Sciatica
What is Sciatica?
The sciatic nerve, the largest nerve in the body, travels from the lower back through the hips and buttocks, and down each leg. Sciatica (also called lumbar radiculopathy) refers to pain that travels along the path of the sciatic nerve. It is most common in individuals between the ages of 30 and 50 years old.
What are the Symptoms of Sciatica?
Sciatica pain can occur almost anywhere along the nerve pathway. However, it is especially likely to follow from the low back to the buttocks and the back of a thigh or calf. It typically only affects one side of the body. Pain intensity and severity can vary—anywhere from a mild ache to a burning, sharp pain. For some, the pain will feel like an electric shock or jolt. Numbness and weakness are also present in more severe cases.
Since sciatica is caused by pressure on the spine, complications can develop if the pressure is not relieved, including:
- Increased pain
- Herniated or slipped disc
- Loss of feeling or weakness in the affected leg
- Loss of bowel or bladder function
- Permanent nerve damage
What Causes Sciatica?
Sciatica is most likely to occur when a herniated disc or an overgrowth of bone (bone spurs) puts pressure on the sciatic nerve, which leads to pain, inflammation and often times numbness in the affected leg. Other conditions that can cause sciatica include:
- Degenerative disc disease
- Spinal stenosis
- Foraminal stenosis
- Spondylolisthesis
- Osteoarthritis
- Injury
- Pregnancy
In some cases, diseases, including diabetes, can damage the sciatic nerve. In rare instances, a tumor can be the cause of pressure on the nerve.
Risk factors include:
- Age
- Obesity
- Occupation (including those that require twisting the back, such as in dentistry)
- Prolonged sitting
- Nerve disorders
How is Sciatica Diagnosed?
Initially, a doctor will likely perform a physical exam to look for activities that worsen sciatica pain (walking on toes or heels, rising from a squatting position, or lifting the legs while lying down). Other tests can be used to diagnose sciatica including:
- MRIs – these can show herniated discs and pinched nerves
- X-rays – these can show an overgrowth of bone that could be pressing on a nerve
- CT scan
- EMG (electromyography) – to determine how severe a nerve root injury is
What is the Treatment for Sciatica?
Mild sciatic pain can improve with self-care measures such as ice or heat, stretching, and over-the-counter pain medications. In fact, most people with sciatica get better on their own. However, sometimes additional treatment becomes necessary and can include:
- Anti-inflammatories
- Corticosteroids
- Antidepressants
- Anti-seizure medications
- Opioids
- Physical therapy
- Chiropractic care
- Acupuncture
- Steroid injections
In some instances, when these treatments don’t work, and the sciatica is causing severe weakness, pain, and/or loss of bowel or bladder control, surgery will be an option. During surgery, the bone spur or a portion of the herniated disc pressing on the nerve will be removed.
While it’s not always possible to prevent sciatica, certain measures can be taken to protect the back, including exercising regularly, keeping good posture when sitting, and using the body correctly (e.g., lifting with the legs instead of the back).
Sciatica can interfere with an individual’s ability to work or carry out daily tasks. If you have been diagnosed with sciatica and are worried that it may be impeding your ability to continue to safely practice on patients, you should speak with an experienced disability insurance attorney.
These posts are for informative purposes only and should not be used as a substitute for consultation with and diagnosis by a medical professional. If you are experiencing any of the symptoms described above and have yet to consult with a doctor, do not use this resource to self-diagnose. Please contact your doctor immediately and schedule an appointment to be evaluated for your symptoms.
Sources
Mayo Clinic
John Hopkins
Cleveland Clinic
