Sciatica

Sciatica is a catchall term for symptoms brought on by compression of the sciatic nerve. Spine disorders such as herniated disc or spinal stenosis are what cause compression of the nerve. Understanding this is important, because management of your condition may involve surgical correction of the underlying disorder, as well as non-surgical treatment to alleviate symptoms.

The sciatic nerve is the largest nerve in the human body. It starts in the lower back and travels downward behind the hip, through the buttocks, and along the back of each leg. When the sciatic nerve is irritated or compressed, numbness, burning, and/or tingling sensations travel along the nerve pathways, causing considerable discomfort and sometimes affecting movement. Approximately 40 percent of adults experience this painful condition during their lifetime. Typically, sciatica affects only one side of the body.

Depending upon the underlying disorder and degree of nerve compression, symptoms can range from mild to severe. Certain activities may make the pain worse, or the pain may only become noticeable after sitting or standing for long periods of time.

 

Symptoms

  • Pain; dull ache to sharp or excruciating
  • Electric shock-like pain
  • Burning, numbness, tingling, or pins-and-needles sensation
  • Muscle weakness
  • Loss of bowel and/or bladder control* (uncommon)

*Loss of bowel and/or bladder control may be a symptom of cauda equina syndrome, a serious medical condition. If control is lost, seek medical care immediately.

 

Causes

Certain spine disorders or medical conditions can put pressure on the sciatic nerve and/or pinch the nerve roots, including:

  • Herniated disc
  • Lumbar spinal stenosis
  • Spondylolisthesis
  • Diabetic peripheral neuropathy
  • Spinal tumors
  • Muscle strain
  • Trauma

In some cases, no cause for sciatica can be found, although there is evidence to suggest that a sedentary lifestyle, long-term use of tobacco, or alcohol abuse may contribute to its development.

 

Accurate Diagnosis Essential

Doctor Frazier carefully analyzes your written medical history and opens up discussion by asking you many questions about your symptoms, when symptoms started, treatments tried, hereditary disorders, existing conditions, and lifestyle.

During the physical and neurological examinations, Dr. Frazier evaluates movement limitations and the location of your pain.  He reviews possible loss of feeling and/or abnormal sensations such as numbness or tingling.

Diagnostic tests may be necessary to reveal more information about your symptoms and to confirm your diagnosis.  To ensure the most accurate diagnosis, Dr. Frazier has access to a complete range of advanced diagnostic equipment including high-speed Magnetic Resonance Imaging (MRI), Computerized Tomography (CT scan), bone densitometry (DEXA), myelography, and discography.

 

Non-surgical Treatment

Many patients respond well to conservative treatment and symptoms resolve within 6-8 weeks. Surgery is seldom required. Treatment may include:

  • Short-term rest
  • Cold or heat therapy
  • Physical therapy
  • Over-the-counter or prescription pain medication
  • Anti-inflammatory medication
  • Epidural injections
  • Acupuncture

 

Surgical Treatment

In the presence of neurological deficit, cauda equina syndrome (i.e. loss of bowel and/or bladder control), or other spinal disorder, surgery may be recommended. Dr. Frazier discusses his findings with you and explains treatment options specific to your diagnosis.

The good news is that most patients with sciatica respond well to non-surgical treatment. Dr. Frazier and his staff are committed to educating you about your condition and providing support to help you recover, minimize risk factors, and stay healthy.