Sciatica

“Have you ever thrown out your back while shoveling, sneezing, coughing, or even just sitting or walking? Did you start feeling pain going down one or both legs? You may have sciatica!”

What is sciatica?

Sciatica is a broad condition to describe any number of problems with irritation of the nerves that lead down the legs and control sensation from and movement in that leg.

How is sciatica caused?

Sciatica occurs when the spinal nerves are irritated or when the sciatic nerve is irritated in the leg. This can be secondary to a disc breaking down in the spine, joint arthritis in the spine, or an overactive muscle in the leg that squeezes the nerves.

What does sciatica feel like?

Everyone is different; however, sciatica sensations can range from a throbbing, tingling, sharp, burning sensation to a milder deeper ache. This sensation can (but does not have to!) radiate from the low back into the thigh and lower leg and sometimes the foot also. The sciatica can cause weakness in the muscles of the thigh, leg, and ankle and can sometimes even cause your foot to flop around when you are walking.

How long does sciatica last?

For 90% of people, sciatica lasts for about 6 weeks. If it lasts longer than this or is associated with weakness or sensory loss, you should see your physician for further direction. How do you diagnose sciatica? The first step in diagnosis is hearing your story. Everyone with sciatica shares some common threads. Your clinician can help differentiate between a sciatica and other conditions including sacroiliitis, facet arthritis, or even hip problems like bursitis and hip arthritis. Sometimes, your clinician may order special tests like an X-ray, MRI, or an EMG to help differentiate between different conditions.

Do I need an MRI?

The large majority of sciatica resolves on its own, without any intervention. If conservative management does not work, or if your pain and dysfunction are too severe, an MRI is helpful to further understand what is going on.

How do you treat sciatica?

Unless, there is a severe problem, sciatica can be treated with simple interventions. Your clinician may decide to refer you for a supervised home exercise program and/or physical therapy and ask you to take some medication to help decrease inflammation. If this does not work, he or she may refer you to a specialist who may recommend some stronger medication injected directly adjacent to the area that is causing your dysfunction. And, if none of that works, you may be referred for a surgical evaluation. Ultimately, we will help you get through this bump in the road and back to your normal self