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About Sciatica

Sciatica occurs when a spinal nerve in your lower back is pinched or compressed, leading to inflammation and irritation. The nerve may become pinched from a herniated disc or degenerative changes associated with spinal arthritis.

Common causes of sciatica include a herniated disc or lumbar spinal stenosis. The chance of developing sciatica is highest during middle age years.

Sciatica causes pain, numbness, abnormal sensations, or weakness in your leg. Pain can start in the lower back and radiate through the buttock and down the leg. Treatment for sciatica depends on what is causing the nerve irritation but may involve physical therapy, medications, injections, or surgery. Most cases of sciatica can be treated without surgery. If surgery is required, it can often be accomplished through minimally invasive spine surgery.

Common Symptoms of Sciatica

Common symptoms of sciatica include:

  • Constant pain in one side of the buttock or leg
  • Burning/tingling in the leg
  • Weakness/numbness/difficulty moving leg or foot
  • Sharp pain that makes standing and walking difficult

Diagnosis of Sciatica

Any of the following tests can be ordered during the evaluation of sciatica:

  • X-rays – provide details of the bone structures in the spine.
  • Magnetic resonance (MR) imaging – provides a detailed image of soft tissue structures, such as the disc and nerves.
  • CT myelogram – provides images of the nerve channel and potential sources of compression.
  • Electromyography (EMG) – provides information on the nerve function.

Treatment Options for Sciatica

Typically, nonoperative measures are successful for treating sciatica and reducing pain in a few weeks. These treatments include:

  • Pain medication
  • Heat/ice packs
  • Massage therapy
  • Stretching/exercise
  • Physical therapy
  • Steroid injections

If pain does not respond to these treatments or the patient is experiencing progressive weakness or numbness, surgery may be considered. If sciatica is caused by a herniated disc the surgeon will perform a microdiscectomy. If sciatica is caused by lumbar stenosis, a procedure called laminectomy will be performed. Some cases of sciatica call for both procedures.