Conditions & Procedures

Sciatica

Sciatica refers to pain, numbness, weakness, or tingling in the leg. This is caused by injury to or pressure on the sciatic nerve. The sciatic nerve begins in the lower spine and continues down to the back of each leg. The nerve is responsible for feeling sensation in the back of the thigh, part of the lower leg, and the bottom of the foot.

Sciatica may be caused by a slipped disc, tumors, pelvic injury, or piriformis syndrome.

The source of the sciatica is not always easy to determine. A complete physical, a detailed medical history and a thorough set of tests may be required. Physical agility tests may be performed to determine muscular strengths and weaknesses. Walking on the toes and heels, rising from a squatting position, and lifting the legs while lying down are activities that will cause pain from sciatica to become worse and help the doctor trace the affected nerves.

A spinal X-RAY, MRI and/or CT scan may help the physician to locate the causative factor and form a treatment plan to alleviate the pain.

Sciatica is actually a symptom of another problem with your back. To understand what sciatica is, you have to understand the basics of back anatomy and physiology. The spine is made of 33 stacked bones called vertebrae. Down the center of this stack runs the spinal cord, which is a bundle of nerves that conveys impulses from the body to the brain. Between each vertebra, major nerves branch out from the spinal cord.

Sometimes when the jelly-like discs that cushion the vertebrae bulge or break, it can push on these nerve roots and cause pain. One nerve root that comes out of the lower part of the spinal column is the sciatic nerve. This is the largest nerve in the body, and it enervates the buttocks, thighs, and down the back of each calf. When a disc is injured and presses on this nerve, pain and symptoms are the consequences.

In rare cases, injections and back surgery may be necessary. Steroid injections are applied to the epidural space in the spinal column. This is a highly vascular area that usually responds well to treatment. The injections help to cut down on the amount of inflammation and allow you to move and exercise. Surgery is usually a last resort because it does not always take away pain, and it makes the back inflexible where the surgery is performed. This option involves removing the disc and fusing the two vertebrae together. In some cases, only the herniated portion of the disc is removed and the back is left with the ability to move.