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Sciatica Illustration
Sciatica
The term ‘Sciatica’ is commonly used to describe pain traveling in the distribution of the sciatic nerve.

Sciatica is a set of symptoms including pain that may be caused by general compression and/or
irritation of one of live nerve roots that give rise to the sciatic nerve or by compression or irritation
of the sciatic nerve itself.

Symptoms are felt in the lower back, buttock, and/or various parts of the leg
and foot. In addition to pain, which is sometimes severe, there may be numbness, muscular
weakness, pins and needles or tingling and difficulty in moving or controlling the leg.

Sciatica

North American Spine’s AccuraScope® procedure treats Sciatica

The AccuraScope procedure treats Sciatica by relieving the pressure caused by bulging discs, and repairing any tears on herniated discs.

Most patients feel immediate relief after the outpatient AccuraScope procedure, and return to light activities the following day.

In some cases, Sciatica may result from pressure created by bone growths on the spinal canal. North American Spine can treat bone-related nerve pressure with the use of specialized, minimally invasive tools.

The best treatment for Sciatica is to identify and address the underlying cause. Allow North American Spine to help you by requesting a free MRI review.

“It’s great being able to participate
in my own life again.”

Curtis C., Age 36, Location: Buxton, NC.
Pre-Surgery Life Style/ Condition: Prior to my injury, I had a very active lifestyle in my work, family and sports activities. When I got injured, I was no longer able to do any of the activities of my daily life. I tried all of the treatments [...]

Sciatica Information

Sciatica Basics
Left gluteal region, showing surface markings for arteries and sciatic nerve.

Consisting of five spinal nerve roots, the sciatic nerve is the largest nerve in the body. These nerve roots exit the spine separately and, after grouping together as a single nerve cluster, travel down both legs to the tips of the toes.

When one or more of these nerve roots is compressed, you may feel pain originating in your lower back and radiating through your buttocks, legs and feet. In addition to pain, you may experience numbness and/or weakness. Most people experience these symptoms, known in total as sciatica, on only one side of their bodies.

If you are experiencing any of these symptoms, see your physician so that you can be properly diagnosed and begin your treatment plan.

Sciatica Causes
Several mechanical problems in your lower back (lumbar) region can lead to the symptoms that comprise sciatica, all of which can be caused by compression of one of the nerve roots in the sciatic nerve cluster:

Herniated disc or Bulging disc: Material from your intervertebral discs protruding into the spinal canal can cause compression of nerve roots.

Spinal Stenosis: Stenosis is a fancy word for “narrowing.” Spinal stenosis indicates that the spinal canal is narrowing – i.e. there is less space for nerve roots to travel where they should. Stenosis can be caused by bulging discs, scar tissue, thickening ligaments or bone spurs.

Degenerative Disc Disease (DDD): This refers to the gradual deterioration of our intervertebral discs. It is a natural part of aging, but some patients may experience it earlier in life. Decreased disc height due to DDD may cause foraminal narrowing, and weakening annular walls are more prone to bulges or herniations. Either may contribute to Sciatica.

Other causes may include:

  • Pelvic injury or fracture
  • Piriformis Syndrome
  • Spondylolisthesis
  • Sciatic nerve tumor
  • Spinal tumors

While sciatica may cause pain or other discomfort and disrupt your regular activities, your symptoms can be relieved with proper treatment.

Risk Factors
Deterioration of the lumbar spine represents one of the most common causes of sciatic nerve compression. This deterioration often accompanies the aging process and can be manifest through herniated or bulging discs, arthritis, or bone spurs. Some activities, however, may trigger the symptoms that characterize sciatica.

  • A sedentary lifestyle – limited physical activity can weaken the muscles in your lower back and increase the likelihood of nerve compression.
  • The wrong workout – high-impact sports or exercise over time can damage the lumbar, as can improper stretching before physical activity.
  • Unhealthy habits –cigarette smoking and excessive alcohol consumption can compromise your spinal health, as can carrying excess body weight, which puts undo stress on the lumbar region.

Symptoms
If you feel pain radiating from your lower back to your buttocks, legs and feet, your sciatic nerve may be compressed or pinched. You also may experience other symptoms such as burning, cramping, muscle weakness, tingling and even numbness in these same areas and usually, on just one side of the body. Problems with sitting, standing or walking, as well as discomfort when you sneeze, cough, laugh or lean backwards also are consistent with sciatica. This collection of symptoms may be caused by a herniated disc or a bone spur in the lower back (or lumbar) region where the sciatic nerve exits the spinal column.

Diagnosis
To ensure that you are getting the proper treatment for the symptoms that comprise sciatica, it is important to be physically examined and interviewed by a physician. Because there are many conditions that can cause the symptoms of sciatica, a physician must rule out other causes before diagnosis. Be prepared to talk in detail about your symptoms: how long you’ve had them, what sensations you’re experiencing (numbness, the nature of the pain/discomfort, and location) and what helps/hurts.

