Sciatica is not a disease or a diagnosis. It is a symptom of an underlying medical condition. The term is used to describe nerve pain, tingling, numbness and weakness that travels from the lower back, across the buttocks, down the back of the thighs to the calves and feet.
It occurs when the sciatic nerve – the longest in the body – gets compacted or aggravated. Common conditions that cause sciatica include herniated lumbar discs, spinal stenosis, degenerative disc disease, and spondylolisthesis.
Sciatica pain can vary from periodic and mildly inconvenient to constant and incapacitating. Symptoms depend on the location of the nerve impingement or irritation and may include:
- Symptoms intensify during sudden movements or changing positions
- Constant pain in one (rarely both) side of the buttock or leg
- Sharp pain in one leg making it difficult to stand up or walk
- Pain originates in the lower back or buttock and continues along the path of the sciatic nerve
- Pain lessens when lying down or walking but increases when standing or sitting
- Pain is burning, tingling, or searing (rather than dull)
- Pain radiates down the leg and possibly into the foot and toes (it rarely occurs only in the foot)
- Lower back pain is not as severe as leg pain
- A “pins-and-needles” or prickling sensation, numbness or weakness down the leg
Sciatica is rare among young people. It tends to start appearing in middle age, between the ages of 40 to 50.
Certain symptoms require immediate medical and possibly surgical intervention. These include progressive neurological symptoms like leg weakness, bowel or bladder dysfunction, infections or spinal tumors.
Seeing a doctor is advisable both for alleviating sciatica pain and to determine or eliminate a serious underlying medical issue. Treatment is focused on addressing the cause of symptoms rather than the symptoms alone and treatment ranges from self- or home-care, nonsurgical therapies, or surgical remedies for severe or intractable pain and dysfunction.
Who Will Treat My Sciatica Pain?
Choosing the right practitioner depends on the type of sciatica nerve pain you are experiencing. Back and leg pain specialists come from a variety of backgrounds, including orthopedics, neurology, traditional, alternative and complementary medicine.
Your primary care physician should be your first stop. He or she will likely advise rest, painkillers, or an oral steroid dose pack along with muscle relaxants, anticonvulsants or opiates. Your doctor may order an MRI to diagnose the source of the pain or rule out other conditions. If the pain does not improve, he may refer you to a neurologist.
Neurologists specialize in disorders of the nervous system, which includes the sciatic nerve. A neurologist may perform several addition diagnostic tests like an EMG (electromyography) or nerve conduction studies (NCS) to localize the problem and determine treatment. Since sciatica is a nerve disorder, involving a neurologist in the diagnosis and treatment of the condition is beneficial.
When conservative methods fail to relieve pain symptoms, a patient may be referred to a neurosurgeon or orthopedic surgeon. Surgery is usually a last resort and used when there is rapid loss of leg function, the pain is completely unbearable, or there is evidence of imminent nerve damage.
In addition, and apart from therapies advised by your primary care provider, interventional pain management specialists are trained and licensed to treat back and leg pain. They may advise epidural steroid injections, piriformis tendon injections in the buttocks, plus exercise and rest.
For nonsurgical options, you may be referred to a physical therapist, chiropractor, or acupuncturist and biofeedback practitioners.
At Front Range Spine and Neurosurgery, we believe that an informed patient is the best patient. We practice comprehensive, patient-centered care designed to help you achieve the best possible outcomes. If you’ve experienced a head injury or have neck, back, or leg pain, call us today at (303) 790-1800 or use our online form to request an appointment.