The sciatic nerves of the body are located within the buttocks and provide feeling to the areas surrounding them (the lower back, buttocks, and legs). When one or more of these nerves becomes compressed, patients will develop feelings of pain that is localized at the nerve and radiates out to these surrounding areas.
Compression of a sciatic nerve can also result in a loss of function in the legs and a feeling of weakness or numbness within them. These are said to be symptoms of sciatica, which is only a term given to the symptoms. This is not a diagnosis of the source of pain, only of the symptoms caused by a separate, underlying condition.
What causes Sciatica (Radiculopathy)?
The most common reason behind the presence of this condition is simply compression of any of the sciatic nerves, which are located in all three regions of the spine (cervical, thoracic, and lumbar). Regardless of the location of the compression, many of the causes behind it are similar, including any condition of the spine that may place pressure on a nerve, such as a bulging or herniated disc, spinal stenosis, arthritic inflammation, and spinal injury. In some very rare cases, this condition is caused by the development of a spinal tumor which places excess pressure on one of the sciatic nerves.
The symptoms of Sciatica (Radiculopathy)
The symptom experienced most by patients is a feeling of pain that originates in the buttocks and shoots down the thighs and legs. Many patients report that this pain feels like being stabbed in the rear, with the pain worsening if the patient is in a seated position. Depending on which nerve is compressed, there may be additional symptoms present.
If the compressed nerve is linked to the lower extremities, there may a loss of function in the legs coupled with a feeling of burning, or pins and needles. Frequent leg cramps are also present for those patients. If it is a lumbar sciatic nerve is compressed, the pain will originate in the lower back and the shooting pain will be felt in the buttocks and thighs.
MRI showing spinal canal constriction from spinal stenosis.
How is Sciatica (Radiculopathy) diagnosed?
When sciatica symptoms become clinically diagnosed, the symptoms take on the name of radiculopathy. For instance, if the symptoms are present in the lumbar spine, the proper diagnosis will be called lumbar radiculopathy. Diagnosis of sciatica is achieved through the combined use of physical examination, an evaluation of the patient’s medical history, and neurological testing. Compressed nerves are searched for via imaging techniques, with the primary technique being an MRI. These will only confirm the presence of a compressed nerve. In many cases, further testing will be required in order to locate and diagnose the root cause of nerve compression. For some patients, the sciatic symptoms have no diagnosable cause.
Formation of the Sciatic Nerve
Treatment options for Sciatica (Radiculopathy)
Treatment for sciatica will be largely based on the underlying cause. The age of the patient, the severity of the symptoms, and what treatment options have been attempted before will also be contributing factors in the development of a treatment plan for the patient. Initial treatment will involve providing relief for the sciatica symptoms while a treatment plan for the underlying caused is made.
Patients who are experiencing these symptoms due to a complication with a spinal disc may see their symptoms fade over time without the need for clinical intervention. In these, the treatment is simply to provide relief for the patient while the cause fades. Those patients who do not see improvement may be required to have surgical correction of their spinal discs in order to obtain relief.
If you or a loved one is suffering from Sciatica and would like more information, contact Consultants in Pain Medicine today. The practice has a Double Board Certified pain management doctor accepting over 50 insurance plans at multiple locations.
Call (210) 202-4030 for more information and scheduling with pain management SA trusts!