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Sciatica

Sciatica

Sciatica is the name given to describe a particular kind of leg pain that starts from the buttocks and travels downwards towards the leg and foot area. It is caused by either direct compression of the sciatic nerve, which is the largest nerve of the human body or due to compression of one of the nerve roots that leave the spinal column and join to form the sciatic nerve.

It is commonly perceived as :

  • Pain starting from the lower back and the buttocks and then going through the thighs to the back and outer sides of the leg and foot. Some patients have a very specific distribution of pain that corresponds to the specific nerve root involved eg pain along the outer part of the leg can be due to L5 nerve root.
  • Numbness, burning sensation or a feeling of pins and needles in the leg or foot.
  • Weakness of leg or foot muscles.
  • Pain that increases with walking for long durations or with prolonged sitting.

Common causes of sciatica are

  • Degenerative disc disease (Black disc) : It is a condition in which due to ongoing wear and tear, the disc looses its cushioning effect and becomes more prone to injury thereby causing some irritation of the nerve roots while they leave the spine and later join to form the sciatic nerve.
  • Herniated disc (Slip Disc) : It is a condition in which the outer layer of the disc is injured and causes the inner gelatinous portion of the disc to leak out and cause irritation of the nerve roots causing pain along the distribution of the nerve.
  • Lumbar Spinal (Canal) stenosis : It is a condition in which the space for the spinal cord and the nerves exiting the spine gets narrowed thereby causing irritation of the nerves. It is commonly age related and caused by height loss of discs with bulging (degeneration), thickening of ligaments around the spinal cord and arthritic changes in the small joints of the back (facet joints).
  • Spondylolisthesis (Instability of spine) : It is condition in which due to degeneration of discs and arthritis of the small joints of the back (facet joints) one vertebra slips onto the lower vertebra in the lumbar spine causing stretching or compression of the nerves coming out from the spine.
  • Trauma : Injury to sciatic nerve can happen due to road accidents, fall from heights, injections or even tumors around the spine.

Diagnosis

Before treating a condition it is very important to diagnose the condition correctly to get maximum benefit from the treatment. Your doctor on the basis of clinical examination and certain tests like X-rays, CT Scan, MRI scan or Electromyogram and Nerve Conduction studies (EMG/NCV) can come to the conclusion on what is the cause of sciatica.

Treatment

In most people this symptom tends to resolve on its own with time or with some basic conservative therapy like exercises or physical therapy, activity modification and some medicines.

For others in whom;
Sciatic pain persists for more than a few months; Is severe and interferes with sleep and daily activities; Does not respond to conservative treatment measures as described previously;

Your doctor might advice spinal injections or even surgery based on the specific reason causing that symptom and the benefits you could expect after the procedure.