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Sciatica

Sciatica is a common condition that accounts for up to 10% of cases of lower back pain. If you suffer from symptoms of sciatica, let the specialists at Vertrae® in Dayton, Ohio, determine the right treatment for you.

Led by board-certified neurosurgeon Kamal Woods, MD, MBA, FAANS, our practice offers several safe and effective treatments for sciatica.

Learn more about your options by scheduling a consultation with Dr. Kamal Woods today!

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Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back, through the hips and buttocks, and down each leg. Sciatica typically affects only one side of the body and can vary from mild discomfort to severe, debilitating pain. The condition occurs when the sciatic nerve is compressed, often by a herniated disc, bone spur, or spinal stenosis.

Several underlying conditions can cause sciatica, including:

  • Herniated disc: When a disc in the lumbar spine bulges or ruptures, it can press on the sciatic nerve, causing inflammation and pain.
  • Spinal stenosis: A narrowing of the spinal canal can compress the sciatic nerve, leading to sciatica.
  • Bone spurs: Overgrowth of bone (osteophytes) due to osteoarthritis can narrow the nerve pathways, pinching the sciatic nerve.
  • Spondylolisthesis: A vertebra that slips out of place may press on the sciatic nerve, causing pain.

The hallmark symptom of sciatica is pain that radiates from the lower back through the buttock and down the back of the leg. Symptoms may vary based on the severity of nerve compression:

  • Radiating pain: Pain may be sharp, shooting, or burning and is often felt along the sciatic nerve’s path. This can range from a mild ache to severe pain.
  • Numbness or tingling: You may experience numbness or tingling in the leg, foot, or toes, depending on which part of the sciatic nerve is affected.
  • Weakness: Muscle weakness in the leg or foot may occur, potentially causing difficulty walking or standing.
  • Worsened by sitting or standing: Prolonged sitting, standing, or sudden movements like coughing or sneezing can aggravate the pain.

Diagnosing sciatica usually involves a combination of medical history, physical examination, and imaging tests:

  • Medical history and physical exam: Dr. Woods will assess your symptoms, lifestyle, and medical history and perform a physical exam to check for nerve irritation, weakness, or abnormal reflexes.
  • Imaging tests:
    • X-rays: While X-rays cannot detect soft tissue issues, they can help rule out bone abnormalities or fractures that might be causing sciatica.
    • MRI or CT scan: These imaging tools provide detailed views of the spine and soft tissues, including discs, nerves, and muscles, allowing Dr. Woods to determine the cause of the sciatic nerve compression.

Treatment for sciatica focuses on relieving pain and addressing the underlying cause of nerve compression. Most cases can be managed with non-surgical treatments, but surgery may be required in severe cases.

  • Non-surgical treatments:
    • Medications: Over-the-counter pain relievers, anti-inflammatory drugs, or prescription medications can reduce pain and inflammation.
    • Physical therapy: A targeted physical therapy program can strengthen the muscles supporting the spine, relieve pressure on the sciatic nerve, and prevent future flare-ups.
    • Steroid injections: Corticosteroid injections can reduce inflammation around the sciatic nerve and provide temporary relief.
    • Heat and cold therapy: Alternating heat and cold therapy can help alleviate muscle spasms and reduce inflammation.
    • Lifestyle changes: Adjustments to daily habits, such as avoiding prolonged sitting, using proper lifting techniques, and engaging in regular exercise, can prevent future sciatica episodes.
  • Surgical treatments:
    • Microdiscectomy: If a herniated disc is compressing the sciatic nerve, a minimally invasive microdiscectomy may be performed to remove the part of the disc causing the pressure.
    • Laminectomy: For cases where spinal stenosis is compressing the nerve, Dr. Woods may recommend a laminectomy, which involves removing part of the bone or ligament that is pinching the nerve.
    • Spinal fusion: In more complex cases, such as severe spondylolisthesis or spinal instability, spinal fusion may be necessary to stabilize the spine and relieve nerve compression.