Sciatica is an irritation of the sciatic nerve. The sciatic nerve leave the spine in the low back. There is one on the left and one on the right. The nerve travels deep into the pelvis to the lower buttocks. From there, it passes down the back of each thigh. Then the nerve divides at the knee into branches that go to the feet.
Symptoms can range from mild to severe. Symptoms may include:
Burning, tingling, or a shooting pain down the back of one leg
Pain in one leg or buttock may get worse with:
Weakness or numbness in a leg or foot
More serious symptoms associated with sciatica that may require immediate medical attention include:
Continuing weakness in a leg or foot
Numbness in groin or the buttocks
Difficulty walking, standing, or moving
Loss of bowel or bladder control
Fever, unexplained weight loss, or other signs of illness
You will be asked about your symptoms and health history. A physical exam will be done. Your doctor will pay close attention to your back, hips, and legs. The physical exam will include tests for strength, flexibility, sensation, and reflexes.
Imaging tests are used to evaluate the affected area:
The goal of treatment is to reduce sciatic nerve irritation.
Treatment options include:
Bed rest is not often recommended. It does not seem to help healing. In fact, it may make your recovery longer.
If you have severe pain, bed rest may be suggested but for no more than 1-2 days. Activities may be restricted for a short period of time. It should then be resumed as soon as possible. Recovery time may be shortened by staying active and exercising. Avoid activities that make the pain worse.
Medications used to treat sciatica include:
Over-the-counter or prescription pain relievers
Muscle relaxants for muscle spasms
Corticosteroid injections in the back
Antidepressants or antiseizure medications for chronic pain
Surgery may be needed. It can help to relieve pressure on the nerve. It is the last resort, if other treatment has not worked. It may also be needed if there are urgent symptoms. Common surgical procedures include:
Microdiscectomy—part of disc between spinal bones is removed
Waddell G, Feder G, Lewis M. Systematic reviews of bed rest and advice to stay active for acute low back pain. Br J Gen Pract. 1997;47:647-652.
6/7/2007 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com: Peul WC, van Houwelingen HC, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356:2245-2256.
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