The sciatic nerve is made up of the spinal nerves that exit between the lumbar vertebra in lower spine. The spinal nerves join together forming the sciatic nerve which then runs from the low back through the buttocks into the legs, calves and feet. Sciatica is the medical term for when the nerve is irritated, inflamed or compressed causing symptoms down the path of the nerve. The cause of sciatica is most commonly a bulged or herniated disc, often referred to as a pinched nerve, rupture or slipped disc. The injured disc will irritate or put pressure on the nerves causing a cascade of symptoms such as a radiating, burning, numbness or tingling down the affected leg.
Most often the very last disc in the spine the L5-S1 disc, is the one involved in causing the sciatica. The disc’s bulged or herniated material irritates or compresses the nerves as they exit past it. Some other causes of nerve compression are central and lateral canal stenosis, or spondylolisthesis, all which shrink the opening of the spinal nerve. “Radiculopathy” is also diagnostic term used meaning one or more of the spinal discs in the low back irritated or compressed a nerve that makes up the sciatic nerve, causing pain in the buttock, leg, calf or foot. The sciatic condition often is due a slow process of wear and tear to the discs and spinal tissues in the lumbar spine and rarely is a surgical candidate.
The sciatic pain affects people differently. One individual may experience excruciating pain while another individual has intermittent moderate pain. Even though sciatica is variable, it usually radiates from the low back into the buttocks, down the leg and often into the foot. The pain is described as:
- Burning and Tingling Down the Back of the Leg
- Difficulty Moving or Straightening the Affected Leg
- Pain in Low Back or Buttocks Worse with Sitting
- Pain in Leg or Calf Worse than Pain in Back
Sciatica is mainly caused by the lumbar spinal discs. The discs have lost their hydration or disc height from “wear and tear” and over time, caused compression or irritation in the spinal nerve. The treatment goal should be to minimize pain by managing inflammation, increase the circulation to the disc so it can get the oxygen and nutrition it needs to heal, and then increase spinal stability to prevent further injuries. Susquehanna Spine has modeled its disc treatment protocol to meet these goal through:
- Integrated Disc Therapy
- Spinal Decompression
- Spinal Rehabilitation
Alternative Sciatica Treatments
Epidural Steroid injections are often used to manage the inflammation, the injections are invasive and a temporary fix.
Most sciatica cases respond well to non surgical management and do not need surgery. Surgery is the last option after all other treatment options have been exhausted. The surgical treatments are the following:
- Discectomy-portion of the disc that was placing pressure on the nerve is removed
- Lumbar Laminectomy-posterior part of the vertebra is removed to provide space for the spinal nerves relieving pressure
Call SSJC at 717-681-0198 for a free consultation to see if we can help.