Causes & Treatment Options for Sciatica

Pain that starts in the lower back and radiates down the back of the leg is what is commonly referred to as sciatica. The pain follows the path of the sciatic nerve down the leg which means that typically, only one side of the body is affected. The sensation that those with sciatica experience varies from one person to the next. While some people feel a sharp, shooting pain, others describe a dull pain. The pain that you experience from sciatica is caused by irritation, inflammation, pinching or compression of a nerve in the lower back.

Sciatica is a common complaint among Americans and according to Harvard Medical School, about 40% of people in the U.S have reported having sciatica sometime in their life. Sciatica can be caused by a plethora of spinal conditions, some of the most common are listed below:

  • A Herniated Disc. This is the most common cause of sciatica and occurs when the discs that are found between the vertebrae undergo trauma or damage and the gel-like center of the disc begins to herniate through the outer wall. The herniation causes irritation and inflammation of the sciatic nerve.
  • Degenerative Disc Disease. This is a condition where the discs found begin to thin and weaken over time which results in reduced space between the vertebrae. When the space is reduced, the sciatic nerve can become impinged.
  • Spinal Stenosis. This occurs when the spaces that surround the spinal cords begin to narrow. This abnormal narrowing can pinch the sciatic nerve roots as they leave the spine resulting in sciatica.
  • A spinal condition that affects the lumbar vertebrae, spondylolisthesis is a disease that causes a lower vertebra to slip forward over the vertebrae directly beneath it. The change in vertebral positioning can cause impingement or irritation of the sciatic nerve.
  • Facet Joint Arthritis. Lumbar osteoarthritis is degenerative arthritis in the low back that causes pain, stiffness and inflammation in the facet joints of the vertebrae. There are two facet joints on the back of each vertebra that connect the bones of the spine. Wear and tear on facet joints on the lower spine cause the cartilage between the joints to break down and causes inflammation and sciatica.

Ultimately, when you have sciatica the goal is to decrease your discomfort and increase your mobility by reducing pressure on the sciatic nerve. In most cases, time and treatment are successful in resolving sciatica pain. According to Mayo Clinic, about 90 to 95% of the time, sciatica cases will be resolved with time and non-surgical treatments. However, if your symptoms persist despite all efforts, surgery might be considered. Oftentimes, surgery is considered for those whose leg pain or weakness is persistent after methods of non-surgical options are unsuccessful. Your physician will ultimately tell you the best solution for your specific needs.

  • Physical Therapy. Physical Therapy can be an excellent option to treat sciatica because it involves stretching that improves your flexibility and strengthens the muscles of your core and lower back. In addition to going to see a Physical Therapist, staying active can also ease your sciatica symptoms.
  • Corticosteroid Injections. This treatment option delivers medication directly to the sciatic nerve via an injection. Corticosteroid injections are often a temporary solution that can provide weeks or months of pain relief.
  • This is a common minimally invasive surgical procedure when sciatica is caused by a large disc herniation. In a microdiscectomy, the surgeon removes the small part of disc material that is compressing the sciatic nerve.

If you find yourself experiencing sciatica symptoms, it is important to stay as active as possible and try to introduce some conservative methods of pain relief. Sometimes, conservative options don’t give you immediate relief, especially if your pain is caused by an irritation of the sciatic nerve. This is when it is best to allow your physician to offer you more aggressive methods of pain relief for your sciatica.

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