The term Sciatica is used to describe pain traveling in the distribution of the sciatic nerve. The sciatic nerve is a very large nerve traveling in the leg. It originates from nerves starting in the lumbar spine which join together to form the sciatic nerve. The pain from sciatica usually involves only one side. It can be described as sharp or dull, burning or aching. It can be associated with numbness or tingling in the leg. Coughing or sneezing can worsen the pain. It may begin with low back pain or start in the leg itself.
Even though we call this type of back pain and leg pain sciatica, the cause does not originate in the sciatic nerve itself. The causes of sciatica include herniated discs, degenerative disc disease, lumbar spinal stenosis, spondylolisthesis, lumbar facet disease and pyriformis syndrome among others. There are other more uncommon causes of sciatica as well.
History, physical examination and radiological studies make the diagnosis of the cause of sciatica. This may include CT scans, MRI scans, bone scans or plain X-rays. Your physician can make the diagnosis or he may refer you to a pain management specialist.
The treatment of sciatica begins with conservative measures. These include bedrest, heat, ice, physical therapy and medications. These medications may include nonsteroidal anti-inflammatories and muscle relaxants. Sometimes the symptoms may resolve with this regimen. If the symptoms of sciatica persist, the next best step is a series of epidural steroid injections. These injections are done by an interventional pain management specialist