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Sciatica

Sciatica

WHAT IS SCIATICA?

Sciatica isn’t a condition; it’s a type of nerve pain that develops when the sciatic nerve in the lumbar spine is pinched, compressed, inflamed or irritated. The sciatic nerve (which is actually formed by a combination of 5 lumbar spine and sacrum nerve roots) is the longest and widest nerve in the human body. It begins in the low back, then branches down each buttock, leg and foot. It controls many motor functions and sensations in the hips, thighs, legs and feet. 

Sciatic pain can be felt at any point along the nerve’s path down the body. Sciatic can be acute and resolve within a few weeks, or cause chronic pain and discomfort. Even if you develop sciatica that resolves, it may recur.

CAUSES AND RISK FACTORS

Sciatic pain develops when the sciatic nerve is compressed, pinched, irritated or inflamed. The sciatic nerve can become pinched or compressed from an injury or damage to the surrounding joints, vertebrae or spinal discs. Common conditions that cause sciatica include: 

  • A bulging or herniated spinal disc
  • Spinal stenosis (narrowing of the space within the spine)
  • Degenerative disc disease
  • Bone spurs
  • Osteoarthritis
  • Spondylolisthesis
  • Traumatic lumbar spine injury (ex.: falls, car accidents)

The biggest risk factor for developing sciatica is age. Aging causes normal wear and tear to the spine, which leads to injuries and damage that put the spinal nerves at risk of compression and irritation. Other risk factors include obesity, a sedentary lifestyle, poor posture and body positioning, a physically demanding job that requires a lot of lifting and bending, and a history of back injuries. 

SYMPTOMS

Sciatica is characterized by one-sided pain that radiates down the low back, buttock, thigh and calf. In some cases, sciatic pain travels all the way to the foot. The type of pain varies from person to person: it can feel like a deep ache, sharp, shooting or burning. It rarely affects both sides of the body. 

Other symptoms you may experience include:

  • Weakness in the buttock, thigh, back of the leg or foot
  • Numbness or tingling in the buttock, thigh, back of the leg or foot
  • Pain that worsens with prolonged sitting or standing
  • Pain that worsens with a sudden movement like coughing or sneezing

Sciatic pain can range in severity from mild and irritating to severe and debilitating. It may remain constant or come and go in flare-ups. It all depends on what’s causing compression or irritation of the nerve.

TREATMENT AND PREVENTION

Sciatica can be difficult to diagnose because the symptoms mimic those of multiple back and spine injuries. To make an accurate diagnosis, your doctor will take your medical history and perform a physical exam. During the exam, he or she will ask you to do certain activities and exercises to determine the origin and severity of your pain. Your doctor may also order imaging tests to look for herniated discs, bone spurs, spinal canal narrowing, arthritis or other injuries that may be causing sciatic nerve compression.

Acute sciatica usually resolves within a few weeks with conservative measures. Treatments can include:

  • Medications. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen and naproxen can relieve pain and inflammation. If you’re unable to take NSAIDs, a painkiller like acetaminophen can relieve pain. For severe pain, your doctor may prescribe stronger medications or muscle relaxants.
  • Ice and heat. Use cold packs on the affected area for up to 20 minutes multiple times a day to reduce pain and inflammation. After a few days, switch to hot packs to soothe irritated areas. You can alternate between hot and cold packs if you continue to experience pain.
  • Stretching. Your doctor may recommend specific stretching and low back exercises that help reduce pressure on the sciatic nerve and relieve pain.
  • Physical therapy. If at-home exercises and stretching aren’t enough, your doctor may recommend physical therapy. A physical therapist can help you strengthen back and core muscles, improve posture, and increase flexibility, balance and tolerance. 
  • Staying active. While it may sound tempting to rest when you’re in pain, prolonged sitting and inactivity will make symptoms worse. Staying as active as you can will reduce pain, inflammation and irritation. 
  • Injections. A corticosteroid injection directly into the spine can reduce inflammation, irritation and pain around the compressed nerve root. The effects of an injection are temporary, but it will buy you time to work on strengthening your back, core and leg muscles.

If you have sciatic pain that lasts longer than a few months, or continues to worsen even with conservative treatment, you may need to consider surgery. 

SURGICAL OPTIONS

Surgery is a treatment option if you’re experiencing the following:

  • Progressive pain 
  • Pain that isn’t relieved by medicines or at-home care
  • Pain the makes it difficult to walk, stand or sit
  • Leg and foot weakness
  • Loss of bowel and bladder control

The type of surgery you’ll need will depend on the underlying cause of your sciatica. In many cases, surgery is performed to remove part of a herniated disc or vertebral bone that’s placing pressure on the sciatic nerve. 

CONTACT INTEGRITY SPINE AND ORTHOPEDICS TO LEARN MORE ABOUT THE CONDITIONS WE TREAT

At Integrity Spine and Orthopedics, we specialize in identifying, diagnosing and treating a wide range of acute and chronic back, spine and joint conditions. Our board-certified orthopedic surgeons specialize in performing minimally invasive spine surgeries to reduce pain and improve mobility for patients diagnosed with spinal arthritis, degenerative disc disease, bulging or herniated discs, a pinched nerve, spinal stenosis and more. 

Some of the primary benefits of minimally invasive surgery include:

  • Smaller incisions
  • Fewer complications and bloss loss during surgery
  • Less damage to surrounding muscle and soft tissues
  • Lower risk of infection
  • Less post-op pain and less reliance on strong pain medications during recovery
  • Faster recovery and rehabilitation
  • Better cosmetic results with minimal scarring 

If you’re experiencing back or joint pain, weakness, or a loss of mobility, reach out to us today to schedule a consultation with our team. We provide compassionate and comprehensive care to help you find relief from pain and get back to doing the activities you love.

Call us at 904-456-0017 or contact us online to request an appointment.