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Sciatica

Sciatica is a sudden pain in the lower back or hip that radiates to the back of your thigh and into the leg, and may have a protruding or herniated disc in the spinal column that is pressing on the roots of the sciatic nerve. Sciatica usually occurs between the ages of 30 and 50 years. It may happen as a result of the general wear and tear of aging, plus any sudden pressure on the discs that cushion the bones or vertebrae of the lower spine.

Herniated Disc and Sciatica
The gel-like center of a disc may protrude into or through the disc's outer lining. This herniated disc may press directly on the nerve roots that become the sciatic nerve. Nerve roots may also get inflamed and irritated by chemicals from the disc's nucleus. Approximately one in every 50 people will experience a herniated disc at some point in their life. Of these, 10 to 25 percent have symptoms that last more than six weeks.

In rare cases, a herniated disc may press on nerves that cause loss of control of the bladder or bowel. If this happens, you may also experience numbness or tingling in your groin or genital area. This is an emergency situation that requires surgery. Phone a doctor immediately.

Sciatica Symptoms
The most common symptoms associated with sciatica include sudden pain in the lower back or hip that radiates to the back of the thigh and into the leg. Sciatica is also known to cause some loss of muscle function and generalized weakness.

Sciatica Diagnosis
Diagnosis begins with a complete patient history. The doctor will ask you to explain how your pain started, where it travels and exactly what it feels like. A physical examination may help pinpoint the irritated nerve root. Your doctor may ask you to perform a series of specific motions to learn what structures are involved.

Most patients with sciatica have compression of specific nerve roots. X-rays and other specialized imaging tools, such as MRIs, may confirm your doctor's diagnosis of which nerve roots are affected.

Non-surgical Treatment of Sciatica
The condition usually heals itself given sufficient time and rest. Approximately 80 to 90 percent of patients with sciatica get better over time without surgery. Non-surgical treatment is aimed at helping manage your pain without long-term use of medications.

First, you'll probably need at least a few days of bed rest while the inflammation goes away. Non-steroidal anti-inflammatory drugs such as ibuprofen, aspirin or muscle relaxants may also help. In addition, you may find it soothing to put gentle heat or cold on your painful muscles. Find positions that are comfortable, but be as active as possible. Motion helps to reduce inflammation. Most of the time, your condition will get better within a few weeks.

Sometimes, your doctor may inject your spine area with a cortisone-like drug. As soon as possible, start physical therapy with stretching exercises so you can resume your physical activities without sciatica pain. To begin, your doctor may want you to take short walks.

Surgical Treatment of Sciatica
You might need surgery if you still have disabling leg pain after three or more months of non-surgical treatment. A part of the herniated disc may be removed to stop it from pressing on your nerve. The surgery—known as laminotomy with discectomy—may be done under local, spinal or general anesthesia. You have a 90 percent chance of successful surgery if most of the pain is in your leg.

If you suffer sciatica symptoms, let the Gwinnett Medical Center–Duluth help you. For a free physician referral to one of Atlanta’s top sports medicine doctors, please call 678-312-5000.