Pain Medicine Consultants

Pain Specialists & Spine Specialists located in Corte Madera, CA - Pleasanton, CA - Pleasant Hill, CA

As one of the most common types of back pain, sciatica affects as many as 40% of adults in the United States. Chronic pain that radiates down your back and into your legs can make it difficult to work or rest comfortably. Pain Medicine Consultants, with offices in Pleasant Hill, Pleasanton, and Corte Madera, California, offers effective, nonsurgical treatment options to reduce sciatica pain, including nerve blocks and innovative stem cell therapies. Learn more about treatment options for sciatica by calling the office nearest you or book online today.

Sciatica Q & A

  1. Introduction to Sciatica
  2. Understanding Sciatica
  3. Common Causes of Sciatica
  4. Symptoms of Sciatica
  5. Diagnosing Sciatica
  6. Treatment Options for Sciatica
  7. Managing Sciatica at Home
  8. Prevention Tips for Sciatica
  9. When to See a Doctor about Sciatica
  10. Risks and Side Effects of Sciatica Treatment
  11. FAQ
  12. Contact Us

1. Introduction to Sciatica

Sciatica is a term that describes the symptoms of leg pain—and possibly tingling, numbness, or weakness—that originate in the lower back and travel through the buttock and down the large sciatic nerve in the back of each leg. It's a symptom of an underlying medical condition, not a medical diagnosis in itself. This condition is relatively common and affects many people at some point in their lives.

The sciatic nerve is the longest and widest nerve in the human body, extending from the lower back down to the feet. When this nerve is irritated or compressed, it can cause a range of symptoms, collectively known as sciatica. The nature of the pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating discomfort. Sometimes it can feel like a jolt or electric shock. It can be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms. Usually, only one side of your body is affected.

2. Importance of Understanding Sciatica

Understanding sciatica is crucial for several reasons:

  1. Early Detection and Treatment:Recognizing the early signs and symptoms of sciatica can lead to a quicker diagnosis and treatment, potentially alleviating pain and discomfort more rapidly and preventing further nerve damage.

  2. Informed Health Decisions: Educated patients are better equipped to make informed decisions regarding their healthcare options. Knowing about the various treatment methods available for sciatica—from conservative measures like physical therapy to more invasive procedures like surgery—enables individuals to discuss these options more effectively with their healthcare providers.

  3. Lifestyle Adjustments: Understanding the role of lifestyle factors in exacerbating or alleviating sciatica symptoms can empower individuals to make changes that improve their overall well-being. This includes ergonomics, exercise, weight management, and posture correction.
  4. Prevention of Recurrences: Sciatica can recur, and individuals who are knowledgeable about the condition are better prepared to take preventative measures, such as strengthening exercises and proper body mechanics, to reduce the likelihood of future episodes.
  5. Empathy and Support: Understanding sciatica can foster empathy and provide support for those suffering from the condition. Recognizing the impact of sciatica on a person's daily life and mental health can lead to better support systems, whether through family, friends, or support groups.

3. Common Causes of Sciatica

Sciatica is often a result of the sciatic nerve being irritated or compressed at the point where it exits the spine or along its path down the leg. This can be due to a variety of underlying conditions or occurrences. 

Understanding the wide range of causes of sciatica is crucial for diagnosing and treating it effectively. Each cause may require a different treatment approach, and in some cases, multiple factors may be contributing to the sciatic nerve pain.

Here's a more detailed look at some of the potential causes of sciatica:

1. Lumbar Herniated Disc

Also known as a slipped disc or ruptured disc, this occurs when the soft inner gel of a disc protrudes through a tear in the tougher outer layer, pressing on the sciatic nerve. This is one of the most common causes of sciatica.

2. Lumbar Spinal Stenosis

This condition involves the narrowing of the spinal canal in the lower back, often due to the aging process. The narrowing can compress parts of the nerves or the spinal cord itself, leading to symptoms of sciatica.

3. Degenerative Disc Disease

As people age, their intervertebral discs can lose hydration and elasticity, making them less able to cushion the vertebrae and more susceptible to tearing. This degeneration can affect the disc's height and cause a herniated disc, which can press against the sciatic nerve.

4. Spondylolisthesis

This condition occurs when one vertebra slips forward over the one below it, often due to a fracture or a congenital defect. The displacement can lead to nerve compression and symptoms of sciatica.

5. Piriformis Syndrome

The piriformis muscle, located in the buttock region, can sometimes spasm and compress the sciatic nerve. Although less common, piriformis syndrome can mimic the symptoms of sciatica.

