Sciatica

Overview

Sciatica refers to back pain caused by compression of the sciatic nerve due to injury or other conditions. The sciatic nerve is rooted in the spinal cord in the lower back and branches out to run through the hips, buttocks, and down each leg. For some sciatica feels like pins and needles, while others compare the experience to getting an electrical shock.

Symptoms of Sciatica

People who experience sciatica often describe the symptoms as follows:

One-sided burning or shooting pain starting in the lower back and radiating down the front or back of the thigh and legs/ feet
Weakness and numbness in the leg
Symptoms can be exacerbated by body movement and position; such as prolonged sitting, standing up, bending forward, and twisting the spine

Potential Causes of Sciatica

The sciatic nerve can get irritated, compressed or inflamed by issues in the lower back. Some of the following factors may affect the sciatic nerve:

Herniated Lumbar Discs – it is estimated that 90% cases of sciatica are caused by a herniated disc. A lumbar herniated disc can cause sciatica by either direct nerve root compression or by irritation of the area around the sciatic nerve due to a leak from the disc material.
Foraminal stenosis – narrowing of the openings between the bones in the spine, may compress or irritate the sciatic nerve
Segmental instability – instability of a vertebral segment or dislocation of one of the vertebrae may compress the sciatic nerve
Muscle spasm
Spondylolisthesis – a defect in a portion of the spine (usually found at L5-S1)
Sacroiliac Joint Dysfunction – improper movement of the joints at the bottom of the spine that connect the sacrum to the pelvis
Tumors, cysts, and infections may compress the sciatic nerve

Risk Factors

Risk factors include:

Age
Excessive weight
Sedentary lifestyle
Diabetes

Diagnosis

Sciatica is diagnosed with a comprehensive exam by a medical professional.

Neurological examination
Comprehensive medical history
Nerve conduction and other neurodiagnostic testing
Radiological imaging

Treatment

Treatment options by Neurologists/ pain management specialists:

Ruling out or treating underlying conditions such as infections, abnormal growths, spasms, and inflammation
Oral medications
- Steroid
- NSAIDs
- pain relievers
- muscle relaxants

Injections

Corticosteroid injections to help with inflammation
Non-steroidal anti-inflammatory and and pain relieving medications
Targeted nerve blocks and epidurals
Trigger point injections

Other procedures include
- RF nerve ablation therapy under specialized fluoroscopy guidance

Other treatments may include:

Corrective biomechanics
Lifestyle changes
Referral to physical/ occupational therapy
Referral for surgical intervention

Through a combination of these methods the best solution can be found for you. To schedule a consultation for yourself or a loved one who may be experiencing these symptoms, call (646) 679-6609 or click the link below.