Typically, a few simple reflex and neurological tests can assess your nervous system function. Additionally, the physician may order an MRI, X-ray or CT scan to see if there are any obvious mechanical issues that could be causing your pain.

If your answers and/or test results indicate nerve root compression in the lower back, the physician may diagnose your symptoms as sciatica and recommend one or more treatment options.

Treatments
No two people will experience sciatica in exactly the same way. That’s why treatment for sciatica should commence only after you’ve been diagnosed by a physician, who will work with you to create an individualized plan that helps manage pain, loss of sensation and muscle weakness.

This treatment plan will focus on decompression of the nerve roots and depends on the level(s) affected and the cause(s) of the compression.

Physicians may employ a variety of treatment modalities for sciatica depending on your diagnosis and the nature and duration of symptoms.

Conservative Treatment
If your symptoms are in the early stages, your physician may prescribe spinal decompression and/or physical therapy to “free” the compressed nerve roots. Physical therapy likely would include stretching and specific exercises to strengthen the muscles in your abdomen and lower back so you can avoid future lumbar problems. Additionally, your physician may prescribe analgesics, acupuncture and/or massage, hot compresses and ice packs (sometimes alternating between the two), or even chiropractic adjustment to help manage your sciatic pain.

Exercise
Not only can exercise, along with physical therapy, help relieve your sciatic pain by increasing the flexibility and strength of your back, but it can help prevent pain and further back problems in the future. Before you begin an exercise program or continue with your existing regimen, however, be sure to consult with your physician first as some movements may worsen your condition.

A few important considerations:

  • Proper posture is important! Your physician or therapist should show you how to position your back correctly while exercising.
  • Pain is a message: stop, take a break, ensure you are maintaining the right posture, and then try again. If your pain continues, don’t try to push through it. Stop the exercise and talk with your physician or therapist.
  • Know the limit: when it comes to stretching or number of repetitions, follow your doctor’s or therapist’s specific directions. Don’t overdo it.
  • Follow the full treatment plan: exercise is an important element, but be sure to follow your physician’s other recommendations including adjustments in how you sleep, sit or stand; medications (if prescribed; and those activities you should avoid.

Exercise helps many people manage and even eliminate their sciatic pain. Some people, however, do not experience relief and are therefore candidates for other treatment options.


Interventional Treatments
If your sciatica symptoms do not respond to conservative measures such as rest, over-the-counter medications and physical therapy, interventional procedures or surgery may be an option.

Spinal Injections
Spinal injections can be effective for both diagnosis and pain management. To diagnose sciatica, a physician may employ a spinal nerve block, which enables the physician to identify the nerve(s) causing your pain, and then inject steroids around the affected portion of your spine. This epidural steroid injection works by reducing the inflammation and irritation caused by the pressure on your sciatic nerve.

While epidural steroid injections have proven highly successful in reducing sciatic pain, some patients experience side effects that, while very rare, may include:

  • Headache
  • Spinal puncture
  • Nerve damage
  • High blood sugar
  • Weight gain
  • Infection

Epidural Steroid Injection is an effective way to reduce inflammation and give the body time to heal before more invasive procedures are required. Pain relief from ESIs may be temporary, however.
Surgery

Surgery: Surgical sciatica treatment, while effective, should only be considered after conservative treatment has been unsuccessful in relieving your systems.
Physicians at North American Spine specialize in the minimally invasive decompression of nerve roots using a variety of techniques.

Microdiscectomy: Through a tiny incision, the surgeon may remove disc tissue from a herniated or bulging disc.
Laminectomy/Laminotomy: The lamina is the bone that forms the “roof” of the spinal canal. When some of the lamina is removed through a very small incision, the sciatic nerve roots are given more space.

Foraminotomy: The foramen are the sides of the spinal canal through which nerve roots exit the central canal. In some cases, it may be helpful to remove bone from the foramen, allowing nerve roots to pass without impingement.

There is no single procedure that is best for everyone. Consult with a minimally invasive spine expert at North American Spine to start building your customized treatment plan today.


Sciatica Prevention
While we can’t stop the natural aging process, which we know can lead to a gradual degeneration of the lumbar spine, we can work on maintaining muscle strength to keep the lower back stable. Regular physical activity is key and, with a physician’s or fitness professional’s encouragement, may include:

  • Walking
  • Running or jogging
  • Swimming
  • Cycling
  • Weight training
  • Yoga, Pilates or Stretching
  • Dancing
  • Tai Chi

Get Started
North American Spine works with leading spine experts who specialize in the diagnosis and treatment of conditions like sciatica. The first step is to register for more information. You will be assigned to a patient coordinator who will be able to review your medical history, answer your questions and guide you through the journey toward relief.

The second step is to submit your MRI or CT scan report for a free review. This will allow the medical team at North American Spine to understand your condition and provide a recommendation – which may or may not include a minimally invasive treatment like the AccuraScope procedure or one of the many other procedures offered by North American Spine. If you haven’t had a recent MRI, you can request one from your primary care physician.

If you know you have sciatica, the next best step is to know your options for treating it.

Fill out the form on this page to get started.