FAQs on Sciatica and Treatment with Maryland Pain Doctors
Sciatica is pain that radiates along the path of the sciatic nerve. This nerve branches out from the lower back through the hips and buttocks then down the legs. Usually, sciatica affects one side of the body only. The most common causes of sciatica involve a herniated disc, narrowing of the spine, or a bone spur on the spine compressing part of the nerve (spinal stenosis).
A patient’s leg may experience numbness, inflammation, and pain. People who have severe sciatica, associated with significant leg pain might be candidates for surgery when conservative treatments fail. Although the pain associated with sciatica can be severe, most cases resolve with non-operative treatments in a few weeks. The cases when surgery is an emergency involve a condition called cauda equina syndrome. In this case, the compression is so severe it leads to bowel or bladder changes, and needs to be addressed immediately so the issues don’t become permanent.
Causes of Sciatica
A herniated disc in the spine or bone spur on the vertebrae may pinch the sciatic nerve causing sciatica. In some rare cases, the nerve may be compressed by a tumor or damaged by diseases such as diabetes. Causes and risks for sciatica include:
Jobs requiring you to carry heavy loads twist around or drive a motor vehicle for long periods may lead to sciatica.
Age-related changes in the spine, such as degenerative disc and arthritis leading to herniated discs and bone spurs, are the most common causes of sciatica.
Excess weight on the body can affect your chances of developing sciatica.
This condition may affect the way the body uses blood sugar. It can increase the risk of nerve damage.
Prolonged sitting. Sitting for long periods of time or a sedentary lifestyle may increase chances of developing sciatica.
A noticeable sign of sciatica is when you notice pain, which radiates from the lower back to your buttock and down the leg. You will tend to feel a painful path along a nerve from the lower back to your buttocks and down the back of the thigh and calf. The pain varies from mild to sharp, with burning sensations. Sometimes, the pain is extreme. At times, it will feel like an electric shock or a jolt. The feeling is worse when you sneeze or cough.
With only one side of the body usually being affected, you will feel this pain more often if you sit too long. There’s also been reported tingling, muscle weakness, and numbness in the leg or foot affected. With sciatica, pain is felt in one part of a leg while another part of the same leg may feel tingling or numbness. Often, and without treatment, some people recover fully from this sciatica. It can cause permanent nerve damage, however. Here are a few symptoms to not ignore and to see a doctor immediately:
Weakness in the affected leg
Loss of feeling in the affected leg
Loss of bowel or bladder function
During a physical examination, your Maryland pain doctor may check muscle strength and reflexes by having you to walk on your toes and then heels. Next, he will have you to rise from a squatting position. Also, the doctor may have you lying on your back while lifting your legs one at a time. The pain is usually worsened by doing these exercises. The doctor may also order these particular tests:
MRI – This procedure uses a powerful magnet and radio waves to produce cross-sectional images of your back. An MRI produces detailed images of bone and soft tissues such as herniated discs. During the test, you lie on a table that moves into the MRI machine.
X-ray. An X-ray of your spine may reveal an overgrowth of bone (bone spur) that may be pressing on a nerve.
Electromyography (EMG). This test measures the electrical impulses produced by the nerves and the responses of your muscles. This test can confirm nerve compression caused by herniated discs or narrowing of your spinal canal (spinal stenosis).
CT scan. When a CT is used to image the spine, you may have a contrast dye injected into your spinal canal before the X-rays are taken, which is a procedure called a CT myelogram. The dye then circulates around your spinal cord and spinal nerves, which appear white on the scan.
Your doctor may suggest some of the following treatments.
Medications – This includes narcotics, muscle relaxants, anti-inflammatory drugs, tricyclic antidepressants, and anti-seizure medications
Physical therapy – Exercises to correct your posture and strengthen muscles supporting your back and improve your flexibility.
Steroid injections – Corticosteroids help reduce pain by suppressing inflammation around the irritated nerve. There are several different techniques for performing epidural steroid injections. While they do not “fix” the condition causing the compressed nerve, they can provide significant relief for weeks to months.
Surgery – When the compressed nerve causes significant weakness, loss of bowel or bladder control, or when you have pain that progressively worsens or doesn’t improve with other therapies.