Sciatica is nerve pain in the leg that is caused by irritation and/or compression of the sciatic nerve. It originates in the lower back, radiates into the buttock then travels down the leg. Onset can be sudden with pain in the lower back or hip. It is caused by a protruding (herniated) disk in the spinal column that is pressing on the nerve roots in the lumbar spine.
Sciatica pain is like no other. It can feel like a bad leg cramp with pain that is often described as stabbing, sharp or electrical. This kind cramp can last for weeks before it begins to ease up. Sudden pain can arise when a person is in motion, with a sneeze, or a cough. Symptoms also include weakness, “pins and needles” numbness, or a burning or tingling sensation down the leg.
People reporting symptoms of sciatica are generally between the ages of 45 and 64 years. It can occur as a result of the general wear and tear associated with aging. It can also happen due to an accident, trauma or a sudden pressure on the disks that cushion the bones (vertebrae) of the lower spine. Some reported occupational risk factors for sciatica include mental stress, cigarette smoking, frequent lifting – especially while bending and twisting, and exposure to vibration from vehicles.
Nonsurgical Treatment (non-trauma related)
Given sufficient time and rest sciatica will resolve by itself. Up to 90 percent of patients with sciatica get better over time without surgery, and typically within several weeks. Nonsurgical treatment is aimed at pain management and short-term use of medications. Nonsteroidal anti-inflammatory drugs such as ibuprofen, aspirin, or muscle relaxants may also help. Heat or cold on the painful muscles can also bring relief. It is important that stay moderately active.
Resist the temptation to remain in bed, as too much rest may cause other parts of the body to feel discomfort. Motion helps to reduce inflammation. In most cases, the condition will get better within a few weeks. Stretching exercises, walking, and physical therapy are all helpful options for healing pain and strengthening the body. Spinal area injections are sometimes advised using a cortisone-like drug to support the healing process.
Surgical Treatment
Sciatica that occurs after an accident or trauma, or if it develops along with with other symptoms such as fever or loss of appetite, prompt medical evaluation is required. When slow onset sciatica leg pain lasts longer than 3 months or more and symptoms do not respond to nonsurgical treatment, surgery may be a good option. Surgery may include removing the herniated disk to stop it from pressing on the nerve.
The surgery (laminotomy with discectomy) may be done under local, spinal, or general anesthesia. This surgery is usually very successful at relieving pain, particularly if most of the pain is in the leg.
Following surgery, the patient may be prescribed exercises to strengthen the back. At this stage, it is important to walk and move while avoiding bending or twisting. It is acceptable to perform low-impact routine activities around the house, such as cooking and cleaning. Following treatment for sciatica patients usually resume normal lifestyle activities and are able to keep pain under control.
The SRO Total Spine Health Program employs innovative diagnostic testing, minimally invasive surgical techniques, and targeted therapies at our full-service onsite physical therapy center to improve mobility and quality of life. The SRO team model provides the combined expertise of an orthopaedic physician and physician assistant working alongside a veteran physical therapy staff to facilitate the best possible results. SRO has set a high standard for comprehensive orthopaedic spine care in Sonoma County. Learn more by visiting the SRO Total Spine Health section, call (707) 546-1922 or Request an Appointment now.
Article Source: American Academy of Orthopaedic Surgeons, OrthoInfo
