Sciatica

The sciatic nerve is a large nerve that originates in the lower back, running along the hip and back of the leg and branching off at the knee. Compression or damage of this nerve can cause pain that radiates from your lower back to the buttocks, to your legs. The intensity of pain varies from mild pain to sharp or burning pain. This may also be associated with numbness, tingling, muscle weakness or burning sensation in the hip, leg and foot. The pain is usually intensified with prolonged sitting, and exaggerated by coughing, laughing or sneezing. In rare cases bladder and bowel function may also be affected (cauda equine syndrome) requiring emergency medical intervention.

Causes

Some of the common causes for the compression of the sciatic nerve may include herniated disc (damage to intervertebral disc), bone overgrowth (spurs), piriformis syndrome (piriformis muscle compresses the sciatic nerve), or injury and tumours of the lumbar spine. Other conditions of the lumbar spine that may cause sciatica include degenerative disc disease (degeneration of vertebral discs), spinal stenosis (narrowing of the spinal canal), diabetes and spondylolisthesis (vertebra slips out). Poor posture, obesity and prolonged sitting can also lead to sciatica.

Diagnosis

Diagnosis of the exact underlying cause is crucial in determining effective treatment. Diagnosis of sciatica includes a medical history and physical examination to evaluate muscle weakness, numbness and abnormal reflexes. Imaging tests such as X-rays, CT and MRI scans are ordered to confirm on the diagnosis.

Treatment

Sciatica often resolves by itself, without any treatment. Your doctor may prescribe pain, anti-inflammatory, anti-seizure, antidepressant or muscle relaxant medications. Conservative management of sciatica includes activity modification, ice or heat application, spinal injection and physical therapy. Spinal surgery may be indicated if the symptoms do not respond to a conservative approach.