Dr. David DeFries

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Sciatica refers to pain, weakness, numbness, or tingling in the leg. It is caused by injury to or pressure on the sciatic nerve. Sciatica is a symptom of another medical problem. It is not a medical condition on its own.  Sciatica occurs when there is pressure or damage to the sciatic nerve. This nerve starts in the lower back and runs down the back of each leg. This nerve controls the muscles of the back of the knee and lower leg. It also provides sensation to the back of the thigh, part of the lower leg, and the sole of the foot. (1) Sciatica occurs most frequently in people between the ages of 30 and 50 years old. Most often, it tends to develop as a result of general wear and tear on the structures of the lower spine, not as a result of injury. (2)

The most common symptom associated with sciatica is pain that radiates along the path of the sciatic nerve, from the lower back and down one leg; however, symptoms can vary widely depending on where the sciatic nerve is affected. Some may experience a mild tingling, a dull ache, or even a burning sensation, typically on one side of the body. Some patients also report  pins-and-needles sensation, most often in the toes or foot and/or numbness or muscle weakness in the affected leg or foot.(1)

Pain from sciatica often begins slowly, gradually intensifying over time. In addition, the pain can worsen after prolonged sitting, sneezing, coughing, bending, or other sudden movements.
Common causes of sciatica include:

  • Herniatied or buldging disc
  • Spinal stenosis
  • Piriformis syndrome (a pain disorder involving the narrow muscle in the buttocks)
  • Pelvic injury or fracture
  • Tumors (2)

In some cases diagnostic imaging such as x-ray, MRI, or CT may be used to rule out a more serious condition, such as a tumor or infection, and can be used when patients with severe symptoms fail to respond to six to eight weeks of conservative treatment.

Many people use the term "sciatica" when describing pain in the low back, buttocks, hip and groin regardless of whether it travels down the leg or not. It is important that a proper examination be performed in order to determine the cause of the discomfort. Unfortunately, sciatica is rarely as simple as a " pinched nerve" and often requires extensive treatment in order to address the cause of the pain in order to reduce future episodes and degeneration. 

Treatment for sciatica depends on the cause and treatment often includes:

  • Mobilization of the pelvis and low back
  • High power laser therapy to the area of pain and lumbar spine
  • Manipulation of restricted joints
  • Traction of the spine
  • Electrotherapy to the spine

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