Sciatica

What is Sciatica?
Sciatica is pain along the large sciatic nerve that runs from the lower back down the back of each leg and is a relatively common form of low back pain and leg pain.

What Causes this Pain?
Any condition that causes irritation or impingement on the sciatic nerve can cause the pain associated with sciatica. The most common cause is a lumbar herniated disc (also referred to as a ruptured disc, pinched nerve, slipped disc, etc.). Other common causes of sciatica include lumbar spinal stenosis, degenerative disc disease, or isthmic spondylolisthesis.

While sciatica can be very painful, it is rare that permanent nerve damage (tissue damage) will result. Most sciatica pain syndromes result from inflammation and will get better within a couple weeks to a few months.

Can it get Worse?
For some people, the pain from sciatica can be severe and debilitating. For others, the pain from sciatica might be infrequent and irritating, but has the potential to get worse. Usually, sciatica only affects one side of the lower body and the pain often radiates from the lower back all the way through the back of the thigh and down through the leg. Depending on where the sciatic nerve is affected, the pain may also radiate to the foot or toes.

Symptoms that may constitute a medical emergency include progressive weakness in the legs or bladder/bowel incontinence. Patients with these symptoms may have cauda equina syndrome and should seek immediate medical attention.

Is there any other symptoms I might experience?

  • Pain in the rear or leg that is worse when sitting
  • Burning or tingling down the leg
  • Weakness, numbness or difficulty moving the leg or foot
  • A constant pain on one side of the rear
  • A shooting pain that makes it difficult to stand up

What are the Treatments?
Sciatica is caused by a combination of pressure and inflammation on the nerve root, and treatment is centered on relieving both of these factors. Typical sciatica treatments include:

Manual treatments for sciatica (chiropractic treatments including physical therapy) to help relieve the pressure.
Medical treatments for sciatica (such as NSAID’s, oral steroids, or epidural steroid injections) to help relieve the inflammation.

Surgery for sciatica (such as microdiscectomy or lumbar laminectomy) to help relieve both the pressure and inflammation may be warranted if the sciatic nerve pain is severe and has not been relieved with appropriate manual or medical treatments.