Condition: Sciatica

Sciatica happens when irritation, inflammation, pinching or compression affects one or more nerves that run down your lower back and into your legs. Sciatica is a very common condition, with estimates suggesting it will affect up to 40% of people at least once in their lifetime. It’s usually not a serious or dangerous condition and most people with sciatica get better on their own with time and self-care treatments. Severe cases may need surgery.

The main symptom of sciatica is pain that shoots or radiates down the leg. This pain is often described as a burning or stabbing pain or like an electric shock. It’s often brought on by sudden movements like sneezing or coughing and from bending down or lifting your legs when lying on your back. It can also come on after being sat down for a long period of time.

Other symptoms of sciatica include:

• Back pain

• Tingling or “pins and needles” (paresthesia)

• Numbness in the legs and feet

• Muscle weakness

Sciatica occurs when the sciatic nerve is irritated, pinched or compressed. A number of conditions can affect the sciatic nerve, including:

• Spinal disc issues such as herniation (often called a ‘slipped’ disc) or degenerative disc disease both of which alter the disc structure and can cause pressure onto the sciatic nerve.

• Spinal stenosis - the area of the lower spine that houses the nerves is narrowed

• Osteoarthritis - the discs and cartilage between vertebrae are worn down and damaged

• Back injuries

• Pregnancy - additional weight, changes in body composition and the baby’s position can put pressure on the sciatic nerve

• Tumours, cysts or other growths

• Cauda equina syndrome - a rare, emergency condition that affects the nerves in the lower part of the spinal cord

Your OneWelbeck consultant will be able to make a diagnosis of sciatica by performing a physical examination, asking you questions about your symptoms, and performing some tests. Tests required may include imaging scans such as X-rays, MRI and CT scans. Electromyography (EMG), a test that measures nerve impulses and muscle response, may also be required to determine the severity of a nerve root injury.

The best treatment for sciatica depends on its severity. Mild cases may benefit from self-care treatments including exercises and stretches, hot and cold compresses and over-the-counter painkillers.

For cases that require specialist care, treatments include:

• Prescription medications including painkillers and muscle relaxants

• Physiotherapy

• Steroid injections

• Decompression surgery to remove portions of a vertebra or herniated disk to relieve pressure on the nerve