Sciatica refers to pain that originates in the low back and spreads or “radiates” down into a leg. It is a common symptom of spinal nerve root irritation usually due to a herniated (ruptured or prolapsed) disc. The spine is composed of a column of bony vertebrae interposed with cartilaginous discs.
The discs permit movement of the spine in bending, turning and rotating. They also serve as shock absorbers for compressive or rotational forces on the spine. Each disc is made up of a semi-fluid interior core (nucleus pulposus) encased in a tough outer cartilaginous ring (annulus fibrosus).
The bony column of the spine encloses and protects the spinal cord. Individual spinal nerves leave the spinal cord, exiting the cervical spinal canal (neck area) below their corresponding vertebra to supply sensory and motor fibers to structures of the arm. Likewise, individual spinal nerves leave the spinal cord and exit the spinal canal in the low back and supply sensory and motor fibers to the structures of the leg.
Causes of sciatica
Over time, repetitive loading forces across the disc spaces (i.e., bending and heavy lifting) can cause small tears in the outer ring of the disc (annulus). Under these circumstances, the inner fluid-like material can leak out of the disc into the spinal canal and cause irritation of the spinal nerve. This irritation leads to pain along the course of the nerve and is experienced as buttock and/or leg pain (sciatica).
In severe cases, the outer ring of the disc (annulus) may undergo a complete tear. This is called a disc herniation (disc rupture or disc prolapse). When this occurs, the interior semi-fluid core (nucleus) can escape the confines of the disc and freely enter the spinal canal.
Due to the location of the herniation, the spinal nerve is compressed. Once again, this irritation of the spinal nerve leads to pain along the course of the nerve and is experienced as buttock and/or leg pain (sciatica).
Signs and symptoms of Sciatica
The lumbar nerve root most commonly involved in sciatica pain is the fifth lumbar nerve root (known as L5). Usually, there is a history of some type of overexertion using the back muscles. The presenting symptoms are low back pain, buttock pain on the affected side and numbness and/or pain on the lateral surface of the lower leg (on the outside of the calf area). If the motor fibers of the L5 nerve root are involved, there will be weakness of the ankle such that the foot will “drag” as the leg is pulled through during swing phase.
Treatment for sciatica
Conservative treatment of a herniated lumbar disc consists of nonsteroidal
anti-inflammatory drugs (NSAIDs such as ibuprofen), bed rest and physical therapy. Often, opioid medication will be required for adequate pain control. Epidural corticosteroid injections can significantly alleviate symptoms.
Surgery is reserved for those cases where conservative measures fail and for those cases where there is significant or progressive numbness and/or weakness. The goal of surgery is to remove the portion of the disc that is intruding on the spinal canal and nerve root.
For quality Fort Lauderdale pain management, Complete Care Medical Center offers top back and neck pain treatment along with sciatica and all types of chronic pain conditions.
Treatment is offered on a self pay basis, call (954) 271-2327 for more information and scheduling with pain management Fort Lauderdale trusts!