Sciatica

Sciatica is a type of nerve pain that originates from the lower back and radiates down through the buttocks and legs.

Sciatica can cause discomfort, pain, and weakness in the affected area, making it difficult to perform daily activities.

There are five nerve points where pain distribution can occur (all through the lumbar portion of the spine): L1 = groin, L2 = upper thigh, L3 = middle thigh, L4 = knee, L5 = shin, top of the foot, and big toe. Then the sacral portion, S1 = lateral calf, heel, and bottom of the foot (this is caused by a herniated disc and annular tear). Sciatica is a condition of the irritation or compression of one or more nerve roots in the lumbar spine. Since these nerves travel to the hips, buttocks, legs, and feet, an injury in the lumbar spine can cause symptoms in these areas. Sciatica might be a symptom of a “pinched nerve” affecting one or more of the lower spinal nerves. The nerve might be pinched inside or outside of the spinal canal as it passes into the leg. Chronic pain is a complication of untreated sciatica. If the “pinched nerve” is seriously injured, chronic muscle weakness, such as “drop foot”, might occur.

Conditions that can cause sciatica include:

• A herniated or slipped disc that causes pressure on a nerve root. This is the most common cause of sciatica.
• Piriformis syndrome which develops when the piriformis muscle, a small muscle that lies deep in the buttocks, becomes tight or spasms, which can put pressure on and irritate the sciatic nerve.
• Spinal stenosis which is a condition resulting from the narrowing of the spinal canal with pressure on the surrounding nerves.
• Spondylolisthesis is a slippage of one vertebra so that it is out of line with the one above it, narrowing the opening through which the nerve exits.

How do I know if I suffer from sciatica?

The symptoms of sciatica include pain, tingling, and numbness in the affected leg. Patients may also experience weakness or difficulty moving the leg. The diagnosis of sciatica is made through a thorough physical examination and imaging studies such as X-rays, MRI, or CT scan. According to Ong et al. (2011), the straight leg raise test is a useful diagnostic tool for sciatica. It involves raising the affected leg while the patient is lying down, and if this causes pain in the leg, it is a positive sign of sciatica. It is important to note that other conditions such as hip arthritis or lumbar spine fractures may mimic sciatica and should be ruled out during the diagnostic process.

Understanding the causes, symptoms, and diagnosis of sciatica is crucial for effective treatment planning and management of this condition. Sciatica is not a condition that always presents itself on a consistent basis, it can come and go. It can cause numbness, tingling, and pain. A complete medical history, including a review of your symptoms and a physical exam, can help the healthcare provider diagnose sciatica and determine its cause. For example, he or she might perform a straight-leg-raise test, in which you lie on your back with your legs straight. The healthcare provider will slowly raise each leg and note the elevation at which your pain begins. This test can help pinpoint the affected nerves and determine if there is a problem with one of your discs. Other diagnostic tests might be performed to look for other causes of sciatic pain. An MRI and/or CT scan are ways to determine whether the abnormality can explain the location and distribution of these symptoms associated with sciatica. Nerve conduction velocity studies or EMG tests examine how well electrical impulses travel through the sciatic nerve. A myelogram using dye injected between the vertebrae to determine if a vertebra or disc is causing the pain.

Sciatica pain treatment options:

• Epidural Steroid Injections
• Caudal Steroid Injections
• Neurostimulation Therapy
• Stem Cell/PRP Therapy
• Anti-inflammatory drugs or medications
• Physical Therapy
• Chiropractic Care
• Pain Psychology
• Percutaneous Discectomy
• Laminectomy
• Biodisc™ uses the body’s own natural fibrin material to help the herniated disc to heal and alleviate pain.

Sciatic pain may go away with time and rest. Some people with sciatica will get better without surgery. If the pain does not subside on its own, then a good treatment plan can help to relieve your discomfort and return you to a pain-free and active lifestyle. Cell Bionics Institute offers a comprehensive spine functional restoration program to help patients with all of their spine care needs. With every treatment, we work to help with your current health situation, while also keeping your future health in consideration. Biodisc™ is a much less invasive option, with a much more shortened recovery period than a more invasive procedure, such as spinal fusion surgery. See if you might be a candidate for Biodisc™ today. Request a consultation with a spine care expert to discuss a treatment customized treatment plan to help with your back pain

Recovery from sciatica is multifaceted and involves managing pain, physical therapy, and prevention.

It is characterized by pain, numbness, or tingling in the lower back and legs. Treatment options for sciatica depend on the severity of the condition and the underlying cause. In mild cases, pain relievers such as acetaminophen or ibuprofen may be prescribed to alleviate pain and inflammation, while in more severe cases, muscle relaxants or narcotic pain medications may be necessary to manage pain. Physical therapy is often recommended to improve flexibility, strength, and mobility in the affected areas. In cases where the pain is caused by a herniated disc or spinal stenosis, surgery may be necessary to relieve pressure on the sciatic nerve. Surgery may involve removing the herniated disc, widening the spinal canal, or fusing the affected vertebrae. However, it is important to note that surgery is not always necessary and should only be considered as a last resort when other treatments have failed to provide relief. Overall, treatment options for sciatica are varied and should be tailored to the individual needs and circumstances of each patient.

Pain management strategies may include the use of non-steroidal anti-inflammatory drugs (NSAIDs), opioids, or muscle relaxants. Physical therapy is a crucial aspect of sciatica recovery, as it helps to improve flexibility, strength, and posture. A study by Legrand et al. (2007) found that physical therapy, specifically lumbar stabilization exercises, was effective in reducing pain and improving function in patients with chronic low back pain and sciatica. Prevention of sciatica involves maintaining good posture, exercising regularly, and avoiding prolonged sitting or standing. Regular exercise, such as yoga, has been shown to improve flexibility and reduce the risk of developing sciatica. Additionally, maintaining a healthy weight and not smoking can also reduce the risk of developing sciatica. Overall, recovery from sciatica requires a multi-faceted approach that includes pain management, physical therapy, and prevention strategies.

Research

• Lutz, GK, ME Butzlaff, SJ Atlas, RB Keller. “Managing low back pain.” The Journal of the American Medical Association, vol. 281, no. 9, 1999, pp. 818-823. Springer, doi: 10.1007/s11999-010-1277-3.
• E Legrand.”Sciatica from disk herniation: medical treatment or surgery?.” https://www.sciencedirect.com/science/article/pii/S1297319X07002862
• E Hay.”Patients’ own accounts of sciatica: a qualitative study.” https://journals.lww.com/spinejournal/FullText/2011/07010/Patients__Own_Accounts_of_Sciatica__A_Qualitative.12.aspx
• “The relation between expectations and outcomes in surgery for sciatica.” https://link.springer.com/article/10.1046/j.1525-1497.1999.10417.x