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Causes of Sciatica

The term sciatica refers to a set of symptoms that might be caused by damage or irritation to the sciatic nerve or any of its roots. The sciatic nerve is the longest in the body, stretching from the lower back to the lower leg. Often these symptoms include pain and/or weakness in the lower back, buttocks, or parts of the lower leg and foot. A person may also experience tingling, numbness or difficulty moving the limb. Normally the symptoms are only on one side of the body.

Since the term refers to the symptoms and not an actual condition, sciatica treatment may be different for different people. The most common cause of sciatica is a herniated disc pressing on one of the nerve roots. Treatment for this generally starts with anti-inflammatory medicines combined with hot and cold compresses. Often these simple methods will stop the pain, but severe injuries could require steroid injections or surgery.

Spinal stenosis, another frequent cause of sciatica, is the narrowing of the spinal canal due to bone spurs, inflammation or other events which lead to decreasing the space in the spinal column and pinching the nerves that lead to the sciatic nerve. As with disc herniation, treatment is usually anti-inflammatory medications and muscle relaxants. Surgery may be suggested if symptoms continue despite conservative treatment. Both spinal stenosis and disc herniation are conditions treated by laser spine surgery.

Other causes of sciatica are less common and include piriformis syndrome, pregnancy and tumors. Also sometimes called wallet sciatica, pain from a spasming piriformis can irritate the sciatic nerve running through the muscle. During pregnancy, the weight of the fetus can press on the sciatic nerve when the mother is sitting. Spinal tumors can press on nerve roots leading to the pain associated with sciatica.

Diagnosing and Treating Sciatica

Since sciatica is about symptoms, diagnosis is made by taking a detailed history and doing a physical examination. Patients may be further tested with X-rays or MRI if spinal damage is suspected.

Sciatica treatments generally involve pain management. NSAIDS are frequently used although they are not always very effective. Opioids and muscle relaxants are also sometimes prescribed. Epidural steroids often provide short-term relief but offer little long-term benefit. Spinal manipulation appears to be effective for acute sciatica, but less so for chronic sufferers. For many, the only solution is surgery. Laser spine surgery can safely relieve pressure on the sciatic nerve in a minimally invasive way.


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