What is Sciatica?

Sciatica refers to symptoms of scorching or electric jolt-like pain that discharges from the sciatic nerve of the lumbar spine and vibrates down through the backside of either leg.

The largest and longest nerve in the human body, your sciatic nerve extends from L3-L5 of your lower back and serves the muscles of your buttocks, thighs, and calves. Terminating all the way down in your toes, your sciatic nerve also enables sensation in your legs and feet.

Because your sciatic nerve occupies such prime real estate in your lower body, a pinched sciatic nerve can make everyday activities—such as standing, sitting, lifting, or extending the back—extremely uncomfortable.

Sciatic nerve compression can result from a wide range of underlying causes. Common causes of sciatica may include: A bulging, ruptured, or herniated disc in the lumbar spine; Degenerative Disc Disease; piriformis syndrome; spinal stenosis (or narrowing of the spinal canal); or spondylolisthesis (a slipped lumbar vertebra)—among many others!

What are the Symptoms of Sciatica?

General Symptoms:

The hallmark of sciatica is leg pain that radiates down a single leg of the body; however, on rare occasions, both legs may be affected. Sciatica may be characterized as pain that comes and goes. But, moderate to severe cases of sciatica can restrict everyday activities or even require a visit to the emergency room. Symptoms of sciatica include:

  • Unilateral (or one-sided) pain that erupts from the sciatic nerve in the lower back or buttocks and pulsates down through the thigh, calf, foot, or toes.
  • Stinging, electric, or searing pain that travels along the sciatic nerve tract
  • Tingling, weakness, or numbness in the hips, hamstrings, calves, feet, or toes
  • Pain that worsens with sudden movements (e.g. sneezing or coughing) or prolonged inactivity (e.g. lengthy episodes of sitting or standing)
  • Difficulty engaging the foot while walking (also known as foot drop)
  • Emergency Symptoms: Seek emergency medical services if your sciatica is accompanied by progressive weakness or paralysis in the legs; bowel or bladder dysfunction; or unrelenting numbness in the “saddle” region of your buttocks, inner thighs, or groin.

Sciatica itself is a symptom of underlying problem and never appears as a stand-alone condition. For instance: Piriformis syndrome—or irritation of the piriformis muscle in the buttocks—can inflame the adjacent sciatic nerve, thus resulting in the characteristic symptoms of sciatica. Other common causes of sciatica may involve:

Degenerative Disc Disease

Degenerative Disc Disease (DDD) from aging can encourage the formation of bones spurs that protrude painfully into the space occupied by your sciatic nerve. DDD also increases your likelihood of suffering a lumbar herniated disc, which can apply undue pressure to your sciatic nerve, generating white-hot or tingling pain in your lower extremities.

Spinal Stenosis

Lumbar spinal stenosis is the most common cause for back surgery in individuals who are older than 60-years-old. Spinal stenosis—or tapering of the spinal canal which houses the spinal cord—can compress the sciatic nerve at its point of exit from the foramen, a nerve passageway that runs through each vertebra. This condition is also known as foraminal stenosis.

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What are the Treatments for Sciatica?

Non-Surgical Treatments:

Noninvasive solutions to sciatica are normally pursued for at least six months before an individual is considered to be a candidate for spine surgery. Usually, these noninvasive alternatives are highly successful at eliminating sciatic pain. Before your doctor discusses surgical options, he or she may recommend the following:

  • Self-care methods, including bed rest or heat & ice application to the lumbar spine/affected limb
  • A guided regimen of pain relievers, including over-the-counter or prescription-strength drugs, such as muscle relaxers or anti-inflammatory medications
  • Physical therapy to condition the spine, promote lumbar flexibility, and modify improper posture
  • Qualified chiropractic care to manually realign the lumbar spine and reduce your episodes of muscle spasms
  • Alternative therapies, such as acupuncture or neuromuscular massage to alleviate sciatic pain and relax tightened muscles

If conservative pain management techniques fail to remedy your sciatica—or your doctor deems your condition to be an emergency—your physician will assist you to explore surgical options for sciatica relief. Depending upon the precise cause of your sciatica, our board certified surgeon Dr. Frazier may recommend the following surgical techniques:

Lumbar Laminectomy

This minimally invasive surgical procedure involves removing a tiny sliver of the lamina (or backside portion of a lumbar vertebra) to relieve sciatic nerve compression that results from spinal stenosis. This technique optimizes patient recovery times by using only a 1-inch incision to minimize postoperative pain and unnecessary scarring.

Microdiscectomy

A microdiscectomy is a sophisticated solution to sciatica that uses video-assisted technology to visualize and decompress sciatic nerve impingement. Recommended for surgical candidates who suffer from a lumbar herniated disc, microdiscectomy involves extracting ruptured disc material and cleaning debris from the vicinity of irritated nerves.

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