Sciatica is the term used to describe radiating nerve pain that begins in the low back and buttock region, runs down the back or side of the thigh and leg and often into the foot. The term came about because the pain is in the distribution of the sciatic nerve, which is a confluence of the lower spinal nerves in the buttock region.
How is it diagnosed?
The diagnosis of sciatica is typically made by taking a detailed patient history alone. However, an MRI of the lumbar spine will often be required to confirm the actual cause of the sciatica pain. It is important for the clinician to conduct a thorough history and clinical examination prior to formulating the final diagnosis so as not to misdiagnose this condition.
What are the treatment options?
Fortunately, sciatica is a condition that frequently will improve on its own over the course of days or weeks. Specific treatments for sciatica vary, depending on the condition causing the sciatic nerve compression or irritation. The majority of cases of sciatica are caused by a herniated disc or bone spur pinching a spinal nerve in the lower spine. Conservative treatments include a short period of rest or activity reduction, as well as non-steroidal anti-inflammatory medications. Pain medicines and/or narcotics may also be prescribed for severe pain and spasm. Epidural steroid injections and/or nerve root blocks may also be utilized for severe pain or moderate pain that is no longer responding to other conservative measures. Surgical decompression, such as microdiscectomy (MLD) or laminectomy, may be recommended for patients who do not benefit from conservative treatments.