Sciatica is characterized by pain radiating from the back into the buttock and into the leg. The pain may travel below the knee and may also involve the foot.
- Pain radiate from the buttock to the leg and foot. There may also be needling or numbness in the region.
- In the more severe case, the leg may become weak.
- The pain feels like an electric shock suddenly or persistently.
- The whole buttock, thigh and leg become tender on touching.
- The leg muscles become very tense and spastic.
- Pain can affect sleep and causes insomnia.
- Cough, sneezing, laughing and sitting may aggravate the pain
There are many causes of sciatica. Any cause of compression on the spinal nerve root can cause sciatica. The most common cause of sciatica include prolapsed intervertebral disc. There other causes include osteophyte or slipping of the vertebra (spondylolisthesis). Intervertebral disc is a soft supporting structure lying between adjacent vertebrae in the spine. The disc composed of a strong ligament ring (the annulus) and the more mobile center (the nucleus). When there is a tear of the annulus, and the nucleus slip out of the annulus, the nearby spinal nerve may can be compressed. The cause of the sciatica can be defined clearly with MRI or CT scan of the lumbar spine. The MRI can is the better investigation, because it can show the spinal nerve better.
When condition is not so serious, patient can be treated with physiotherapy or other manipulative treatment to reduce the pressure on the spinal nerve. Acupuncture may relieve the pain but cannot relieve the pressure on the spinal nerve. Painkiller or special drugs for neuropathic pain may also reduce the pain but cannot cure the underlying cause of sciatica. With these conservative treatment, 90% of the patient can have relieve of sciatica within 8 weeks. However, if the pain persists despite conservative treatment, or when the leg become weak or loss sensation in the leg, one should seriously consider surgical treatment; otherwise the nerve may become permanently damaged and leave permanent deficit. Nowadays, neurosurgeon got many different forms of minimal invasive surgical methods to treat sciatica, including percutaneous Hydrocision lumbar discectomy, endoscopic lumbar discectomy, lumbar disc nucleus replacement (Satellite ™ implant), artificial disc replacement, different dynamic lumbar spine stabilzation methods and minimal invasive lumbar spine fusion (such as TLIF or PLIF). You may consult your neurosurgeon to decide which minimal invasive surgery is most appropriate to your condition.
Note: Anyone reading this article should consult his/her physician before considering treatment or surgery.