Kraus Back & Neck Institute: 281.446.3876(281.44.Neuro)

Conditions

Sciatica

Sciatica is a symptom of a disorder that compresses the sciatic nerve. The sciatic nerve is one of the largest nerves in your body. It begins in your lower back, and travels downward behind the hip joint, through the buttocks, and along the back of each leg into the feet.

Symptoms

Classic sciatica is often defined as symptoms that travel into one leg below the knee and sometimes into the foot on the same side. Although that is the classic definition, back pain and symptoms above the knee certainly can mimic sciatic-like symptoms.

  • Pain; mild ache to sharp and excruciating
  • Pain is felt in the lower left or right side of the body
  • Pain can present as electric shock-like
  • Aggravated by a cough, sneeze, when sitting
  • Sensations: burning, numbness, tingling, or pins and needles
  • Difficult and painful to walk, stand, bend forward, backwards, side-to-side
  • Muscle weakness
  • Bowel or bladder dysfunction* (rare)

*Bowel or bladder dysfunction (loss of control) may be a symptom of cauda equina syndrome, a serious medical condition that requires urgent care.

Causes

Sciatica can be caused by spinal disorders affecting the lumbar spine—your low back and extremities.

  • Compression Fracture
  • Degenerative Disc Disease
  • Herniated Disc
  • Spinal Stenosis
  • Spondylosis
  • Spondylolisthesis; Degenerative or Isthmic

Other causes and contributing factors include:

  • Nerve damage such as related to diabetes
  • Falling down (trauma)
  • Poor posture
  • Improper body mechanics
  • Prolonged sitting
  • Lack of regular exercise
  • Smoking

Accurate diagnosis

Consult an expert, especially if sciatica develops suddenly, quickly worsens, or you have a pre-existing back disorder. An accurate diagnosis is essential to an effective and successful treatment plan.

Your medical history and physical and neurological examinations are very important. You and your doctor discuss your symptoms, when they developed, and treatments tried. The doctor tests your reflexes and evaluates you for muscle weakness, loss of feeling, and signs of neurological injury.

Diagnostic tests help the doctor to determine if you have spinal nerve or canal compression. A simple x-ray can often reveal the effects of spinal degeneration. CT and MRI are sensitive imaging tools that detail bone, disc and nerve structures.

Treatment options

Sciatica often resolves on its own. It can be very painful and disabling but, seldom is spine surgery necessary. Your treatment plan depends of what is causing or contributing to sciatica. Your doctor may doctor may combine two or more therapies to maximize the success of your treatment.

  • Short-term bed rest
  • Cold therapy the first 24-hours, moist heat thereafter
  • Activity modification
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Pain medication
  • Muscle relaxing medication
  • Spinal injection
  • Short-term lumbar bracing supports the spine, may help relieve pain
  • Physical therapy
  • Acupuncture
  • Spine surgery

Part of treatment often includes learning healthy spine habits and making lifestyle changes to help reduce current symptoms and prevent further attacks.

Next steps

We hope this information about sciatica has answered your immediate questions. Remember, your doctor is your most valuable source to answer your questions about symptoms and your healthcare.

Gary Kraus, MD,
Neurosurgeon, is Board Certified
Meet Gary Kraus, MD
Masaki Oishi, MD,
Spine Fellowship at the University
Meet Gary Kraus, MD
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