Sciatica refers to pressure on the nerves in the low back which form the sciatic nerve. This causes pain to run down the lower extremity to the thigh, calf and ankle. This can cause numbness, tingling or weakness in the lower extremity as well. Pressure on the nerves that form the sciatic nerve is usually caused by a ruptured disc or bone spurs.
The diagnosis of sciatica is made by listening to the patient’s complaints and combining this with the findings upon examining the patient. The final step in confirming the diagnosis is by obtaining an MRI of the lumbar spine. An MRI is a special study using a magnetic field that shows a detailed image of the spine and allows the physician to see pressure on the nerves that form the sciatic nerve.
Treatment of sciatica depends upon the severity of the patient’s pain. If the symptoms are not severe than no treatment is necessary. Patients will not become paralyzed from this condition. Patients that have bothersome pain are first treated with a short course of oral steroids followed by a non-steroidal medication. If the patient does not respond to this, then the next treatment step is an Epidural Steroid Injection, which is the placement of steroids around the nerves using xray control with the goal of decreasing the inflammation of the nerves. Occasionally patients will not respond to this non-operative care and surgical treatment becomes an option. The specific surgical treatment depends upon the location and degree of pressure on the nerve roots. Many of these procedures are done on an outpatient basis with the patients quickly returning to activity.