While sciatica is most commonly the result of a herniated disc in the lower back, any inflammation or unusual pressure on the sciatic nerve could be a culprit.
- a burning sensation
- a tingling sensation from the lower back throughout the entire leg
- numbness of the leg
If these symptoms become persistent, it is important to have them addressed early on. At Peachtree Spine, our group of back specialists meticulously examine the patient in order to properly diagnose and treat sciatica. Typically, a well-developed treatment plan will allow the patient to heal without resorting to invasive surgery.
What is Sciatica?
Sciatica is a form of radiculopathy, which simply means that one or more nerves along the spine are being negatively affected in some way and thus not working properly.
The term sciatica refers specifically to lower back pain which can include pain down the leg that is caused by the compression or irritation of spinal nerve roots that are connected to the sciatic nerve, or compression or irritation of the sciatic nerve itself.
The sciatic nerve is actually the longest and widest nerve in the entire human body; it begins in the lower back area and runs through the buttock and down the lower limbs. This is why sciatica, or the pain felt as a result of radiculopathy, can be present in the lower back as well as the legs and feet. In addition to pain, those with sciatica may experience difficulty of motion, numbness and a burning or tingling feeling throughout the lower limbs including the feet and toes.
What Causes Sciatica?
It is important to reinforce the fact that sciatica refers to the type of pain felt, and not the cause of that pain. Sciatica is most often caused by a herniated disc (also referred to as a slipped disc, bulging disc, ruptured disc, protruding disc or pinched nerve) which presses on the sciatic nerve roots.
A normal disc consists of a hard outer wall with a jelly-like center that can push out or “rupture” through the outer wall, forming a “bulge”. This can happen because of injury, but more often is due to general wear over time. The ruptured disc material can irritate the sciatic nerve and cause the pain felt in sciatica. (This is true of lumbar herniated discs; cervical herniated discs on the other hand may cause head and neck pain, as well as arm pain.)
Sciatica can also be felt due to spinal stenosis, a condition in which the spinal canal becomes narrowed and thereby compresses the spinal cord and sciatic nerve roots. This can be caused by herniated discs, spondylolisthesis (a condition where vertebrae slip forward or backward, distorting the spinal canal) or by simple inflammation. There are many other causes of sciatica that can include pregnancy, scar tissue and muscle strain so it is important to determine the direct cause of the pain in order to diagnose one’s condition and provide proper treatment.
What Treatments are used for Sciatica?
Treatments for sciatica include anti-inflammatory medications in addition to epidural steroid injections that deliver medicine into the space between the disc, spinal cord and spinal nerve.
The needle is directed into the epidural space using x-ray imaging whereby a small amount of dye is injected to confirm the placement of the needle. A combination of steroids and local anesthetic is injected directly into the painful area providing relief and allowing the patient to regain movement that may have been lost due to pain as well.
This is especially important as it will allow a patient to perform the back exercises and physical therapy which may also be prescribed to help further alleviate pain and reduce the incidence of future episodes of sciatica.