Sciatica

If you experience pain or numbness in your buttocks or legs, the source of the symptoms might actually be derive from your lower back, commonly known as sciatica. Depending on the range of severity there are several treatment options. Sometimes, sciatica can go away through careful rehabilitation, while more serious forms may require surgery in order to relieve pain and restore function.

What is sciatica?

If you suddenly start feeling pain in your lower back or hip that radiates to the back of your thigh and into your leg, you may have a protruding (herniated) disk in your spinal column that is pressing on the nerve roots in the lumbar spine. This condition is known as sciatica. The spinal discs are positioned between each individual section of the spinal cord, and when working properly, they act as a sort of cushion to take some of the pressure placed upon the vertebrae. When a lumbar disc bulges or gets pushed out of place, it can encroach upon the area occupied by the nerve root, sending pain and numbness shooting into an individual’s lower extremities.

Sciatica may feel like a bad leg cramp, with pain that is sharp (“knife-like”), or electrical. The cramp can last for weeks before it goes away. You may have pain, especially when you move, sneeze, or cough. You may also have weakness, “pins and needles” numbness, or a burning or tingling sensation down your leg.

You are most likely to get sciatica between the ages of 30 and 50 years. It may happen as a result of the general wear and tear of aging, plus any sudden pressure on the disks that cushion the bones (vertebrae) of your lower spine.

What causes sciatica?

Sciatica is most commonly caused by a herniated disk. The gel-like center (nucleus) of a disk may protrude into or through the disk’s outer lining. This herniated disk may press directly on the nerve roots that become the sciatic nerve. Nerve roots may also get inflamed and irritated by chemicals from the disk’s nucleus.

Approximately 1 in every 50 people will experience a herniated disk at some point in their life. Of these, 10% to 25% have symptoms that last more than 6 weeks.

In rare cases, a herniated disk may press on nerves that cause you to lose control of your bladder or bowel, referred to as cauda equina syndrome. If this happens, you may also have numbness or tingling in your groin or genital area. This is an emergency situation that requires surgery. Schedule an appointment immediately.

When you suffer from sciatica, it’s imperative to see a doctor right away. If the issue is caught early, you may be able to get away with a non-surgical means of repairing the damage. Dr. Bray can advise you on the various activities to take part in to prevent an exacerbation of the damage, as well as those actions that you should strive to avoid. After six weeks to three months of conservative treatment and rehabilitation you may be able to recover fully.

Herniated disk (side view and cross-section)

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How do you treat sciatica?

Most patients experiencing sciatica do not require surgery. Through soft tissue treatment, over the counter medication, pain management techniques and other conservative methods, many patients find lasting relief.

In cases where surgery is required, a lumbar microdiscectomy for bulging disc removes the section of intervertebral disc that has herniated into the spinal canal, leaving the healthy portion of the disc intact. A small incision is made in the back. Muscle tissues are lifted off of the protective bony arch, called the lamina, and a window into the spinal canal is made. The nerve is gently pushed aside allowing herniated tissue to be removed. Without the obstructing portion of disc, the nerve root can comfortably occupy the spinal canal and should cause no discomfort. Dr. Bray perform microdiscectomies in the industry leading surgery center at DISC. DISC patients are dutifully cared for by dedicated staff and remain the top priority from admission to discharge. This level of service helps reduce microdiscectomy risks and improve recovery time. While some microdiscectomy pain after surgery is to be expected, patients frequently feel discomfort associated with sciatica immediately improves following the procedure. Six weeks is typical for microdiscectomy recovery time, with patients often experiencing significant improvement in overall comfort by that point.

When do I consult a physician for sciatica?

Most types of sciatica that will naturally heal show signs of improvement in the first six to twelve weeks. Chronic pain in the leg and buttocks that persists for longer than 12 weeks should be evaluated by a medical professional. A Lumbar Microdiscectomy is a rapid, reliable way of dealing with disc herniation and pain caused by an obstructed nerve root. It has been shown to offer immediate relief from sciatic pains, and, importantly, allows the quickest return to an active lifestyle when considering debilitating sciatic pain treatments. Dr. Bray routinely perform microdiscectomies on an outpatient basis, with most patients returning home the same day. Take a stand against sciatic pain.

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