Sciatica

Sciatica is a common condition characterized by pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of the body and is often caused by a herniated disc, bone spurs on the spine, or narrowing of the spine (spinal stenosis) compressing part of the nerve. This compression causes inflammation, pain, and often some numbness in the affected leg.

Causes and Risk Factors

The primary cause of sciatica is nerve compression, often due to or worsened by:

  • Herniated or bulging discs
  • Bone spurs or spinal stenosis
  • Piriformis syndrome, where the piriformis muscle compresses the nerve
  • Pregnancy or obesity, which can add pressure on the sciatic nerve
  • Prolonged sitting or sedentary lifestyle
  • Diabetes, which can increase the risk of nerve damage

Symptoms

Sciatica presents itself through a unique set of symptoms primarily affecting one’s lower body. These symptoms may vary in intensity and frequency, often giving rise to discomfort, pain, or even disability. Here are some common symptoms associated with sciatica:

  • Pain: The hallmark symptom of sciatica is pain radiating from the lower back to the leg. This pain may be sharp, shooting, or burning and can vary in intensity.
  • Numbness or Tingling: Some individuals may experience numbness or a pins-and-needles sensation along the sciatic nerve path.
  • Muscle Weakness: Sciatica may also cause muscle weakness, particularly in the leg or foot muscles.
  • Difficulty Moving: The pain and discomfort associated with sciatica may make it challenging to move or perform daily activities.
  • Bowel or Bladder Problems: In severe cases, sciatica can cause bowel and bladder control issues.

Diagnosing Sciatica

At Excel Health, diagnosing sciatica begins with a comprehensive physical examination. Our specialists focus on the patient’s back and legs, assessing muscle strength, reflexes, and the intensity and nature of the pain. This examination helps to determine whether the sciatic nerve is involved and the possible underlying causes. 

To further identify the cause of sciatica, such as a herniated disc or bone spur, imaging tests like MRI or CT scans are often utilized. In some cases, particularly where nerve damage needs to be assessed, nerve conduction studies or electromyography (EMG) may be conducted. This thorough diagnostic approach ensures that we develop an effective and personalized treatment plan for each patient.

Treatment Options

Conservative Treatments

Initial treatment for sciatica typically involves non-surgical methods, including:

  • Physical therapy exercises to improve posture, strengthen muscles, and increase flexibility
  • Medications such as pain relievers, anti-inflammatories, and muscle relaxants
  • Hot or cold packs for pain relief
  • Lifestyle modifications, including weight loss and ergonomic adjustments at work
  • Chiropractic care and acupuncture

Surgical Treatments

Surgery for sciatica is considered when conservative treatments fail, and the pain is severe or debilitating. Surgical options are focused on relieving the pressure on the sciatic nerve, either by removing a herniated disc or addressing the underlying cause, like spinal stenosis. The decision to proceed with surgery is based on the patient’s specific condition, symptoms, and overall health.

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