Sciatica is pain caused by a medical problem in or around the sciatic nerve. Because the Sciatic Nerve runs from the lower back down into each leg, we may refer the associated pain. While lower back pain is the most common symptom of sciatica, you may also feel pain in your hips, buttocks or legs, often on a specific side of the body.
The Sciatic Nerve is the combination of five nerve roots, two from the lumbar spine and three from the sacral segment. Bundled together to form the Sciatic Nerve, these nerves branch out again in the leg to carry motor and sensory messages to specific areas of the leg and the foot.
Sciatica pain typically comes on suddenly but may last for days, even weeks. The primary symptom is a sharp pain in or around the lower back, similar to a cramp, that radiates down into one leg. This is why Sciatica is sometimes referred to as “Radiating Leg Pain.”
In addition to the pain, sciatica may also cause tingling or numbness in the buttocks or legs. You may wake up one morning in too much pain to get out of bed. Or, you may be sitting in your favorite chair, and find it difficult to stand, due to pain, tingling or weakness on one side of your body, from the lower back to toes, or anywhere in between.
If you cough or sneeze, and you feel a sharp, radiating pain in your lower back, buttocks or leg, that could also be a sign of Sciatic Nerve trouble.
Specific Indicators of Sciatica
● Consistent, sharp, searing pain in the lower back, buttock or leg, usually on one side
● Severe, shooting pain that makes it difficult to stand
● Radiating pain
● Pain that dissipates when lying down or walking, but worsens when standing or sitting
● Tingling “pins and needles” feeling in one leg
● Weakness or numbness in a leg or foot
Different combination of symptoms or the location of symptoms may indicate certain, definitive causes of your Sciatic Nerve pain.
Causes of Sciatic Nerve Pain
Sciatica is most common in people between the ages of 30 and 50, but that doesn’t mean people outside that age bracket can’t be affected.
Sciatica may be the result of a traumatic injury or poorly healed damage from a previous injury. And it may be the result of simply lifting, bending or twisting improperly. Pregnant women may be at higher risk because the developing uterus presses on the Sciatic Nerve.
In addition to these risk factors, there are several other causes of Sciatic Nerve Pain, including:
● Isthmic Spondylolisthesis - small stress fracture that allows one vertebra to slip onto another
You may have read that nearly 90 percent of all people diagnosed with Sciatica recover successfully without surgery. While there is some truth to that statement, it doesn’t mean these symptoms “definitely” will go away, or even that they “probably” will go away on their own.
Because the symptoms of Sciatica are similar to so many different back or lower body issues, it’s always best to seek a proper medical diagnosis before assuming your symptoms will disappear on their own. While that could possibly be the case for some people, because these symptoms could be related to a progressive degenerative medical condition, we caution against taking the risk of ignoring symptoms.
During your initial visit with Dr. Skaliy, he will begin with a few questions about your medical history as well as when, where and how your first noticed the pain or other symptoms. He will then conduct a physical examination to determine the location, level and extent of your symptoms. Depending on the location and extent of your symptoms, Dr. Skaliy may recommend diagnostic imaging tests including X-rays, MRIs or a CT scan to determine the precise cause of your symptoms.
If you can catch Sciatica-related symptoms early, there are several steps you can take, at home, to halt or delay further progression of the conditions causing the symptoms.
● Daily stretching may relieve mild sciatica pain and prevent further symptoms
● Regular, low-impact exercise will strengthen muscles and other connective tissue
● Practicing proper posture
● Lifting properly
● Practicing proper form when playing sports or engaging in other physical activity
● If overweight, losing weight can lessen the strain on joints and muscles that may lead to Sciatica
To relieve pain and inflammation related to sciatica, you may apply ice and/or heat to the affected area. Ice will reduce inflammation, and heat will elevate blood flow. To avoid burns, do not place ice packs or heating pads directly on the skin. In addition, over-the-counter pain medications or NSAIDs (non-steroidal anti-inflammatory drugs) may help relieve symptoms.
What About Surgery For Sciatica?
One of the most difficult challenges for people suffering with Sciatic Nerve pain is the immediate and long-term impact it can have on your life. Sometimes, Sciatica will not go away on its own, and, sometimes, it comes back without warning. In these instances, the pain may be debilitating and have a severe negative impact on your life. In cases such as these, some physicians will recommend surgical intervention.
Typically, two different surgeries are considered, depending on the cause, location and duration of the Sciatic Nerve pain.
● Microdiscectomy — a common surgical approach to relieve Sciatica due to lumbar disc herniation. The surgeon removes the portion of the disc, pinching the nerve.
● Lumbar Laminectomy — generally recommended surgical intervention for those suffering from Sciatica related to Spinal Stenosis. Surgeons remove bone and/or disc material pinching the nerve root.
While these surgeries do offer a reasonable success rate, patients considering surgery should be advised that all surgical intervention comes with inherent risks, including but not limited to infection, blood clots and residual pain. Because of the risks associated with surgery, Dr. Skaliy recommends minimally invasive treatments for symptoms related to Sciatica.
Minimally Invasive Treatments For Sciatica
Epidural Steroid Injections - These injections, a combination of anesthetic and anti-inflammatory medications, are often effective in reducing pain short term.
Spinal Cord Stimulation (SCS) - Also called epidural nerve stimulation (ENS), is a minimally invasive procedure offering proven relief to patients experiencing chronic pain.
To learn more about the treatments for your Sciatica related symptoms, click here to make an appointment with Dr. Skaliy today.