Sciatica

WHAT IS SCIATICA?

Sciatica refers to the moderate to intense back pain caused by an issue with the sciatic nerve (the large nerve extending from the lower back down the posterior area of each leg.) Typically, a trauma or constant pressure (from sitting or a sleeping position) places pressure on the sciatic nerve, generating pain in the lower back that spreads to the hip, glutes, or lower extremities.

The pain from sciatica can range from mild to excruciating. In most cases it’s self-limiting, meaning it goes away on its own. However, in extreme cases, called Cauda Equina Syndrome, a patient may experience a myriad of symptoms, including burning, tingling, or numbness, and muscle weakness in the legs, which can develop within as quickly as 24 hours. Without immediate medical intervention, paralysis, impaired bladder or bowel function, and walking difficulties may develop.

Obesity may become a factor and most surgeons recommend losing as much body fat as possible to reduce the instance of extra pressure on the nerves.

Sciatica is often caused by a herniated disc or bone spur in the spine pressing against the nerve, causing pain. Sciatica typically triggers on only one side of the body.

HOW DO NEUROSURGEONS TREAT SCIATICA PAIN?

Fortunately, most cases of acute sciatica recover simply with simple self-maintained techniques, which include:

Over-the-counter medications such as ibuprofen.

Exercises such as walking, yoga or light stretching.

Heat or Ice to help to reduce pain.

In moderate cases where self-maintenance does not relieve the pain, the surgeon may recommend an epidural steroid injection to relieve the pain.

Finally, in extreme cases, surgical intervention may be necessary. The most common surgery for extreme sciatica patients is the microdiscectomy. A very common surgical intervention approach, the microdiscectomy treats sciatica caused by a lumbar disc herniation. In this surgery, a small part of the disc tissue under the nerve root or bone is removed, relieving the pressure and allowing the herniated disc to move freely within the joint, which allows it repair quicker.