Sciatica

Sciatica is not in itself a medical condition but rather a symptom of various kinds of back ailment. It is the travelling of pain down the sciatic nerve which starts at the buttocks and runs down the side of each leg.
It can manifest itself at different levels of intensity ranging from numbness to constant pain travelling down a leg. It usually goes down one leg, not both.
It often feels like a numbness or tingling.
It is often worse when sitting and sometimes there is a sharp pain that it makes it difficult to stand up and walk.
Herniated discs, Spinal Stenosis and degenerative disease are some of the ailments that can lead to sciatica. Whatever the triggering cause, the effect is that at some point the nerve is being compressed. The point at which they are compressed affects where in the leg, the pain or numbness will be felt.
There are two situations when Sciatica can require urgent medical attention. The first is when there are bowel or bladder incontinences or a progressive numbness of the legs. These can happen when there is extreme compression of the nerve sac in the lower spine.
The other is when the nerve is actually damaged. Weakness and numbness in the leg can be a possible indication of this.

Treatments

While there are certain procedures to help with sciatica, there are also other treatments that can greatly reduce the pain produced by sciatica.

Medication

Drugs like over-the-counter pain relievers such as ibuprofen and naproxen can help to reduce great amount of pain. You may also prescribe stronger pain relievers if these are not working. It’s also recommended to use muscle relaxants such as chlorzoxazone (Lorzone, Parafon Forte DSC).

Epidural Steroid Injection

If medication does not help the pain that comes from sciatica and remains severe, then an epidural steroid injection could be suggested to relieve the pain. This injection goes straight into the painful area around the sciatic nerve and works on the inflammation that causes the pain. This treatment is temporary and can work from one week to up to a year and might not be effective for everyone.

Physical Therapy

Using a combination of strengthening, stretching, and aerobic exercises are part of most sciatic care plans. You will be provided a routine of gentle exercise to perform everyday which can help you to recover quicker and suffer from less episodes of pain.

Surgery

You will be considered for surgery if you have suffered from severe leg pain for four to six weeks or more, the pain has not been relieved despite your effort with the above treatments, you can no longer perform everyday activities. You will need urgent surgery if you have severe weakness in your legs or loss of bowel or bladder control. One of two surgeries may be recommended depending on how long the sciatica has been afflicting you and what the cause of it is.

Microdiscectomy — If your sciatic pain is coming from a lumbar disc herniation then you will be recommended for a microdiscectomy. This is a small open surgery using magnification and is the most common approach when it comes to surgery. Only the small part of the herniated disc is removed – the part that is pinching the nerve. This surgery will be recommended after four to six weeks of chronic pain that is not relieved by other treatments.
Lumbar Laminectomy — If your sciatic pain is being caused by lumbar spinal stenosis then you will be recommended to have a lumbar laminectomy. This is where a small portion of bone and disc removed, only the small parts that are pinching the nerve. This surgery will be recommended if you can no longer stand to do activities like you used to.

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