Sciatica refers to low-back pain radiating to the leg (medical terminology: lumbosacral radiculopathy) due to a slipped or herniated disc
Pain that goes from your lower back through your buttock and down your leg-foot could be sciatica. Nerve pain related to a compression of the sciatic nerve usually affects only one side of your body but can also radiate to both legs (lower limbs). A slipped disc or herniated disc is a condition when a soft cushion (cartilage) of tissue between the bones in your spine pushes out. This is painful if it presses on nerves, especially the sciatic nerve at the low back region. The cause is usual age-related wear and tear of the discs. Spinal discs lose some water as you age, which makes them more prone to tear or rupture due to a strain. This can leads to pain, numbness and sometimes weakness in the leg.
Main risk factors for sciatica includes:
- Age: herniated disks can happen at adult or older age, causing the typical sciatic pain; but disc degeneration, bone spurs and lumbar stenosis (narrowing of the spinal canal and foramen), which can cause pain, numbness and even weakness to one or both legs, are more common among older people.
- Sedentary lifestyle: people who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are.
- Smoking cigarettes: increases your risk of having disc disease.
- Lifestyle: it’s suspected that twisting your back, lifting heavy weights and bad posture may lead to sciatica.
Sciatica symptoms
- Pain that radiates from your lower spine to your buttock and down the back of your leg and foot is a typical symptom of sciatica.
- The pain may range from being quite mild to severe. Some people experience it like an electric shock.
- The pain is often aggravated by coughing, sneezing or sitting for a long period.
- Some people have numbness, tingling or weakness in the affected leg or foot.
Diagnosis:
- At King’s, a spine specialist will start to assess the patient with a medical history, physical exam, checking for muscle strength, sensation and reflexes. If necessary, imaging tests may be required.
- You may be asked to have an x-ray, MRI, CT scan and/or electroneuromyography (ENMG) for the proper diagnosis.
Conservative treatment:
- The King’s spine specialist will give you a plan for your low-back pain radiating to the leg and/or foot (lumbosacral radicular pain) treatment, according to the case.
- This plan could include medications, such as: anti-inflammatories, painkillers and muscle relaxants and physical therapy-rehabilitation program.
- Pain clinic and spinal injections can also be used to try to alleviate the pain.
Surgical treatment:
- If the patient does not improve with conservative treatment, our spinal surgeons can proceed with the required surgical treatment to alleviate his sciatic problem due to lumbar disc herniation or related problem.
- The main indications for surgery for cases of lumbar disc herniation are the following:
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- Significant and persistent pain to the leg and/or foot
- Weakness of the lower limb, and in more severe cases, loss of bowel and/or bladder control (cauda equina syndrome).
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- The spine surgeon may use microsurgical and/or minimally invasive surgical techniques to remove part of the herniated disc and to decompress the sciatic nerve (lumbar decompression and microdiscectomy).
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