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Anatomy of the Sciatica
Sciatica or sciatic pain and symptoms are associated with a pinched or compressed spinal nerve root (exiting nerve) from the spinal cord. Your spinal cord stems from the base of your skull and travels through the cervical, thoracic, and lumbar regions of your back. Between each vertebra, at each level, a pair of spinal nerves exit through holes in the bone of the spine called the foramen on both sides of the spinal column. These nerves are called nerve roots or radicular nerves.
The sciatic nerve is an extension of the exiting nerve and anatomically runs down both legs, connecting to muscle and tendons into your hip, buttock, thigh, knee, calf, and foot. The main cause of sciatica nerve pain is a herniated disc compressing or pinching a nerve root. Sciatica can be present in one or both legs. Another common term used to describe this pain is radicular pain or radiculitis (nerve root inflammation). Radicular pain is usually secondary to inflammation or compression of a spinal nerve. This pain is often deep and steady and usually reproduced with certain positions and activities such as walking or sitting. Once a nerve dysfunction is documented by a specialist, the condition is referred to radiculopathy. There are treatments available at the Spine Institute of North American for sciatica nerve pain. You can contact us to make your appointment today and learn more about sciatica treatment options.
What Is Sciatica?
Sciatica is a form of sharp pain felt in areas like the lower back, buttocks, at the back of the thigh and behind the knee. Also known as sciatic nerve pain, it occurs when the sciatic nerve gets irritated. This large nerve starts at the lower part of the spinal cord and goes down through the buttocks to the lower limbs.
What Are the Causes of Sciatica?
Sciatic nerve pain is caused by a variety of lower back conditions, including the following:
- Herniated disc: When lumbar disc herniation presses directly on the sciatic nerve, it can lead to inflammation or irritation of the nerve. This issue is also known as radiculopathy — a feeling of numbness, tingling or weakness in the legs.
- Spinal stenosis: This problem occurs in older adults. Spinal stenosis is a type of nerve compression disorder. It leads to leg pain during walking or standing.
- Spondylolisthesis: This disorder affects the lower part of the back. It occurs when a vertebra slips forward over another vertebra adjacent to it.
- Trauma: Trauma from injuries sustained during sports, motor vehicle accidents or falling can cause nerve compression, especially when there are fragments of broken spinal bones.
Typical sciatica symptoms usually occur on one side of your body. They might affect your shoulder, arm, or leg. In more severe cases of spinal stenosis, the condition could affect the exiting nerves on both sides of the spinal cord, causing sciatica symptoms on both sides of your body. This can cause pain that becomes debilitating. You might experience symptoms such as:
- Sharp, needle-like pain
- Muscle weakness
In order to accurately diagnose sciatica, your spine specialist will need to take you through a workup that could include the following:
- Getting your medical history, including an assessment of your current symptoms as well as any treatments or care you’ve received in the past.
- A thorough physical examination. This will help your doctor see any symptoms such as muscle weakness, pain, or signs of spinal cord damage.
- Tests including CT scans, MRIs, and x-rays. These give the spine specialists a detailed, three-dimensional view of your spinal structure so they can identify abnormalities that could be the cause of your sciatica nerve pain.
Treatment Options For Sciatica
For many of our patients, surgical solutions are not required in order to get relief from a herniated disc and sciatica nerve pain. Clinical studies show that many patients find relief without surgery in four to six months.
Non-Operative Sciatica Treatment Options
- Cold and hot compresses on the affected area for 24 to 48 hours
- Pain medications including anti-inflammatories, narcotic pain killers (only in severe cases), and muscle relaxers
- Epidural steroid injections to help pinpoint the cause of your pain and provide pain relief
- Physical therapy exercises that stretch, strengthen, and massage the back
Least-Invasive Surgical Treatment Options
If the conservative treatments listed above don’t work to ease your pain and evidence is supported by testing and imaging, your doctor might recommend surgical treatment. These sciatica pain relief options have a 90% success rate when treating bulging discs and pinched nerves.
- Endoscopic Discectomy (transforaminal or interlaminar): Making an incision that’s only ¼ inch long, the surgeon enters the spinal canal without damaging the surrounding muscles. After observing the damaged disc, they work to remove the damage using a high-definition camera. Most patients are able to go back to work within a week. You’ll be given conscious sedation and kept comfortable during the procedure.
- Endoscopic Foraminalplasty: This procedure uses endoscopic techniques to decompress the area where the nerve is exiting the spinal cord, relieving the pressure and the painful symptoms the patient is experiencing.
- Endoscopic Laminotomy: During the Endoscopic Laminotomy procedure, the surgeon creates an opening of the lamina above and below the painful disc to relieve nerve compression.
Recovery from Least-Invasive Surgical Treatments
Most patients who undergo these procedures are able to get out of bed about an hour after the surgery is finished. Once they are cleared by our team, they can go home. Some patients might experience a small amount of pain at the incision site, which can be controlled with pain medication. Your doctor will give you tips on how to care for yourself at home as well as exercises you can do to prevent your back from becoming stiff. You’ll be able to increase your activity gradually after resting for a few days. Your doctor will also give you a timeframe as to when you can start activities such as walking, driving, yard work, and sporting activities. If you experience an increase in your pain levels or have any concerns, you should contact our office right away.
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