What is Sciatica?
Sciatica refers to pain that radiates along the path of the sciatic nerve, which is the largest nerve in your body. This nerve starts at your lower back and branches through the hips and buttocks and down each leg.
What are the Symptoms of Sciatica?
The symptoms of sciatica can vary and may include a mild ache to excruciating pain along the path of the sciatic nerve. There may also be numbness, tingling sensations, and/or muscle weakness that stretches from your lower back, down into your lower leg muscles, and even into your foot. Typically, people with sciatica only experience symptoms on one side of the body.
What Causes Sciatica?
Sciatica is caused by anything that puts pressure on the sciatic nerve, such as:
- A herniated disk: Sometimes the gel-like center of a disk in your vertebrate pushes through its outer lining and presses on the sciatic nerve.
- Spinal stenosis: Stenosis is a narrowing of the spinal canal and can squeeze parts of the sciatic nerve.
- Bone spurs: A small piece of adjacent bone may jut out and touch the sciatic nerve.
- Spinal tumors: Although rare, any tumor that grows along the spine can cause sciatica.
- Sacroiliitis: The spot where the lower spine connects to the pelvis is called the sacroiliac joints. If those joints become inflamed, then they can press the sciatic nerve.
- Injury or infection: Other causes of sciatica include muscle inflammation, infection, or injury, such as a fracture.
Who is at Risk for Developing Sciatica?
People who lead sedentary lifestyles are at increased risk of developing sciatica because sitting for long periods of time compresses the spine which may lead to herniated disks. At the other end of the spectrum, extreme athletes are also susceptible to developing sciatica because they’re prone to back injury and muscle inflammation. Sciatica is also quite common in pregnant women due to changes in the body and more weight pressing on the sciatic nerve.
Those age 40 and older are at risk because of age-related degeneration of the spine, which can lead to herniated disks, bone spurs, and joint problems. Being overweight also puts people at risk of developing sciatica.
How is Sciatica Diagnosed?
To diagnose sciatica, your doctor will observe you as you squat, walk on your heels and toes, and perform other muscle tests. Your doctor may also order certain imaging tests to determine the cause of the problem. An MRI will show the alignment of your vertebral disks, as well as the ligaments and muscles around the sciatic nerve. A CT scan can provide a clear picture of your spinal cord and nerves. An x-ray can help identify bone fractures or spurs that may be touching the sciatic nerve.
Keep in mind that your doctor may not order all these tests, but they are all tools that can help him or her reach an accurate diagnosis.
How is Sciatica Treated?
Although the pain may be severe, sciatica can most often be resolved with non-surgical treatments including physical therapy, heat and ice therapy, stretching, and lower back exercises. Oral pain medication may be prescribed, or your doctor may inject medication or steroids directly into your back.
If your pain is due to a herniated disk and does not subside in 4 to 6 weeks, then surgery may be recommended. Surgery may also be called for if the sciatica interferes with bowel function, bladder control, or your ability to walk.
If your sciatica is chronic, then your doctor may recommend transcutaneous nerve stimulators, also known as TENS units. With this form of therapy, small electrodes placed on the body transmit tiny pulses of electricity which interrupt the nervous system’s ability to transmit pain and stimulate the production of endorphins, which are your body’s natural pain killers.
If you’re experiencing pain that’s interfering with your quality of life, then make an appointment to see a pain specialist such as Dr. Mingi Choi of Somerset Orthopedic & Sports Medicine. Dr. Choi has more than 25 years of experience successfully diagnosing and treating those who suffer from chronic pain. He is board-certified by the American Board of Physical Medicine and Rehabilitation and a Fellow of American Academy of Physical Medicine and Rehabilitation.