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Levi Pearson, III, MD, MBA, DABA, DABPM
Sciatica – Pain Management
Metropolitan Pain and Spine
. https://www.metropolitanspine.com/

Sciatica – Pain Management

The sciatic nerve is the thickest and longest nerve in your body. The sciatic nerve extends from your lower back down to your feet. If the sciatic nerve is compressed or inflamed, a painful condition called Sciatica can result. Symptoms of Sciatica include shooting pain, tingling, weakness, and numbness that may travel from the lower back, through the back of one leg, and into your foot.
Trauma, spinal conditions, or medical conditions that irritate the sciatic nerve cause Sciatica. The majority of people with Sciatica experience relief with non-surgical treatments. However, those with spinal conditions can benefit from surgery that eliminates the pressure on the sciatic nerve if other treatments fail.
Severe pain is the most common symptom of Sciatica. The pain usually begins deep in the lower back and spreads to one side. The pain may shoot down one buttock and travel down the back of your leg. Sciatic leg pain typically feels worse than the back pain.
You may feel burning pain, tingling, weakness, or numbness in your calf, foot, or toes. The pain or weakness may be so bad that you cannot move your foot, bend your knee, or walk. You may have difficulty moving from a seated position to standing up because of shooting pain. Additionally, your pain may become worse when you sneeze, laugh, cough, bend backwards, or have a bowel movement.
In rare cases, the loss of bowel and bladder control accompanied by significant arm or leg weakness indicates a possible serious problem. If you experience these symptoms, you should seek immediate medical attention.
Your doctor can determine the cause of your sciatic nerve dysfunction and determine treatment appropriately. Your doctor will perform a physical examination, ask you about your symptoms and medical history, ask you to perform simple movements to assess your muscle strength, joint motion, and joint stability and test your reflexes and sensation. Your doctor may also order lab studies to rule out disease.
Imaging studies may be ordered to identify the location, source, and extent of your sciatic nerve compression. X-rays will be ordered to see the condition of the vertebrae in your spine and to identify narrowed discs or thickened facet joints. Sometimes doctors inject dye into the spinal column to enhance the X-ray images in a procedure called a myelogram. A myelogram can indicate if there is pressure on your nerve roots from herniated discs, bone spurs, or tumors.
Your doctor may also order Magnetic Resonance Imaging (MRI) scans to get a better view of your spinal structures. The MRI scan is very sensitive and provides the most detailed images of the discs, ligaments, spinal cord, nerve roots, or tumors.
Most people with Sciatica are successfully treated with non-surgical methods aimed at relieving pain and pressure on the sciatic nerve or its roots. Initially, your doctor may advise you to rest to help relieve the pain. Over-the-counter medication or prescription medication may be used. If your symptoms do not improve significantly with these medications, your doctor may inject your sciatic nerve roots with steroid medication.
Physical therapy and aquatic therapy can also help to reduce pain, muscle spasms, and loss of motion, as well as ease discomfort and allow exercises to be done with less stress on your body.

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