Sciatica is a general term that describes nerve pain that occurs when a nerve root in the lumbar spine becomes compressed. While nerve pain that runs down the leg is often described as sciatica, it’s actually a symptom of a specific condition. These causes can include:
- Degenerative disc disease. As discs age, they can dry out and shrink, potentially leading to instability and pain.
- Disc herniation. A herniated disc occurs when the soft, inner part of a spinal disc pushes through a crack in the outer layer, sometimes leading to nerve compression that causes pain, numbness or weakness.
- Piriformis syndrome. This happens when the piriformis muscle in the buttock spasms and aggravates the sciatic nerve, which can cause pain, numbness, and tingling in the buttock and down the leg.
- Spinal stenosis. A narrowing of the spinal canal, which often results from age-related wear and tear and puts pressure on the nerves and spinal cord.
However, not all radiating low back and leg pain is sciatica. In many cases, it can be caused by an impingement of lumbosacral spinal nerve.
At Summit Orthopedics, we offer comprehensive sciatica pain management with expert diagnosis and tailored treatment plans developed in partnership with you. If you’re in the Minneapolis/St. Paul area, depend on the experts at Summit Orthopedics to help.
Sciatica Symptoms
Sciatica symptoms can lead to a range of uncomfortable sensations that typically radiate from the lower back. Common sciatica symptoms include:
- Electric shock-like pain. You might experience sudden, intense jolts of pain that feel like an electric shock traveling down the affected leg.
- Muscle weakness. Weaknesses in the leg or foot can make it difficult to move or flex those areas.
- Numbness or tingling. A pins-and-needles sensation or feeling numb in areas along the path of the sciatic nerve.
- Pain relieved by lying down or walking. Finding a comfortable position, such as lying down, or gentle movement like walking may sometimes provide temporary relief.
In rare and severe cases, sciatica can be associated with loss of bowel or bladder control, a serious symptom that suggests a significant compression of the spinal nerves. This requires immediate medical attention.
Diagnosing Sciatica
To find the underlying cause of your sciatica, your provider will review your medical history, do a physical exam and recommend diagnostic tests.
- Medical history. Your provider will ask what your pain feels like and where your pain is located. You will also discuss symptom onset and past injuries that could be causing your pain.
- Physical exam. A physical exam can help your provider determine the location of the irritated nerve root. During this test, your provider may ask you to perform certain tasks, like squat and rise, heel or toe walk or other tests.
- Diagnostic imaging. Diagnostic imaging, such as X-ray, MRI and CT, allow your provider to see the bones, discs and soft tissues in your lower back and locate the cause of nerve compression or irritation.
Nonsurgical Sciatica Treatment
Nonsurgical treatment options for sciatica are often the first line of therapy. They include:
Injections
Treating sciatica with injections delivers medication directly to the inflamed or irritated tissues surrounding the sciatic nerve. Injections used for sciatica include:
- Epidural steroid injections[JH1] . These injections deliver corticosteroids into the epidural space surrounding the spinal cord and nerve roots to help reduce inflammation and pressure on the sciatic nerve.
- Facet joint injections[JH2] . While not directly targeting the sciatic nerve, these anesthetic or corticosteroid injections address pain originating from the facet joints in the spine, which can sometimes contribute to or mimic sciatica-like pain.
- Nerve root blocks[JH3] . These injections deliver local anesthetic and/or corticosteroids to a specific nerve root that exits the spinal column.
- Piriformis muscle injections. If your provider suspects piriformis syndrome is causing your sciatica, they may inject local anesthetic or corticosteroids into the piriformis to reduce inflammation.
Medication
While medications don’t typically address the underlying cause of nerve pain and compression, they can provide significant relief so you can resume daily activities.
Physical Therapy
Physical therapy is a key part of sciatica treatment that can help reduce pain and improve function. Tailored exercise programs improve flexibility, strengthen core muscles and promote better nerve mobility.
Self-care
Self-care strategies performed at home can help reduce your pain. Some of the techniques we recommend include:
- Gentle movement. Light exercise promotes blood flow and circulation and reduces inflammation.
- Heat or ice. Warm compresses and showers can relax muscles and increase blood flow. Ice reduces inflammation and numbs pain. Your provider will help you choose the best approach.
Surgical Sciatica Treatment
Surgery may be an option if you have persistent, debilitating sciatica and have tried nonsurgical options with no success. The primary surgical goal is to relieve pressure on the compressed sciatic nerve. Several surgical options are available, and the choice depends on the underlying cause of the sciatica. Common surgical options include:
Disc Replacement Surgery
Disc replacement treats sciatica by removing the damaged or degenerated disc compressing the sciatic nerve and replacing it with an artificial disc. This restores normal disc function and alleviates nerve pressure.
Decompression Surgeries (Laminectomy and Foraminotomy)
These surgeries relieve pressure on compressed spinal nerves.
- Laminectomy entails removing part or all of the lamina, the back part of a vertebra, to create more nerve space within the spinal canal. Providers often use it to treat sciatica caused by lumbar spinal stenosis.
- Foraminotomy enlarges the foramen, the bony openings where nerve roots exit the spinal canal. Removing bone provides more space for the nerve root, reducing compression and pain.
Lumbar Interbody Fusion
The surgeon makes a small back incision, removes the lamina and trims facet joints to create space. Nerve roots are moved aside to remove disc material, and a bone graft is inserted into the disc space. Screws and rods stabilize the spine for healing and fusion before the incision is closed.
Microdiscectomy
Microdiscectomy involves special tools and small incisions that allow providers to remove parts of a herniated disc that may be compressing the sciatic nerve. It’s a type of minimally invasive spine surgery that helps you recover faster and with less pain than other spine surgeries.
Comprehensive Sciatica Treatment at Summit Orthopedics
At Summit Orthopedics, we offer comprehensive sciatica pain management with expert diagnosis and tailored treatment plans developed in partnership with you.
Summit Orthopedics has nearly 30 convenient locations across the Minneapolis/St. Paul metro area, serving Minnesota and western Wisconsin. Our state-of-the-art, comprehensive orthopedic centers offer same-day appointments from a team of experts who offer the full scope of orthopedic care.
Find your Summit Orthopedics spine expert, request an appointment or call us at (651) 968-5201 to schedule a consultation.