6. Pregnancy

The changes in a woman's body during pregnancy, including weight gain, a shift in the center of gravity, and hormonal changes, can lead to sciatica. The growing uterus can also press on the sciatic nerve, and the baby's position can directly compress the nerve.

7. Muscle Spasms

In some cases, a severe back muscle spasm can put pressure on the sciatic nerve, leading to sciatica symptoms.

8. Spinal Infections or Tumors

Although rare, infections or tumors in the lumbar spinal region can exert pressure on the sciatic nerve, leading to sciatica.

9. Sacroiliac Joint Dysfunction

The sacroiliac joint, located at the bottom of the spine, can become irritated or inflamed, which can also affect the nearby sciatic nerve.

10. Injury or Trauma

Direct injury to the lower back or the pathway of the sciatic nerve can result in sciatica. This can include accidents or injuries from sports or physical activities.

11. Osteophytes or Bone Spurs

These are bony projections that form along joint margins, often as a result of osteoarthritis. They can press against the sciatic nerve, causing irritation and pain.

4. Symptoms of Sciatica

Sciatica is primarily characterized by pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body. However, the nature and intensity of the pain, as well as other symptoms, can vary significantly from one person to another. Here is a detailed look at the symptoms:

Common Symptoms

  • Pain: The hallmark of sciatica is a sharp, shooting pain that extends from the lower back or buttock down to the thigh and leg along the course of the sciatic nerve. The pain can vary in intensity from mild to severe and may be described as burning, electric, or stabbing.
  • Numbness: Patients may experience numbness in the affected leg or foot, which may accompany or occur independently of pain.
  • Tingling and Pins-and-Needles Sensations: These sensations are commonly felt in the legs or feet and are indicative of nerve irritation or damage.
  • Weakness: There might be a noticeable weakness in the affected leg or foot, making it difficult to move or lift the affected limb.
  • Discomfort: The pain might worsen when sitting, coughing, sneezing, or during sudden movements.

Variability of Symptoms

The symptoms of sciatica can vary widely from person to person, both in terms of the type and severity of the pain, as well as the specific areas affected. Some people may experience predominantly pain, while others might have more numbness or weakness. 

The distribution of symptoms along the leg can also differ, with some people experiencing widespread symptoms, while others may have pain isolated to a small area.

Positional Changes in Symptoms

The intensity and nature of sciatica symptoms can change with body position and activity. For example, sitting for long periods or sudden movements like standing up or twisting can aggravate symptoms. Conversely, lying down or walking may provide some relief for certain individuals.

When to Seek Medical Help

  • Severe Pain: If the pain is severe and unmanageable with over-the-counter pain medications.
  • Persistent Symptoms: If symptoms persist for more than a week or continue to worsen over time.
  • Neurological Symptoms: If there is significant weakness, numbness, or difficulty controlling bowel or bladder function, it is critical to seek immediate medical attention, as these could be signs of more serious conditions such as cauda equina syndrome.
  • Accompanying Symptoms: If sciatica symptoms are accompanied by fever, unexplained weight loss, or other systemic symptoms.

Understanding the range and variability of sciatica symptoms is crucial for individuals to recognize their condition and seek appropriate medical evaluation and treatment. Recognizing the signs that warrant medical attention can also help in preventing complications and facilitating a more favorable outcome.

5. Diagnosing Sciatica

The diagnosis of sciatica is primarily clinical, starting with a detailed medical history and physical examination, followed by diagnostic tests to confirm the cause and extent of nerve involvement. This comprehensive approach helps healthcare providers develop an effective treatment plan tailored to the individual's needs. Here's how the process typically unfolds:

Medical History

The diagnostic process begins with a thorough review of the patient's medical history. This includes questions about the onset, duration, and character of the symptoms, any activities or injuries that might have precipitated the pain, and any previous episodes. The healthcare provider will also inquire about other symptoms that may accompany the sciatica, such as numbness, tingling, or weakness in the legs, and any treatments or medications the patient has already tried.

Physical Exam

The physical examination focuses on the patient's spine, legs, and neurological function. The healthcare provider will look for signs of nerve irritation or compression, including:

  • Pain and symptom reproduction through specific maneuvers, such as the Straight Leg Raise (SLR) test.
  • Assessment of muscle strength, reflexes, and sensory testing to check for neurological deficits that might indicate nerve root involvement.

Imaging Tests

Imaging tests are not always immediately necessary but may be ordered if the sciatica does not improve with initial treatment, if the diagnosis is uncertain, or if there are concerns about other underlying conditions. The most common imaging tests include:

  • Magnetic Resonance Imaging (MRI): This is the preferred imaging metho