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What is Sciatica?
Sciatica refers to pain — and possibly numbness, tingling, and weakness — that originates in the lower back and travels through the buttock and down the large sciatic nerve located in the back of each leg. Your sciatic nerve and its branches allow you to control the muscles in your lower legs and the back of your knees, while also providing feeling in the soles of your feet, the back of your thighs and certain portions of your lower legs. When one or more of these nerve roots is compressed, you may feel pain, numbness and weakness in these areas.
What are the symptoms of Sciatica ?
In its classic form, the pain of sciatica follows the course of your sciatic nerve and extends from your lower back through your buttocks to the rear of your upper legs. For some people, the sensation is similar to a mild leg cramp; however, unlike a leg cramp, the pain lingers for weeks at a time. For others, the pain is more severe and feels like an electric shock or a burning sensation. Sciatica-related pain often grows worse at night, directly after you sit or stand, walk for any substantial distance, or bend your body at the waist.
More about Sciatica
Are you suffering from sharp, shooting pain that radiates down the back of your leg, possibly even reaching the toes? Do you experience a deep ache or burning sensation in the hip, buttock, or thigh area? Does this pain interfere with sitting, standing, or walking at times? Do you have a history of lower back pain or other back problems? If so, you may have sciatica.
In order to better understand sciatica, it’s helpful to review some basic human anatomy; particularly that of the spine and nervous system. The nervous system consists of the brain, spinal cord, and the peripheral nerves. The spinal cord attaches to the base of the brain and extends down the back of the body, encased in the protective vertebrae of the spine. The nerves that branch off of the spinal cord supply the body with sensation, assist the muscles with movement, and promote communication between the brain and the rest of the body.
The sciatic nerve may become irritated if a vertebra slips out of place, otherwise known as spondylolisthesis. Also, a tiny muscle deep within the buttocks, the piriformis muscle, can spasm. As a result, sciatic nerve irritation and compression occurs.
Because of age-related degenerative changes that occur in the spine, individuals over 60 are at increased risk of developing sciatica. Also, added pressure on the sciatic nerve may occur during pregnancy or in individuals who are obese. Occupations that involved frequent twisting, turning, and heavy lifting place an individual at higher risk for developing back problems, which in turn, may produce sciatic pain. Conversely, people who spend long hours sitting are also at increased risk for sciatica.
What are the causes of Sciatica?
You can develop sciatica if a spinal disc in your lower back tears, bulges, or herniates, compressing the root of the sciatic nerve. Sciatica can also be caused by an abnormal narrowing of your spinal column, called stenosis. Other potential causes of sciatica include spondylolisthesis, a condition that develops when one or more spinal bones slips out of place.
What is the treatment like for Sciatica?
Most physicians will first recommend a conservative approach, such as hot/cold compresses, medication, exercise or physical therapy. They could also recommend epidural steroid injections (ESI), selective nerve root block injections (SNRB), or a combination of the two. These injections are usually performed in a series of three: a physician injects an anti-inflammatory, typically a mix of steroid and local anesthetic, into the problem area. If symptoms persist, a minimally invasive procedure might be an option for long term relief.
If the source of your sciatica is a bulging/herniated disc, you may be a candidate for a minimally invasive laser spine procedure. For more severe herniation, a minimally invasive discectomy may be performed. If stenosis, bone spurs or spondylolisthesis is the source of your sciatica, a minimally invasive spine surgery such as laminectomy/laminotomy, or fusion might be an option to relieve your symptoms.
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