Sciatica is a condition that causes a group of symptoms, including pain that radiates along the path of the sciatic nerve. This nerve begins in the lower back and branches through each hip and buttock and down the leg. People typically experience sciatica on only one side of the body. Usually, sciatica is the result of nerve compression due to a herniated disc, narrowing spine, or bone spur on the spine. These conditions can cause symptoms such as inflammation, numbness, and pain in the affected leg. The pain associated with sciatica is sometimes severe, although most people recover with conservative, non-surgical treatments within a few weeks. In some severe cases that cause bladder or bowel changes or significant leg weakness, or in cases where symptoms do not respond to conservative measures, surgery may be recommended.
Sciatica Symptoms
Sciatica symptoms can range from mild and infrequent to debilitating and constant. The specific symptoms a person will experience depend on which spinal nerve root is compressed or irritated. A given case of sciatica may affect one nerve root or multiple nerve roots together. Sciatica causes some symptoms that are specific to nerve roots, while others commonly occur in all types of sciatica. Sciatica typically affects just one side of the body at a time; pain and numbness tend to radiate from the lower back down through the buttock and the back of the thigh. However, there may also be pain in the front or sides of the leg as well. Some common symptoms include:
- Sciatica causes pain that may be intermittent or constant. Most people describe the pain as a sharp, shooting pain or a burning sensation. This pain may be more severe in the leg than in the back, even though the problem originates in the back. Leg pain may be felt all the way down in the back of the lower leg, below the knee; sometimes, this pain is more severe than the pain felt in other parts of the leg.
- Leg and foot weakness. Patients may notice that the affected leg or foot feels weak. A “heavy” sensation may make it difficult to lift the foot off the floor to walk normally.
- Numbness or tingling. Altered sensations in the back of the leg such as numbness, tingling, or a “pins and needles” feeling may occur in the back of the leg.
- Changing position may relieve or exacerbate pain. Some people may notice that pain decreases when they walk, apply heat, or do pelvic exercises. Alternatively, the pain may increase with actions such as sitting, standing for long periods, bending forward, twisting at the waist, or coughing.
- Disturbed sleep. Sciatica pain may remain constant when the person is lying down, so sleep disturbances are a common complaint with this condition. Elevating the knees with a pillow or lying on the side with a pillow between the knees may help.
There may be other symptoms depending on the person such as pain in the hip, weakness of the thigh muscles, or toe numbness, to name a few.
Sciatica Treatment in Houston
Treating sciatica effectively begins with an accurate diagnosis. To diagnose the problem, your physician will perform an exam and several tests. During your physical exam, you may be asked to perform specific actions such as rising from a squatting position or walk on your toes or heels to see which trigger pain. Imaging tests include x-rays, MRIs, CT scans, and electromyography, all of which can help diagnose bone spurs or herniated discs (which point to the likelihood of sciatica).
Once you know what is causing your pain, you can begin your sciatica treatment. Your doctor may recommend conservative treatments first, such as:
- Different types of medicines may help lessen sciatica pain, including narcotics, anti-inflammatories, muscle relaxants, tricycle antidepressants, and anti-seizure medications.
- Physical therapy. With acute pain under control, patients may benefit from a rehabilitation program designed by a physical therapist to help you avoid future injuries and recurrences. You may be prescribed exercises to help your posture, improve your flexibility, and strengthen your core muscles (which help support your back).
- Steroid injections. In some instances, sciatica treatment may involve the use of steroid injections into the area around the affected nerve root. Corticosteroids can help relieve pain by reducing inflammation around the irritated nerve. The effects of a steroid injection usually last a few months, and the number of these injections a person can receive is limited because of the increased risk associated with frequent treatments.
If your pain does not improve with the above therapies, or if you are experiencing severe symptoms such as significant leg weakness, loss of bladder or bowel control, or worsening pain, then your doctor may recommend sciatica surgery. Surgery generally focuses on removing the portion of the herniated disc or the bone spur that is compressing the affected nerve.
Sciatica Surgery in Houston
As mentioned, surgery for sciatica is usually considered when symptoms are persistent or even progressive after conservative treatment or when they are so severe that they interfere with daily activities and quality of life. The goal of sciatica surgery is to eliminate the underlying cause of the pain. Your doctor can determine the right procedure for you, such as these common surgeries.
- In this surgery, the surgeon removes a small part of the disc or bone that is compressing the nerve.
- Lumbar decompression surgery. There are several surgeries designed to relieve nerve irritation or compression, including laminectomy, foraminotomy, and facetectomy.
These procedures may be used alone or combined with other procedures and performed simultaneously as appropriate. For instance, a patient might benefit from a laminectomy and a foraminotomy; when performed together, this is known as a laminoforaminotomy. Additional procedures may also be performed with any of the above, such as the removal of abnormal bone or ligament tissue.
If you are experiencing symptoms of sciatica or another type of back pain, contact us for a consultation. Proper diagnosis and treatment are essential to achieve the best possible outcome.