Sciatica
At one time or another during their lives, many people will experience the unpleasant effects of sciatica. People between the ages of 30 and 50 are most commonly affected. Signs that you may be afflicted with this syndrome include pain, tingling, weakness, or numbness that radiates from the back into the buttocks or leg—and/or from the neck down the arms. The discomfort from sciatica is often characterized as burning pain, usually only affects one side of your body, and often worsens when you are sitting.
Sciatica itself is a symptom that is caused by a separate health condition. It involves your body’s largest nerve—the sciatic nerve—and when it’s pinched the associated irritation can go a long way. The location and extent of your pain will depend on where your sciatic nerve is pinched.
What Are Some Common Causes of Sciatica Pain?
- Herniated or slipped disc compressing the sciatic nerve (most common cause)
- Scar tissue resulting from injury or surgery
- Piriformis syndrome (spasming of the piriformis muscle deep inside the buttocks)
- Bone spurs on the spine
- Spinal stenosis resulting from the narrowing of your spinal canal
- Spondylolisthesis caused by a slipped and misaligned vertebra
- Obesity
- Poor posture
- Tumor
- Infection/Abscess
- Blood clot
- Nerve disorder
How Is Sciatica Diagnosed?
Sciatica is frequently diagnosed based on your medical history, symptom review, and physical exam. Additional tests can help confirm your diagnosis, and these may include:
- Straight-leg-raise test to pinpoint pinched nerves and assess potential disc issues (as you are lying down, your doctor will raise each of your legs, noting when your pain begins)
- Imaging tests including X-ray, CT scan, or MRI to look for fractures and nerve or tissue damage
- Electromyography to look at how electrical impulses travel through your sciatic nerve
- Myelogram using dye injected between the vertebrae to determine if a vertebra or disc is causing the pain
What Are Sciatica Treatment Options?
In most cases, sciatica is successfully treated and resolved through the use of conservative, nonsurgical treatments, including:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Oral corticosteroids
- Muscle relaxants
- Physical therapy and exercise
- Heat or cold for muscle soreness
- Massage
- Epidural corticosteroid injections
- Ergonomic/positioning modifications:
- Avoid sitting unless standing is even less comfortable
- Alternate lying down with short walks during which you walk a little farther each time as long as you don’t have pain
Surgical Treatment
In rare cases when sciatica has not resolved, surgery might be considered to treat the underlying cause. Available surgeries, performed to relieve nerve pressure and subsequent neurological symptoms, include the following:
- Laminectomy in which the bone that covers the spinal cord is removed along with the tissue encasing the sciatic nerve. Learn more about laminectomy
- Microdiscectomy in which fragments of a herniated disc are removed to relieve nerve compression