always an elective quality-of-life decision.