What is Sciatica?
Sciatica is pain that radiates along the path of the sciatic nerve, which runs from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of the body and is a symptom of an underlying problem, not a diagnosis itself.
The sciatic nerve is the longest and widest nerve in the human body. When this nerve becomes pinched or irritated, it causes the characteristic sharp, burning pain that radiates down the leg.
Common causes of sciatica include herniated discs, bone spurs, spinal stenosis, or spondylolisthesis. Less commonly, the nerve can be compressed by a tumor or damaged by conditions like diabetes.
Signs & Symptoms
Sciatica symptoms can range from mild to severe and may include:
- Sharp, shooting pain from the lower back down one leg
- Pain that worsens with sitting, standing up, coughing, or sneezing
- Numbness or tingling down the leg
- Muscle weakness in the affected leg or foot
- Burning or electric shock-like sensations
- Pain that typically affects only one side
Seek Immediate Care If You Experience:
- • Loss of bowel or bladder control
- • Sudden severe weakness in the leg
- • Numbness in the inner thighs or genital area
These may indicate cauda equina syndrome, a medical emergency.
How is Sciatica Diagnosed?
Dr. Rastegar performs a thorough evaluation to identify the cause of your sciatica:
- Medical History: Understanding when symptoms started and what triggers them
- Physical Examination: Testing reflexes, muscle strength, and performing specific maneuvers like the straight leg raise test
- MRI: The most effective imaging for visualizing herniated discs and nerve compression
- X-rays: Shows bone structure and alignment
- EMG (if needed): Nerve conduction studies to assess nerve function
Treatment Options
Non-Surgical Treatment
Most sciatica cases improve with conservative treatment:
- Physical Therapy: Specific exercises to reduce pressure on the sciatic nerve
- Medications: Anti-inflammatories, muscle relaxants, and pain relievers
- Epidural Steroid Injections: Targeted injections to reduce nerve inflammation
- Ice and Heat Therapy: To manage pain and reduce inflammation
Surgical Treatment
If conservative treatments don't provide relief after 6-12 weeks, or if you have severe weakness, surgery may be recommended:
- Microdiscectomy: If sciatica is caused by a herniated disc
- Laminectomy: If sciatica is caused by spinal stenosis
Frequently Asked Questions
How long does sciatica last?
Acute sciatica often improves within 4-6 weeks with conservative treatment. However, recovery time varies depending on the underlying cause. Some cases may take several months to resolve, while chronic sciatica may require more aggressive treatment.
Should I rest or stay active with sciatica?
While a day or two of rest may help during severe flare-ups, prolonged bed rest can actually make sciatica worse. Dr. Rastegar recommends staying as active as tolerated with gentle movement and specific exercises to promote healing.
Can sciatica be cured permanently?
Yes. When the underlying cause is identified and treated appropriately, sciatica can be permanently resolved. Surgery to remove a herniated disc or decompress the nerve has a high success rate for long-term relief.
What's the difference between sciatica and regular back pain?
Regular back pain is localized to the back. Sciatica is characterized by pain that radiates from the lower back down the buttock and leg, following the path of the sciatic nerve. Sciatica often includes numbness, tingling, or weakness in the leg.