Sciatica Specialist

What is sciatica?

Sciatica is pain in the distribution of the sciatic nerve that affects the lower back or legs, sometimes on one side at a time, and other times both sides simultaneously.  Sciatica is also known as lumbar radiculopathy or lumbar radiculitis.The sciatic nerve is the largest and longest nerve in the body and comes from nerve roots from three nerve roots of the lower back and two nerve roots of the  sacrum. The nerve travels through the pelvis and down each buttocks and then down the back of each thigh and calves.  The sciatic nerve carries sensory and motor signals from and to the hip and legs and the spine. The motor portion helps you stand or walk. The sensory portion helps you feel sensation in your legs. The sciatic nerve splits into two nerve branches, the common peroneal nerve that runs on the outer knee down to the foot and the tibial nerve that runs down the back side of your calf to the heel and sole.

What causes sciatica?

Sciatica is used as a term that refers to anything that affects the sciatic nerves. These may compress or irritate the sciatic nerves.

Causes of sciatica include:

• Bone spurs are known as osteophytes, extra bone that grows on existing bone near the sciatic nerve.
• Degenerative disk disease, seen when spinal discs wear down.
• Spondylolisthesis, comprising pars interarticularis fractures, lead to vertebrae slipping to the side.
• Spondylosis, a condition where degenerative changes occur to the bony structure of the spine.
• Traumatic injuries
• Spinal stenosis, a narrowing of the space in the vertebrae for the spinal cord. 
• Herniated or bulging discs, when the vertebral disc bulges.
• Piriformis syndrome, seen when the piriformis muscle presses on the sciatic nerve.

Risk associated with Sciatica:

Some risk factors for getting sciatica include:

• Age, as we get older the risk of sciatica increases especially between the ages of 30 to 50.
• Diabetes - uncontrolled diabetes increases chances of getting more nerve damage including sciatica.
• Heavy lifting - both occupational lifting and exercise induced lifting.
• Obesity - increased BMI causes extra pressure on the bones and nerves.
• Pregnancy - as women who are pregnant advance through their pregnancy, the sciatic nerve can become compressed.
• Prolonged sitting- people who sit for a long time are more likely to develop sciatica.
• Running and cycling can increase piriformis due to development of that muscle.
• Smoking
• Sedentary lifestyle

What are symptoms of sciatica?

Sciatica symptoms are often alarming to patients as they may affect your leg which are vital in day to day functions.

These symptoms include:

• Tingling or pins and needles 
• Burning of lower back or legs
• Numbness to lower back, thigh or calf
• Muscle weakness on the side of the affect nerve
• Loss of bowel or bladder control
• Sharp or shooting pain down the legs.

Sciatica symptoms may improve over time depending on the cause but may also become chronic if the cause is constant.

How can I manage my sciatica?

The team at Bellevue Pain and Wellness will perform a thorough medical history, a physical examination, and previous treatments. They will order and review the results of necessary CT’s or MRI’s or other imaging and tests as necessary.  Using this, they will form a diagnosis based on their findings. 

With an accurate diagnosis, the team can create a treatment plan that considers the underlying cause, risks and other conditions. After your evaluation, the team plans your treatment using a customized plan utilizing a combination of in-office treatments as well as prescription and nonprescription medications. Most cases of sciatica respond well to these conservative treatments and do not need surgery. 

Please call our office if you have concerns or symptoms of sciatica or lumbar radiculopathy. Our office staff is adept and skilled at diagnosis and treatment of sciatica and can also help with surgical referral if necessary. Most causes of sciatica can be treated and symptoms can be alleviated.