Sciatica
What is Sciatica?
There are over 7 trillion nerves in the human body, and the sciatic nerve has the distinction of being the largest and longest nerve of them all. It runs from the lumbar to the buttocks and down into the thighs. It’s responsible for sending nerve signals to and from the muscles and skin of the legs, so when the sciatic nerve is damaged or pinched, symptoms typically affect this region of the body. Radiating pain and numbness in this region is known as sciatica.
Sciatica is synonymous with sciatic nerve compression. However, since the symptoms produced by nerve compression in this region vary from person to person, sciatica isn’t just pain or just weakness, it’s all of the above. Sciatica can usually be treated with conservative methods; however, many patients find that surgery is the best option for long-term relief that doesn’t require significant lifestyle modification. A spine surgeon performs surgery on the lumbar spine to correct symptoms of sciatica.
Sciatica Symptoms
Pain that radiates from the lower back, into the buttocks, and down the back of one leg (sciatica generally affects one side of the body) is the most common symptom of sciatica. It’s far from the only symptom though. Persistent discomfort along the sciatic nerve, sudden pain, or an unfamiliar burning sensation, whether mild or extreme, may all be indicators of sciatica. Some patients describe sciatica as a “jolt” reminiscent of those old-fashioned prank buzzers comedians used to conceal in unassuming handshakes. This pain has a tendency to grow worse during extended periods of sitting, such as an eight-hour shift in the office. Coughing, sneezing, hiccuping, and other involuntary actions may also aggravate symptoms. If you feel off, whether it’s a light tingling sensation or just a feeling, don’t hesitate to consult an orthopedic surgeon to put your worries to bed with an accurate diagnosis.
Who is at Risk?
Individuals who have suffered a pinched sciatic nerve, which is usually caused by a herniated disk or bone spur, are at risk of sciatica. These are two degenerative spine conditions most commonly found in older adults. Therefore, older patients are a greater risk for sciatica. Obesity is another common risk factor. Additional weight puts too much stress on the spine making it more susceptible to degenerative spine conditions that lead to sciatica. Occupation and lifestyle may also increase an individual’s chance of sciatica. If you are required to frequently twist, bend, or carry heavy objects you have an inherently greater risk of spinal injury and sciatica. Patients with diabetes should also be cautious. Their increased risk of nerve damage makes them prone to sciatica.
Mild sciatica may go away on its own or with the application of conservative treatments, but there’s no guarantee that your experience will be that simple. When pain persists for a week or more, it’s time to pick up the phone and call your medical provider; doubly so if your condition or situation resembles any of the following:
- You are having difficulty controlling your bowels or bladder
- You are experiencing sudden, debilitating pain in your lower back or leg
- You are experiencing uncharacteristic weakness or numbness in your leg
- You are feeling strong pain signals after having been involved in a car accident or other form of traumatic accident
Causes
Sciatica occurs when the sciatic nerve is pinched. Although sciatica can be resolved with conservative treatments or even a good dose of rest, it can also return without warning when you least expect it. Arguably, the most common cause of sciatica is a herniated disc. A herniated disc occurs when the nucleus pulposus of an intervertebral disc protrudes through a tear in the wall of the annulus fibrosus. When this happens, the disc compresses on the nerves, resulting in pain, weakness, and numbness. A herniated disc in the lower back could lead to sciatica.
Bone spurs can also cause the sciatic nerve to become pinched. These bony projections develop as a result of osteoarthritis and spinal degeneration. Similar to a herniated disc, bone spurs compress the nerves in the lumbar spine; however, unliked a herniated disc, they may not be detected for years. Foraminal stenosis, or the narrowing of the foramen the spinal nerve roots pass through, can also cause sciatica when diagnosed in the lumbar spine. Another cause of sciatica, injuries, become apparent much more readily. A fractured pelvis or a traumatic injury to the buttocks or thigh could lead to the immediate onset of sciatica.
What Are the Treatment Options?
There are numerous ways to treat sciatica, from simple lifestyle changes and self-care to surgery. Patients can work together with their medical provider to determine the best course of treatment for their symptoms. Most patients kick off their treatment with anti-inflammatories, muscle relaxants, narcotics, tricyclic antidepressants, or anti-seizure medications. Physical therapy can also be used to help further ease pain. Most medical providers can recommend a physical therapist to help re-strengthen your back and legs. Physical therapy is an important aspect of whole-patient care that shouldn’t be neglected.
Slightly more interventional methods, like steroid injections, can one step further to provide patients with the relief they are seeking. Injections must be administered by a medical professional in an outpatient setting. They reduce inflammation and help relieve nerve compression, but this relief is temporary — only a few months at most. Steroid injections are associated with some serious side effects.
Finally, surgery can help provide long-term relief for sciatica. An orthopedic surgeon will typically perform a discectomy, foraminotomy, or laminotomy to eliminate the root cause of sciatica. All of these minimally invasive surgical techniques can be performed in an outpatient setting without the need for extended hospitalization. Furthermore, these procedures have a low risk of complications and side effects, and patients benefit from reasonable recovery times that allow them to get back to their daily routine sooner rather than later. A discectomy involves the removal of herniated disc material causing nerve compression. The goal of a foraminotomy is to decompress nerves, too; however, this is achieved by enlarging the foramen. A laminotomy involves the partial removal of the lamina to relieve pressure in a specific area. Consult an orthopedic surgeon to learn more about these treatments. If you are a good candidate for surgery, you could be on the road to recovery in as little as 24 hours!
Contact Florida Surgery Consultants
If you believe you have symptoms of Sciatica, contact Florida Surgery Consultants. We are a group of spine surgeons based out of Tampa, Florida. We can perform minimally invasive spine procedures for Sciatica with fast recovery times. At Florida Surgery Consultants, we have some of the top rated spine surgeons in Florida. Listed below is the Spine Surgeons in Florida that perform surgeries for Sciatica: