The term sciatica refers to pain, numbness, or tingling along the sciatic nerve, which runs from your lower back, down the back or side of your thigh and leg, to your foot. Your symptoms may be constant or happen with certain activities such as sitting too long or driving.
Your symptoms may be described as severe, sharp pain, dull and aching pain, a sensation of tightness, numbness, tingling, or burning.
There are multiple causes of sciatica.
History and physical exam by a qualified musculoskeletal expert is the first step to diagnosing sciatica. X-ray or MRI scanning may be required.
Most patients with sciatica will get better over time and not need surgery. Some patients will have pain go away quickly, while for others it could take longer. There are both non-surgical and surgical treatments available.
Non-surgical Treatment
Non-surgical treatment could include physical therapy to improve the flexibility and strength of the back. Treatment may also include non-steroidal anti-inflammatory drugs such as ibuprofen. If over-the-counter anti-inflammatories are not adequate, oral corticosteroids could be taken to reduce swelling and pain. Corticosteroids can also be injected into the lower back to further reduce swelling and pain enough for recovery.
Surgical Treatment
In some cases, non-surgical treatment is not enough and surgery may be an option. The goal of surgery is to create more space in the lower back joints to reduce the compression that may be irritating the nerves. The type of surgery chosen typically depends on the structures that are causing the compression. Compression may be caused by a disc that has herniated, a bone spur, a narrow hole, or a collapsed joint. Common surgeries include decompression, discectomy (removal of the disc), laminectomy (removal of a part of the bone), foraminotomy, and fusion. Surgical options will be discussed during a consultation with a physician.
Recovery time following surgery depends on the individual patient as well as several other factors, including the type of procedure performed. The prognosis for surgery is good and the majority of people will return to normal activity after surgery. Healing may take longer for some patients. Range of motion exercises can be recommended depending on healing time. Physical therapy may also be prescribed to help restore flexibility, strength, and function after surgery.
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