Sciatica Symptoms and Treatment
The diagnosis of ‘sciatica’ means that there is inflammation of the sciatic nerve. The sciatic nerve supplies information about movements to the leg, and sends information about sensations back to the brain. The sciatic nerve is quite large in fact, it is the largest peripheral nerve in the body.
The sciatic nerve is formed from the lower segments of the spinal cord; it is made up from the lumbar and sacral nerve roots from the spine. The sciatic nerve exits the lower part of the spinal cord (lumbosacral region), passes behind the hip joint, and runs down the back of the thigh.
The most common symptom of true sciatica is posterior thigh, lower leg or foot pain that can be much worse than the accompanying lower back pain. Usually a patient will experience moderate to severe pain, which begins in the buttocks and runs down through the leg or foot. It is important to know that true sciatica will produce pain that radiates beyond the knee. Often a patient will have a previous history of lower back pain beginning a few days or weeks before the leg pain occurs, then the leg pain becomes worse than the back pain, and in some cases the back pain will completely disappear.
However, in the case of longstanding history of sciatica, the pain may gradually become localized to the buttocks and back of the leg. In this situation, the patient may have a vague aching pain that does not reach all the way to the lower leg or foot, though it may have done so earlier in the course of the disease.
The primary treatment of sciatica is rest, to allow the inflammation of the nerve to subside. In an effort to alleviate the pain, various medications (such as analgesics and muscle relaxants) may be prescribed, or anesthetic agents may be injected into the area around the spinal cord. In cases that do not respond to such conservative measures, surgery may be necessary.
Recently, new surgical techniques, such as microsurgery and the percutaneous (through the skin without cutting, as with a needle) removal of disk fragments, have been developed. These techniques have considerably decreased hospital stays and loss of work time. So far, success at relieving pain and neurologic symptoms has been good. Not all individuals with disk problems, however, are suitable for this surgery.
Physical therapy under a doctor’s supervision or prescription is often used to relieve the pain of sciatica. Many therapists advise their patients to overcome the effects of a ruptured disk by developing the core muscles (the four muscle groups that form at the waist) in order to provide a supportive column of muscle that will help keep the disk in place.