Neurosurgery, Spine Surgery
November 26, 2021
Symptoms & Solutions: Sciatica
Sciatica results from sciatic nerve compression, leading to pain that radiates down the leg from the base of the spine through the hips and buttocks. Sciatica can be caused by a bone spur, osteoarthritis, a herniated disc, or spinal stenosis, which is a narrowing in the spinal column that may compress the nerve. Other causes of sciatica include spinal tumors, traumatic injuries, and some rare neurological conditions.
Symptoms of Sciatica
Sciatica symptoms, such as inflammation and partial numbness in the leg, can range from mildly irritating to intensely painful and limiting. They are sometimes confused with other types of hip pain, but a spine specialist can help you determine if your hip or leg pain results from sciatic nerve compression.
Common symptoms of sciatica include:
- Pain—usually a sharp, shooting pain running from the hip down the leg—or a burning sensation. The pain is often most severe in the thigh or calf rather than the back and may feel like an electric shock or zapping sensation. In most cases, it is only experienced on one side of the body. Discomfort is worse with sudden movements or prolonged sitting.
- Numbness or tingling in the hip or the back of the buttocks or thigh. Some people describe this as a “pins-and-needles” sensation.
- Weakness that interferes with lifting your feet. Your leg or foot may feel heavy.
- Sudden buckling of the leg due to severe pain or numbness.
If your symptoms continue for more than a week or become more severe, contact your doctor. If you experience difficulty with bladder or bowel control, seek emergency medical attention, as this could be a sign of serious complications.
Can I Treat Sciatica on My Own?
The symptoms of sciatica can be mild, with only occasional flare-ups, or intensely painful and debilitating. In most cases, sciatic nerve pain resolves within a few weeks with proper treatment. If the symptoms don’t improve, surgery may be needed, but this is only in the most severe cases.
Here are the simplest ways to treat mild symptoms of sciatica:
Heat or Cold
For occasional sciatica, applying ice packs or gentle heat may alleviate pain. Initially, you should apply ice to reduce inflammation. You can use ice packs for 15-20 minutes at a time several times a day. After the first few days, you can switch to a heating pad or warm towels to minimize the pain. If you are still experiencing pain, try alternating heat and cold until you find what works best for you.
Many over-the-counter medications can reduce sciatic nerve pain. Non-steroidal anti-inflammatories such as ibuprofen, aspirin, and naproxen sodium can minimize swelling and pain. If over-the-counter medications don’t help, it may be time to talk to a specialist at Arkansas Surgical Hospital about prescription medications, physical therapy, or other options.
Stretching exercises can help alleviate sciatica symptoms. Just be sure to be gentle, avoiding pushing yourself too hard or overextending the leg. See our suggestions for simple sciatica exercises here. These exercises can also strengthen your body’s core muscles, which helps reduce the risk of developing sciatica in the future.
More Sciatica Treatment Options
If six weeks or more of the above methods haven’t dramatically decreased your sciatica symptoms, a consultation with a specialist at Arkansas Surgical Hospital may be needed. Options your doctor may recommend include:
If over-the-counter medications aren’t effective, your physician may prescribe muscle relaxants such as Flexeril or Amrix, which calm muscle spasms. Certain antidepressants or anti-seizure medications may also help relieve sciatic nerve pain.
Exercising at home may not give you enough relief. A physical therapist can help relieve pressure on the nerve and work with you to develop a course of simple exercises and stretches. Your treatment will focus on improving flexibility, strengthening muscles, and improving aerobic fitness. Physical therapy may include swimming, walking, or water therapy.
Corticosteroid injections in the base of the spine reduce swelling and may alleviate pain. These spinal injections usually bring relief for about three months, then need to be repeated if sciatica pain returns. Spinal injections are given as an outpatient procedure under local anesthesia. The interventional pain management specialists at Arkansas Surgical Hospital can determine whether spinal injections may relieve your pain.
Surgery for sciatic nerve pain is generally not considered unless other treatment options have failed. If an individual’s sciatica has become more severe, lasted for an extended time, has led to leg weakness, or is causing bowel or bladder control problems, surgery may be advised to alleviate the spinal compression.
In most cases, surgery can be scheduled well in advance to minimize interference with your daily routine. However, if there is a loss of bowel or bladder control, emergency surgery may be required.
In a microdiscectomy procedure the surgeon removes all or part of the herniated spinal disc that is putting pressure on the sciatic nerve. This surgery is done under general anesthesia. It usually takes about an hour or two, and you can go home the same day or the following morning. You will be encouraged to walk around a few hours after surgery to promote quick healing. You will need someone to take you home, as you won’t be permitted to drive following the procedure.
A surgical laminectomy removes the lamina, which is the part of the vertebrae that surrounds and protects the spinal cord. This widens the spinal canal to relieve pressure on the sciatic nerve caused by spinal stenosis. The surgery usually takes two to three hours. In some cases, patients can return home the same day after getting on their feet to walk around. For others, a hospital stay of up to three days may be needed. As with a microdiscectomy, you will need someone to drive you home.
Recovering from Sciatica Surgery
Recovery from these surgeries requires resting at home for two to four weeks before returning to work (or longer, if your job is strenuous). During the first few weeks, avoid sitting for long periods, lifting heavy objects, and bending over often. Your doctor may prescribe pain medication for the short term. Physical therapy and at-home exercises recommended by your surgery can help reduce recovery time.
Start Treating Your Sciatica Pain
If you suffer from sciatica that has lasted more than a few weeks or has become more severe, it’s time to talk to one of the specialists at Arkansas Surgical Hospital about possible treatment options. Contact us at (501) 748-8000 to schedule an appointment and discuss ways to eliminate your sciatic nerve pain.
Photo by Kindel Media