>>
Complaints of sciatica are common. We’ve all probably heard someone we know say (or have maybe even said ourselves), “My sciatica is acting up.” The colloquial use of the term “sciatica” has become a catchall, and the true meaning is often misunderstood. If you think you may suffer from sciatica, it is important to know what true sciatica is, what causes it, and how to treat it.
Sciatica is actually a symptom of an underlying medical problem, and is not a disorder in and of itself. The set of symptoms are varied, and usually include electrical, burning or shooting pains down the leg as well as tingling and “pins and needles” sensations. Patients may also complain of leg numbness and weakness. Sitting and bending forwards as well as sneezing and coughing can aggravate symptoms.
The sciatic nerve is the largest peripheral nerve in the body. Multiple nerve roots in the lower back join together in the region of the buttock to form the sciatic nerve. This large “tree trunk” –type structure descends down the back of the thigh and ultimately divides behind the knee to form two large branches. The sciatic nerve performs two important functions. First, it relays signals from the brain, which control most of the muscle groups in the legs. Second it transmits most of the sensory information collected in the legs and sends it back to the brain. The normal functions of the sciatic nerve can be disrupted by compression of or irritation to the nerve roots. The result is the set of symptoms commonly referred to as “sciatica.”
The most common cause of disruption of normal sciatic nerve function is a disc herniation. Lumbar discs normally do a remarkable job of absorbing and redistributing the complex forces that are placed on the spine on a daily basis. However, degeneration of the disc over time, or lifting injuries, falls or other sorts of trauma can cause the inner portion of the disc to be forced out of the disc itself and compress the nerve root, causing irritation, inflammation and pain.
Another cause of sciatica is spinal stenosis. Spinal stenosis is a condition where the spinal canal narrows. It can narrow from disc herniations, arthritis (bone spurs) and vertebral slippage (spondylolisthesis). Ultimately there is compression on the spinal cord and sciatic nerve roots.
Your physician diagnoses sciatica with a thorough history and physical exam. X-rays, MRI and/or CT of the lumber spine as well as nerve testing (EMG) can help to define the cause of sciatica.
Although some cases of sciatica may require surgery, most are successfully treated by more conservative measures. Treatment varies from patient to patient depending on the underlying cause. A period of rest with a short course of anti-inflammatory medication (Advil or Motrin) and/or oral steroid is a good place to start. Muscle relaxers and neuropathic pain medications can be helpful. Once the pain subsides, a formal physical therapy program can be started. Epidural steroid injections can help to reduce the inflammation around the nerve.
Fortunately the prognosis for sciatica is generally good. Most patients fully recover from their episode of sciatica. If you suffer from typical sciatica symptoms, see your physician, find out what the underlying cause is, and seek treatment.
|
