Sciatica

Sciatica is a very common complaint. About 40% of people in the U.S. experience sciatica sometime during their life. People describe sciatica pain in different ways, depending on its cause. Some people describe the pain as sharp, shooting, or jolts of pain. Others describe this pain as “burning,” "electric” or “stabbing.”

How does this happen?
Irritation of the sciatic nerve is caused by nerve root entrapment (also known as nerve compression, pinched nerve or entrapment neuropathy). This particular form of entrapment is called lumbar radiculopathy, since the damaged nerves roots are located in the lumbar (lower back) portion of the spine. The nerve compression itself is most commonly irritated from disc tissue that is compressing the nerve, other structures in the spine that can also compress the nerve, or by an inflammatory reaction near the nerve.

Causes of sciatica include:

• A herniated disc – also known as a ruptured or slipped disc – in which the gel-like center of an intervertebral disc of the spine sticks out through a tear in its outer ring (called the annulus). This slippage puts pressure on the nerve roots located just next to the disc. Herniated discs can be brought on by wear-and-tear over time or by an acute back injury.

• Spinal stenosis – a narrowing of the canal that houses the spinal nerves.

• (Less often) inflammation of body parts adjacent to the spine, which in turn may be caused by:

  • bone or muscle injuries such as a broken hip

  • diseases such as tumors or infections

  • pregnancy

  • orthopedic surgery of the hip

There are many contributing factors that may increase the risk of sciatica, but one of the most important is improper spine mechanics. This would include how we lift and how we sit.

How is it found?
The doctor will first perform a history and physical examination, and then X-rays, MRI and/or MR neurography exams will confirm whether there is a lumbar nerve root compression.

How can this be treated?
Nonsurgical treatments may include applying cold packs or heat, medications and/or physical therapy. In some cases, epidural steroid injections may also help you return to full activity. Severe cases may require spinal decompression surgery.

These are the medical professionals you want!
Dr. Mathew Cyriac, Dr. Leland McCluskey, Dr. Lisa Jaubert, Dr. Jami Montagnino and Bryan Seely, PAC

First-time patients suspected of having sciatica are usually seen by Bryan Seely, Physician Assistant. Bryan works closely with Dr. Mathew Cyriac, our Chief of Adult Spine.