What Is Sciatica?

The sciatic nerve, also known as the ischiadic nerve, is your body’s widest and longest nerve. It starts outside your spine, branches from your lower back through your hips and buttocks, and down to the back of each thigh on each leg. Your sciatic nerve helps you feel sensations and controls the muscles in your legs, behind your knees, and thighs.

Sciatica (also known as lumbar radiculopathy) refers to a sensational shooting pain that radiates along the path of the sciatica nerve. It occurs when this nerve gets pinched and irritated, inflamed, or compressed and affects one leg at a time.

It can manifest as a sharp moderate stabbing, shooting, burning, or severe pain in your back, buttocks, and legs. Sciatica also describes back pain during pregnancy resulting from the pressure of the growing baby as it moves into position.

Sciatica pain might come (suddenly) and go or be constant depending on the cause; for example, arthritis in the spine develops slowly, while a herniated disk causes sudden pain. Sitting or standing for long periods and sudden body movements can worsen the pain.

Symptoms

Sciatica mainly affects only one side of the lower body. The pain usually extends from the lower back down through the back of your thigh or leg and may extend to the foot or toes. Common symptoms include:

• A mild to sharp, excruciating pain or burning sensation that makes it hard to stand up
• Feeling like a jolting pain or electric shock
• Lower back pain
• A constant pain on one side of the rear
• Hip pain
• Burning or tingling down the leg, foot, and toes
• Pain in the rear or leg that gets worse when sitting
• Numbness, weakness, or difficulty moving the leg or foot
• Inability to control your bladder or bowels (rare)
• Muscle weakness in your foot or leg
• You should seek urgent medical assistance if you have:
• Redness or swelling in your back or spine
• Fever and back pain
• Sudden severe pain in your lower back or leg and muscle weakness or weakness in your leg
• The pain follows a violent injury such as a motor accident
• You have a loss of bladder or bowel control or not being able to make it to the toilet on time

Sciatica Causes and Risk Factors

Sciatica may be caused by several conditions that affect the nerves running along your back and might involve the spine. It can occur due to a spinal or sciatic nerve tumor on an injury. Common causes of sciatica include:

• Bone spurs (osteophytes): These are hard bumps that form and grow on the bone.
• Herniated disc disease/ bulging disc/ slipped disc: a condition that occurs when your spinal disk bulges through its protective outer ring.
• Lumbar spinal stenosis (spinal stenosis): is a narrowing of the spinal canal in your lower back
• Degenerative disk disorder: happens when the jelly-like cushioning between your spinal bones(vertebrae) wears down
• Spondylolisthesis: This occurs when one spinal bone or vertebrae extends forward over another
• Piriformis syndrome: A rare neuromuscular disorder in which your piriformis muscles involuntarily tighten or contract.
• Pregnancy
• Osteoarthritis
• Spinal tumors (benign or malignant)
• Damage from various diseases such as diabetes
• Pinched nerve
• Hip disease
• Fibromyalgia
• Nerve damage from infections or injury
• Peripheral neuropathy
• Muscle spasms in the back or buttocks
• Spinal and pelvic misalignments

Sciatica Risk Factors

Other causes or risk factors that are likely to cause sciatica include:

• Aging causes changes in herniated disks or bone spurs in the spine
• Prolonged sitting
• Genetic susceptibility
• Vitamin B 12 deficiency
• Being overweight or obese
• Not exercising regularly
• Sleeping on a hard or too soft mattress
• Family history or genetic predisposition
• Mental health issues such as depression or anxiety
• Wearing high heels
• Smoking
• Fatigue
• Diabetes
• Arthritis
• Nature of work like if you carry heavy things, twist your back, or drive for an extended period

Diagnosis

Our specialist doctor will ask you about your symptoms, take your medical and family history, and review your current medications to diagnose your condition.

Your doctor will also conduct a physical exam to check your muscles’ strength and reflexes. Your spine will be examined, and a neurological exam might also be performed. You may also be asked to perform certain activities such as squatting, lifting each leg simultaneously, and walking in your heels to evaluate your sciatic nerve condition.

If your pain is severe, your doctor will order imaging tests to check herniated disks and bone spurs. You could get tests like:

X-rays to take pictures using low radiation to check for bone spurs

A CT scan uses special computers to better look at your spinal cord and spinal nerves.

MRI uses radio waves and magnets to create detailed images of the soft tissues at your back and spine.

Electromyography (EMG) measures how fast nerve signals travel through your body and checks for such things as a herniated disk.

Once we obtain all the information we need to make an accurate diagnosis, our experienced doctors at Axon Health Associates will begin formulating a treatment plan.

Sciatica Treatment

Our treatment plans aim at helping you manage pain without the long-term use of medications to improve your quality of life. Treatment may include the following:

Home remedies such as:

• Exercises and stretching
• Hot or cold packs for pain relief
• Over-the-counter medications for pain management
• Rest when the pain is too much
• Limit sitting and driving for long hours

Prescription medications include muscle relaxants, steroid injections, anti-inflammatories, anti-seizure drugs, and narcotics.

Physical therapy may be recommended, involving exercise to strengthen the surrounding region, align the spine, and relieve and prevent sciatic pain.

Alternative treatments/therapies to improve and relieve sciatic pain include acupuncture, yoga, massages (for muscle spasms), and biofeedback to ease stress and alleviate pain.

Surgery

Surgery is only necessary for severe sciatic cases. It is recommended when you have not improved with other treatments; your pain is worsening and preventing you from working or standing; loss of bladder or bladder control and you have severe muscle weakness in your lower extremities. Surgical options may include:

Laminectomy is the most common type of surgery involving removing part of the vertebral bone, causing pressure on the sciatic nerve.

Microdiscectomy to remove bone spurs on the herniated disk that is pressing on the pinched nerve.

Sciatica Prevention

• Lose weight if obese or overweight
• Maintain good posture when sitting or standing
• Practice safe habits when lifting heavy objects
• Support your spine with a good back pillow, mattress, and comfortable office chair.
• Stop smoking
• Exercise regularly
• Minimize stressing your back by doing stretching exercises
• Wear comfortable shoes and declutter your room to prevent falling
• Chose physical activities that won’t strain or pressurize your back, such as yoga or swimming

If you are looking for sciatica pain relief in Manhattan, you can rely on Axon Health Associates for customized, comprehensive care. Contact us today to learn how we can help you or schedule an appointment online.