FAQs on Sciatica and Treatment Options in Nashville

Sciatica is pain that occurs due to sciatic nerve irritation. The pain of sciatica occurs in the buttocks and radiates down the back of the thigh to the lower knee. The nerve of the spinal cord branches to extend through each buttock region, and it sends nerve endings down the leg. The sciatic nerve is the body’s largest nerve, and pain associated with this structure is called sciatica.

How common is sciatica?

The pain of sciatica is a common occurrence. However, most cases will resolve spontaneously or require only mild medications and physical therapy. The lifetime incidence of sciatica is between 13 and 40%, according to statistics.

What is the cause of sciatica?

Any disorder or condition that causes inflammation or irritation to the sciatic nerve can produce symptoms of sciatica. Most often, sciatica is the result of lumbar disc herniation, but it can occur from any structure of the spine that compresses the large sciatic nerve. In addition, material that protrudes from the intervertebral discs can cause nerve irritation, as can injury, bony projections, tumors, internal bleeding, or infections in and around the lumbar spine.

What are the risk factors for sciatica?

Many things increase the risk for sciatica, such as:

  • Increasing height
  • A genetic predisposition
  • Driving or operating heavy machinery
  • Age of 30-50 years
  • Degenerative spinal arthritis
  • Herniated lumbar disc

What are the symptoms associated with sciatica?

Sciatica feels like a bad leg cramp, with patients reporting a “knife-like” sensation or a shooting electric pain. The pain associated with sciatica can linger for weeks or months, and it is often worsened with coughing, moving, and sneezing. Some patients report associated symptoms of tingling, weakness, numbness, and/or burning down the leg. The symptoms of sciatica are worse with bending at the waist or walking.

What are the treatment options for sciatica?

The treatment of sciatica will depend on the underlying cause and the severity of the patient’s condition. Treatment options include:

  • Medications – First-line treatment for sciatica involves prescribed drugs, such as anti-inflammatory drugs, muscle relaxants, tricyclic antidepressants, and anti-seizure agents. For severe pain, short-term opioids are prescribed.
  • Physical therapy – To prevent further injury and help improve flexibility, physical therapy is prescribed for patients with spinal conditions. Physical therapy also is used to correct posture and strengthen muscles.
  • Epidural steroid injection (ESI) – This procedure involves injecting a long-acting corticosteroid into the epidural space. For added benefit, sometimes an anesthetic agent is also used. The doctor inserts a small needle into the through the epidural layer into the space that separates the epidural from the spinal cord. The efficacy rate of this procedure is around 80-90%, according to clinical studies.

Resources

Abdi, S, Datta, S, Trescot, AM et al. (2007). Epidural steroids in the management of chronic spinal pain: a systematic review. Pain Physician, 10(1), 185-212.

Nachemson Al, Waddell G, Norland AL. Nachemson AL, & Jonsson E (eds.) (2000). Epidemiology of Neck and Low Back Pain, in. Neck and Back Pain: The scientific evidence of causes, diagnoses, and treatment. Philadelphia: Lippincott Williams & Wilkins, 165-187.

Stafford MA, Peng P, & Hill DA (2007). Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. Br J Anesth, 99(4), 461-473.

Wheeler AH & Murrey DB (2005). Spinal pain: pathogenesis, evolutionary mechanisms, and management, in Pappagallo M (ed). The neurological basis of pain. New York: McGraw-Hill, 421-52.