SCIATICA

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Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body.

Sciatica most commonly occurs when a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses part of the nerve. This causes inflammation, pain and often some numbness in the affected leg.

Although the pain associated with sciatica can be severe, most cases resolve with non-operative treatments in a few weeks. People who have severe sciatica that's associated with significant leg weakness or bowel or bladder changes might be candidates for surgery.

SPINE ANATOMY

DISEASE EXPLAINED

SYMPTOMS

Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg is the hallmark of sciatica. You might feel the discomfort almost anywhere along the nerve pathway, but it's especially likely to follow a path from your low back to your buttock and the back of your thigh and calf.

The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating pain. Sometimes it can feel like a jolt or electric shock. It can be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms. Usually only one side of your body is affected.

Some people also have numbness, tingling or muscle weakness in the affected leg or foot. You might have pain in one part of your leg and numbness in another part.

CAUSES

Sciatica occurs when the sciatic nerve becomes pinched, usually by a herniated disk in your spine or by an overgrowth of bone (bone spur) on your vertebrae. More rarely, the nerve can be compressed by a tumor or damaged by a disease such as diabetes.

TREATMENT

TREATMENT OPTIONS

If your pain doesn't improve with self-care measures, your doctor might suggest some of the following treatments.

MEDICATIONS
The types of drugs that might be prescribed for sciatica pain include:

Anti-inflammatories

Muscle relaxants

Narcotics

Tricyclic antidepressants

Anti-seizure medications

PHYSICAL THERAPY
Once your acute pain improves, your doctor or a physical therapist can design a rehabilitation program to help you prevent future injuries. This typically includes exercises to correct your posture, strengthen the muscles supporting your back and improve your flexibility.

STEROID INJECTIONS
In some cases, your doctor might recommend injection of a corticosteroid medication into the area around the involved nerve root. Corticosteroids help reduce pain by suppressing inflammation around the irritated nerve. The effects usually wear off in a few months. The number of steroid injections you can receive is limited because the risk of serious side effects increases when the injections occur too frequently.

SURGERY
This option is usually reserved for when the compressed nerve causes significant weakness, loss of bowel or bladder control, or when you have pain that progressively worsens or doesn't improve with other therapies. Surgeons can remove the bone spur or the portion of the herniated disk that's pressing on the pinched nerve.

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