Sciatica is one of the most common types of pain, yet is also one of the most misunderstood and often gets lumped in with regular back pain. It affects millions of Americans with symptoms ranging in severity from a minor nuisance to debilitating pain.
What is sciatica?
Sciatica refers to the pain that radiates along the path of the sciatic nerve–a nerve that branches from your lower back through the hips and buttocks and down each leg.
What causes sciatica?
Sciatica describes a set of systems of an underlying medical condition. There are a variety of causes that may contribute to the development of sciatic nerve related pain.
Sciatica can occur at any age, but you are most likely to get it between the ages of 30 and 50 years old. For adults under 60, the most common causes are:
- Lumbar herniated disc
- Degenerative disc disease
- Isthmic spondylolisthesis
Thanks to degenerative changes in the spine, the most common causes of sciatica in adults over the age of 60 are lumbar spinal stenosis and degenerative spondylolisthesis.
Other common causes of sciatica include pregnancy, scar tissue, muscle strain and bone fractures. In some cases, it can be prevented with simple lifestyle changes that decrease the chances of development including regular exercise, healthy weight management, and proper posture.
What are the symptoms?
The sciatic nerve is comprised of five nerve roots, and symptoms are generally dictated by which of these nerve roots are agitated or pinched. In some cases, more than one nerve root can be pinched at a time resulting in a mixture of symptoms.
The most common symptoms include:
- A shooting pain anywhere along the sciatic nerve, including the lower back, through the buttock and down the back of either leg
- Numbness in the leg along the nerve
- Tingling (or pins and needles) in the feet or toes
- Weakness in your legs
- Burning sensation in the leg along the nerve
How is sciatica diagnosed?
As with all back conditions, the diagnosis of sciatica begins with a physician conducting a complete patient medical history. Be prepared to explain how your pain started, where it travels and exactly what it feels like.
Through a physical examination, your doctor may be able to pinpoint which nerve root is the source of your sciatica. This may require you to complete a series of physical tasks such as walking on your heels and toes, squatting then rising again, or raising your leg while it is straight.
Diagnostic imaging tests such as an X-ray or MRI scan may be used to confirm your doctor’s diagnosis of which nerve root(s) is affected.
Approximately 80-90% of patients with sciatica get better over time without surgery, often within a period of a few weeks. To help manage your pain during this time, your doctor may recommend or prescribe non-steroidal anti-inflammatory medications such as ibuprofen, or muscle relaxants. In some cases, your doctor may administer a cortisone shot into your spinal area.
Things you can do at home include heat or cold compress to soothe painful muscles, stretching and short walks.
If sciatic pain is debilitating, continues for more than 3 months and isn’t responding to nonsurgical treatment methods, surgery may be recommended. The most common procedure is called a laminectomy, during which a herniated disc may be removed to relieve the pressure on your nerve.
Both non-surgical and surgical patients with sciatica can also benefit from physical therapy and cognitive behavior therapy.
When to seek help
If you experience sudden, severe pain in your low back or leg, numbness or muscle weakness in your leg, if the pain follows a violent injury such a car accident, or you have trouble controlling your bladder or bowels, you should seek medical attention immediately.
Pacific Spine Specialists is one of the top spine surgery practices in the Portland area. Dr. Keenen has built a reputation on accurately diagnosing patients’ spine condition to identify the source of the pain rather than focusing on the treatment of symptoms. If you are suffering from persistent sciatic nerve pain, complete our new patient self-referral form to request an appointment for Dr. Keenen today.