Orthopedic and Neurosurgical Spine: Sciatica (Spinal Stenosis)

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Orthopedic & Neurosurgical Spine

WHAT IS SCIATICA?

Sciatica is a term given to any type of pain affecting the nerve called sciatic. This nerve extends from the lower back all the way through the buttock and down to the leg. Most of the time, only one side of the lower body is affected. The pain may also radiate to the foot or toes depending on where the sciatic nerve is affected.

What are the causes?

Most sciatica cases occur when the sciatic nerve is pinched or compressed. This can be due to any of the following:

  • Herniated disc – also known as ’slipped disc’, a condition that occurs when the intervertebral disc ruptures which causes a portion of the soft disc to bulge out
  • Degenerative disc disease – a condition that usually occurs due to aging, it is the breakdown or degeneration of the intervertebral discs. The disc then loses the ability to cushion and protect two adjacent vertebra.
  • Lumbar spinal stenosis – narrowing of the spinal canal
  • Spondylolisthesis – is a condition in which one vertebra slips forward over another vertebra
  • Tumor – abnormal growth of cells

What are the risk factors?

  • Aging
  • Severe obesity
  • Trauma or injury on the lower back
  • Prolonged sitting/ sedentary lifestyle
  • Inherited spine abnormalities
  • Diabetes
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Diagnosis

What are the signs and symptoms?

  • Pain – Pain due to sciatica vary widely. Some experience mild ache at the lower back while others experience a sharp or burning sensation on one side of the lower extremity. In some cases, excruciating pain occurs depending on the severity of nerve compression.
  • Discomfort – Some patients who have sciatica complains of a sensation of jolt or electric shock. There are reports that it is aggravated and becomes worse when coughing, sneezing, or sitting for long periods of time
  • Tingling, weakness and numbness – the pressure on the nerves caused by compression disrupts the nerve function causing weakness, numbness, and tingling sensation on the affected part
  • Difficulty or impaired leg mobility – Individuals with sciatica may have difficulty walking, standing and sitting in relation to the pain, discomfort, and loss of sensation as well as weakness of the leg or foot.

What are the treatment options for Sciatica?

  • Medications – these includes anti-inflammatory drugs, pain relievers, and muscle relaxants to reduce inflammation and alleviate pain
  • Steroid injections – Corticosteroids help reduce pain by decreasing inflammation, consequently preventing compression and irritation of the sciatic nerve
  • Physical therapy – stretching and exercise can be used to help improve posture and body mechanics to reduce pressure off the pinched nerve
  • Alternative therapies – Some patients believe that acupuncture and chiropractic help sciatica
  • Surgery – if sciatica is caused by disc herniation or any spinal abnormalities, surgical procedures may be recommended. There are different types of spinal surgeries for sciatica and the surgeon will recommend the best procedure depending on the spinal condition and causing the nerve compression.

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Treatment plans may vary from patient to patient. Some may benefit from medications but may not be effective to others. If you have sciatica, discuss different options with our orthopedic specialists and pain management doctors to be informed of the causes, symptoms, complications, and treatment options.