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Brain & Spine Disorders

Sciatica

sciaticaSciatica is low back pain and/or leg pain that usually travels down the large sciatic nerve, from the lower back down the back of each leg.  This pain is generally referred to as sciatica or radiculopathy and is fairly common. This pain can be caused when a nerve root in the lower spine that helps form the sciatic nerve is pinched or irritated.

Sciatica is usually caused by pressure on the sciatic nerve from a herniated disc (also referred to as a ruptured disc, pinched nerve, slipped disk, etc.) in the lumbar spine. The problem is often diagnosed as a "radiculopathy", meaning that a disc has protruded from its normal position in the vertebral column and is putting pressure on the radicular nerve (nerve root) in the lower back, which forms part of the sciatic nerve.

Sciatica occurs most frequently in people between 30 and 50 years of age. Often a particular event or injury does not cause sciatica, but rather it may develop as a result of general wear and tear on the structures of the lower spine. The vast majority of people who experience sciatica get better with time (usually a few weeks or months) and find pain relief with non-surgical treatments.

Symptoms of sciatica pain can vary greatly but usually decreases after a few weeks or months with non-surgical treatment.

Understanding Sciatica
For some people, the pain from sciatica can be severe and debilitating. For others, the pain 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.

One or more of the following sensations may occur as a result of sciatica:
  • 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
  • Low back pain may be present along with the leg pain, but usually the low back pain is less severe than the leg pain
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 two weeks to a few months. Also, because the spinal cord is not present in the lower (lumbar) spine, a herniated disc in this area of the anatomy does not present a danger of paralysis.

Symptoms
Symptoms that may constitute a medical emergency include progressive weakness in the leg or bladder/bowel incontinence. Patients with these symptoms may have cauda equina syndrome and should seek immediate medical attention. In general, patients with complicating factors should contact their doctor if sciatica occurs, including people who have been diagnosed with cancer, take steroid medications, or have unexplained and significant weight loss.

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. Other common causes of sciatica include lumbar spinal stenosis, degenerative disc disease, or isthmic spondylolisthesis.

Sciatica Medical Definition
To clarify medical terminology, the term sciatica (often misspelled as ciatica or siatica) is often used very broadly to describe any form of pain that radiates into the leg. However, this is not technically correct. True sciatica occurs when the sciatic nerve is pinched or irritated and the pain along the sciatic nerve is caused by this nerve (radicular pain). When the pain is referred to the leg from a joint problem (called referred pain), using the term sciatica is not technically correct. This type of referred pain (e.g. from arthritis or other joint problems) is quite common.

Treatment
Sciatica nerve pain 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:
  • Non-surgical sciatica treatments, which may include one or a combination of medical treatments and alternative (non-medical) treatments, and almost always includes some form of exercise and stretching. The goals of non-surgical treatments should include both relief of sciatica pain and prevention of future sciatica problems.
  • Sciatica surgery, such as microdiscectomy or lumbar laminectomy and discectomy, to remove the portion of the disc that is irritating the nerve root. This surgery is designed to help relieve both the pressure and inflammation and may be warranted if the sciatic nerve pain is severe and has not been relieved with appropriate manual or medical treatments.

Low Back Pain

Low Back Pain & Disorders (Lumbar Spine)

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