Sciatica

Sciatica¹‚² is a condition in which the sciatic nerve is compressed, causing debilitating pain. Sciatica is often the symptom of an underlying diagnosis causing the pinched nerve. Sciatica is more common between the ages of 30 and 50.

The L4 through S2 nerve roots make up the sciatic nerve, the largest nerve in the body. The sciatic nerve affects the lower extremities’ direct and indirect motor function. It also provides indirect sensation to the posterior (back) and lateral (outside) of the lower leg and sole (bottom) of the foot.

Causes

A herniated (slipped) disk or arthritis commonly causes sciatic pain. Inflammatory conditions can also irritate the sciatic nerve. Pain worsens with lumbar (low back) spine flexion, twisting, or bending.

Symptoms

Sensation like a severe leg cramp.
Electrical or sharp pain.
Worse with movement, coughing, or sneezing.
Lower extremity weakness.
Numbness or “pins and needles” sensation.
A burning or tingling sensation running down the leg.

Diagnosing

The diagnostic process begins with a complete medical history. A physical exam helps the orthopedic surgeon locate the pinched nerve. X-rays or an MRI may assist in determining the affected roots.

Treatments

Sciatica often improves with time and conservative management. Whether the treatment is conservative or surgical, exercises that focus on strengthening the back muscles are essential.

Conservative Treatment Options

Conservative treatment focuses on pain relief without long-term medication use. Pain often improves after a few weeks of treatment.

NSAIDs like ibuprofen, aspirin, or naproxen
Muscle relaxers
Encouraging movement
A cortisone injection into the spine near the irritated nerve
Stretching exercises like yoga

Surgical Treatment

Surgery may be necessary if the pain is debilitating and does not improve with conservative treatment. Treatment focuses on removing the herniated disks or bone spurs. Other procedures, such as a laminotomy or laminectomy, can be effective in relieving sciatic pain.

References:

Park, MD, FAAOS DK. Sciatica. OrthoInfo. Published August 2021. https://orthoinfo.aaos.org/en/diseases–conditions/sciatica/
Davis D, Vasudevan A, Maini K. Sciatica. Nih.gov. Published August 6, 2022. https://www.ncbi.nlm.nih.gov/books/NBK507908/