Sciatica is a painful condition that occurs when the sciatic nerve becomes compressed at the spot where it exits the spine in the lower back. In most cases, this compression is caused by a herniated or “slipped” disc, but other conditions like spinal stenosis and spinal arthritis can also cause sciatica. Sciatica is more common among people who sit or stand for long periods as well as those who are overweight or who perform repetitive bending or heavy lifting. Pregnant women also frequently experience sciatica as their growing belly puts extra strain on the lower back muscles and spinal joints.
The sciatic nerve has two main branches that extend down each leg. When sciatica occurs, symptoms like pain, numbness, burning or tingling sensations, and muscle fatigue or weakness can be felt anywhere long this nerve pathway, from the lower back through the hips and buttocks and into the legs. Symptoms can range from mild to severe, and pain can vary from a dull, throbbing ache to an electricity-like pain. Often, symptoms are severe enough to interfere with sleep or work.
Sciatica is usually diagnosed with a physical examination, an overview of the patient’s medical history and a review of their symptoms. In a few cases, diagnostic imaging like X-rays or MRIs may be ordered to confirm a diagnosis or rule out other issues that can cause similar symptoms. Imaging may also be useful in evaluating the spine to determine the cause of nerve compression.
Some mild forms of sciatica may be treated with rest and stretching exercises. More significant symptoms that interfere with sleep or activities, or sciatica that recurs may need more proactive treatment to relieve pain and improve mobility and quality of life. Sacroiliac (SI) joint injections can be especially effective through the administration of medication directly into the sacroiliac joint in the lower back where most sciatica begins. This relieves inflammation, irritation, and pain in the lower back, hips, and elsewhere along the nerve pathway. Relieving inflammation also helps restore mobility as it enables a slipped disc to resume its normal position.
Other treatments used to treat sciatica include:
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