By Sripad Dhawlikar, M.D.
Sciatica, also called lumbar radiculopathy, is a pain that originates along your sciatic nerve. This main nerve in your leg extends from the back of your pelvis down the back of your thigh, and is the largest nerve in your entire body.
Sciatica is typically caused by a herniated (or bulging) disk in the spine that is putting pressure on the sciatic nerve. Other reasons for this pressure may include obesity, poor posture, tumors or abscesses, blood clots or nerve disorders. Even an awkward sitting position may cause pressure on your sciatic nerve, and sometimes the cause of your sciatica cannot be clearly identified.
The most common symptoms of sciatica include lower back pain that radiates or spreads down your buttock and the back of one thigh, pain that extends from your buttock down to your foot, numbness, and weakness. The symptoms of sciatica may look like other conditions or medical problems, make an appointment with your health care provider to receive a proper diagnosis.
There are several methods for diagnosing sciatica; along with a complete medical history and physical exam, tests for sciatica may include an x-ray, magnetic resonance imaging (MRI), electromyography and nerve conduction study (EMG and NCS).
EMG and NCS are procedures done together to record and analyze electrical impulses in your muscles. During the EMG, thin needles are placed in your muscle to record electrical activity. The NCS is often done along with the EMG to determine if a nerve is working normally. Electrodes are then placed in various locations on your skin along the nerve pathway. When stimulating the nerve at various places, your health care provider can then determine the specific site of your injury.
Sciatica usually heals on its own with rest and time. To help relieve the pain, sciatica treatment may include nonsteroidal anti-inflammatory (NSAIDS) medicines such as ibuprofen, or heat or cold applied to the sore muscles. It is also important to keep your body in motion, as movement minimizes inflammation. For severe cases, surgery may be recommended to repair herniated disks if the condition persists.
Since sciatica is caused by pressure on a nerve in your spine, complications may develop if the pressure is not relieved. Possible complications of unrelieved nerve compression include increased pain, a slipped or herniated disc, loss of feeling or weakness in your affected leg, loss of bowel or bladder function, and even permanent nerve damage. Though sciatica usually heals on its own with rest and time, call your health care provider if your pain worsens, you lose feeling in your affected leg, or notice weakness in your leg, you develop problems with your bowels or bladder, or your pain returns after successful treatment of your sciatica.
Board certified orthopedic surgeon and spine specialist Sripad Dhawlikar, M.D., is part of the Human Motion Institute at Hackensack Meridian Health Raritan Bay Medical Center. The institute’s Neck and Back Center uses a multifaceted approach to accurately diagnose and treat back and neck pain. Treatment options include physical therapy, medication, alternative therapies, lifestyle changes, non-surgical, and minimally invasive surgical procedures, with help from a nurse navigator who guides patients and their families through treatment and surgical care.
Dr. Dhawlikar has an office located in Suite 310, 2 Hospital Plaza, Old Bridge. For a referral, call 1-855-5-MOTION.
