Sciatica

While it sounds like a medical term, sciatica is actually a historic name given to leg pain caused by a problem with the sciatic nerve. The medical term for sciatica is lumbosacral radiculopathy. Sciatica is a condition that causes pain in the buttock and upper leg. Sciatica causes pain that shoots down the leg and may be associated with specific neurological symptoms such as numbness or tingling in the affected leg or foot.

 

What causes sciatica?

 

The leg pain of sciatica may be caused by any abnormal pressure or dysfunction of the sciatic nerve in the upper leg. In many cases, the sciatic nerve is being “pinched” at some point at or near the spine. Sciatica may be caused by lumbar disc herniation, spinal stenosis, bone spurs pressing on the sciatic nerve, or degenerative disc disease. Less commonly, sciatica may be a consequence of diabetes, infection, local inflammation, or tumor.

 

How is sciatica diagnosed?

 

Sciatica is, for the most part, the clinical diagnosis. That means that the physician can reach the correct diagnosis of sciatica by simply taking a careful clinical history and performing a thorough physical and neurological examination. If the patient with sciatica is contemplating surgery, the physician may order additional diagnostic tests such as an MRI of the spine and electromyography including nerve conduction studies. These tests can help determine the severity of sciatica and if surgery will be helpful (i.e., the patient has a bone spur rather than local inflammation).

 

How is sciatica treated?

 

Mild cases of sciatica are treated with over-the-counter pain medications, such as nonsteroidal anti-inflammatory drugs or NSAIDs. Physical therapy can be helpful in some cases. Corticosteroid injections into the affected area can help minimize inflammation, which can improve pain and neurological symptoms.

 

Sciatica may require surgery if one of these situations exists:

 

  • Pain is severe and does not respond to conservative treatments
  • There is an obvious structural cause for sciatica that can be relieved through surgery
  • Sciatica is caused by a tumor (cancerous or benign)
  • Sciatica is causing significant neurological problems and/or muscle wasting

 

There may be other indications for surgery that may arise on a case-by-case basis. If you have sciatica or believe you might and think surgery is needed, it is important to find an orthopedic surgeon who can expertly treat the various causes of sciatica.