What is Sciatica?
The sciatic nerve is a large nerve that is formed in the lower back and runs down from the lower back and into the back of the leg where it divides into two nerves that then supply the lower leg. The term sciatica is often used to describe pain or discomfort in the lower back that radiates into the legs or feet. Sciatic pain is caused by a piece of spinal disc or bone compressing the sciatic nerve and causing irritation or inflammation of the nerve.
Common spinal conditions that can cause sciatica include:
• A herniated disc
• Spinal Stenosis
• Arthritis of the spine
• Degenerative Disc Disease
• Spinal trauma or a spinal fracture
What are the Symptoms and Causes of Sciatica?
The common symptoms of sciatica a person may experience are:
• A pulling or tight, painful sensation when walking or trying to stretch the leg
• A burning sensation or electric shock type of pain in the lower back, thigh or legs
• Numbness or tingling in the legs or feet
Can Sciatica Be Treated Without Surgery?
The first step in treatment begins with rest and time as the majority of acute episodes of sciatica will resolve within 4-6 weeks.
If symptoms do not decrease with rest and time, a visit to a Northern Arizona Orthopaedics Spine Specialist is recommended. At that time, our Spine Specialists can evaluate the symptoms of the pain and develop a care plan that fits your needs. Your doctor may prescribe over-the-counter medications and physical therapy to assist in the recovery process.
If the symptoms last longer than expected or there are potential risks noted during the physical exam, further testing may be required. The most common testing that a patient is asked to do is an MRI scan of the lower back. Nerve testing may also be recommended in cases where the cause of sciatica is in question.
If sciatica persists, further treatment with interventional procedures may be recommended. The most typical treatment option would be an epidural steroid injection. In studies, this injection is a surgery sparing option if sciatica is related to a disc herniation.
What are the Surgical Options for Sciatica?
In cases where non-surgical treatment options are not effective in treating the pain and symptoms of sciatica, there are surgical procedures that are aimed at decompressing the spinal nerves.
Two common minimally invasive procedures used to treat sciatica are known as a Microdiscectomy and a Minimally Invasive Spinal Fusion.
Microdiscectomy: During this procedure, a small incision (about 1 inch) is made in the area of the lower back where the sciatic nerve is located. Using a small specialized surgical tools, pieces of the spinal disc or bone spurs that are compressing the sciatic nerve can be removed. Once the disc material or bone spurs are removed, the pressure on the sciatic nerve is relieved and symptoms subside almost immediately.
Minimally Invasive Spinal Fusion: During this procedure, a small incision is made in the area of the lower back where the sciatic nerve is located. Using a small specialized tools and real time X-Ray (known as fluoroscopy) the entire spinal disc is removed in order to relieve pressure on the sciatic nerve. The disc is then replaced with a small metal implant to regain correct height and position of the spine and small screws and plates are used to stabilize the spine.
If you are suffering from sciatica or are not sure which treatment is best for you, contact our offices to schedule an appointment with one of our Spine Specialists. We will create a treatment plan based on your lifestyle and goals so that you can get back to doing what you love!