Sciatica Pain

Herniated disc diagram.
Herniated disc diagram. BSIP/UIG/Universal Images Group/Getty Images

Sciatica Pain

Sciatica is a term often used by non-medical people (as well as some licensed health care providers) to describe pain, tingling or numbness that goes down one leg.  Contrary to what many people believe, sciatic does not always involve the sciatic nerve.  Electrical symptoms down one leg may be caused by an irritation to a spinal nerve root (which often happens when a disc is herniated.)  

Sciatica Causes

Sciatica is not technically a back condition. Instead, it is a set of symptoms associated with one or more conditions that result in irritation to a spinal nerve root or nerve.

Causes of "sciatica" include:

Disc Herniation that irritates a spinal nerve root. The herniated material presses on the spinal nerve root (the place where the spinal cord branches out to become a nerve.)  When this occurs, it may cause pain, electrical feelings and/or weakness down one leg, i.e. "sciatica."

Spinal stenosis.  In spinal stenosis, the spinal canal narrows due to arthritic changes.  This may result in irritation to the nerve root as the spinal cord branches into the spinal nerve.

Sacrolioac Joint Dysfunction is another low back condition that can irritate the L-5 nerve, and mimic the effects of sciatica.

Piriformis Syndrome. A rare condition, piriformis syndrome, occurs when a tight piriformis muscle pinches or irritates the sciatic nerve, which runs underneath it.

Less common causes of sciatica including tumors, infections, and total hip replacement for congenitally dislocating hips.

How to Deal Effectively with Sciatica

Very often, sciatica will go away on its own, or will respond well to conservative treatment methods. Sometimes, however, sciatica is treated with discectomy to repair the herniated disc or to make more space in the vertebrae.

A September 2005 review of studies sponsored by the U.S. Agency on Healthcare Research and Quality revealed that over the long term, reduction of pain was approximately the same between sciatica patients treated with surgery and those treated without surgery. In these 3 studies, a total of 544 sciatica patients were followed for 10 years.

Also, a review published in the April 2011 issue of European Spine Journal entitled "Surgery versus conservative management of sciatica due to lumbar herniated disc: a systematic review," found mainly low quality evidence that early surgery in patients with sciatica gives better short-term relief of leg pain, when compared to extended non-surgical, conservative care.

Sources:

Kendall, F., McCreary, E., & Provance, P. (1993). Muscles: Testing and Function with Posture and Pain. Baltimore: Williams & Wilkins.

Outcomes/Effectivness Research. Patients with sciatica and lumbar disc herniation or spinal stenosis treated surgically or medically have similar 10-year outcomes. Retrieved January 10, 2007, from Agency for Health Care and Quality Web site: http://www.ahrq.gov/research/sep05/0905RA29.htm

Wheeless' Book of Orthopaedics. Retrieved January 10, 2007, from Duke Orthopaedics Web site: http://www.wheelessonline.com/ortho/greater_sciatic_foramen

Wilco C. H. Jacobs, Maurits van Tulder, Mark Arts, Sidney M. Rubinstein, Marienke van Middelkoop, Raymond Ostelo, Arianne Verhagen, Bart Koes, and Wilco C. Peul. Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review. Eur Spine J. 2011 Apr; 20(4): 513–522. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065612/

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