Sciatica refers to pain, weakness, numbness, and/or tingling in the leg and it is caused by injury to or pressure on the sciatic nerve.
The sciatic nerve starts in the lower spine and runs down the back of each leg. Not only does it control the muscles of the back of the knee and lower leg, but it also provides sensation to the back of the thigh, the sole of the foot, and part of the lower leg. When there is pressure or damage to the sciatic nerve, sciatica occurs.
The most common causes of sciatica include pelvic injury or fracture, tumors, herniated discs, and piriformis syndrome (a pain disorder involving the narrow muscle in the buttocks).
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When a herniated disc presses on nerve roots, it can cause pain, numbness, and weakness in the area of the body where the nerve travels. A herniated disc in the lower back can cause pain and numbness in the buttock and down the leg. Sciatica is the most common symptom of a herniated disc in the low back.
If a herniated disc is not pressing on a nerve, patients may have a backache or no pain at all.
Sciatica pain tends to vary from patient to patient. Some may feel a mild tingling, dull ache, or burning sensation, but in more severe cases, the pain is sometimes intense enough that a patient is unable to move. Though it usually only affects one side of the lower body, patients occasionally experience pain on both sides.
Symptoms of sciatica are burning or tingling down the leg, pain in the rear of the leg that is worse when sitting, shooting pain that makes it difficult to stand, and weakness, numbness, or difficulty moving the leg or foot. Pain may also extend to the foot or toes depending on where the nerve is affected.
Pain can also start slowly and get worse after standing or sitting for long periods of time, at night, when patients sneeze, cough, or laugh, and when patients bend backward or walk more than a few yards (this most often occurs with spinal stenosis patients).
After sciatica is diagnosed by a pain management specialist, the next step is determining and treating the underlying cause because sciatica is a symptom of another medical condition. In certain cases, recovery occurs on its own and no treatment is required.
The main objective of sciatica treatment is to calm the symptoms and reduce inflammation. Applying heat or ice to the painful area is a good idea, as well as taking over-the-counter pain medications such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol). Patients should reduce their activity for several days, though bed rest is not recommended. Also, avoid heavy lifting or twisting of the back for the first six weeks after the pain begins.
If patients still feel pain, injections to reduce inflammation around the nerve may have to be given. Other prescription medications may also be prescribed, along with physical therapy exercises. Since nerve pain is typically difficult to treat, patients may want to see a neurologist or a pain specialist.
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