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Check Your Health is a web-only feature being offered monthly by The Cheshire Herald. Each month, a professional from MidState Medical Center will offer advice on a different issue pertaining to health.
If you’ve ever had issues with sciatica before, there’s no doubt you’ll contest that it may be some of the worst pain of your life. In fact, some women have said that sciatic pain is worse than childbirth! Typically, the hallmarks of sciatica are pain and numbness that radiate down the back of the leg, often below the knee. Since sciatic pain is often felt along the course of nerves and their branches, the symptoms are felt mainly in the legs, even though the problem originates in the lower lumbar region of the spine.
It is important to know that sciatica is not a diagnosis in and of itself. Rather, it is a symptom of an underlying medical condition, often an offshoot of a disc problem, with a piece of the disc pressing on your sciatic nerve, irritating it and causing it to act up. In nine out of 10 cases, this is the cause, particularly in younger patients.
Sciatica symptoms (e.g., leg pain, numbness, tingling, weakness, possibly symptoms that radiate into the foot) are different depending on where the nerve is pinched. For example, an irritated nerve can cause weakness in extension of the big toe and potentially in the ankle. Typically, sciatica sufferers experience constant pain only in one side of the buttocks or leg, they may have pain that makes it difficult to stand or walk, and they may be worse when sitting.
So, you may be wondering…who is the unlucky one to get sciatica? The answer is that the incidence can vary, but it greatly increases in middle age. It rarely occurs before age 20, but can, and the probability of experiencing sciatic pain from a disc peaks in the 50s and then declines. Often, people do not recall a specific event that caused their symptoms.
Typically, the diagnosis of sciatica can be made by patient descriptions of what they’ve been feeling and a physical examination. However, an MRI can provide direct evidence of a disc problem and confirm or deny that diagnosis.
The vast majority of people who experience sciatica get better within a few weeks or months and find pain relief with conservative treatment options. Conservative treatment— a catchall term for everything but surgery—used to emphasize inactivity or even bed rest.
However, now we generally advise patients to keep up their daily activities as much as possible. Pain relievers, usually standard non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, are often prescribed. In addition, physical therapy can help strengthen muscles in the abdomen and around the spine, which may take some pressure off the discs. If none of this works, corticosteroid injections, which have a strong anti-inflammatory effect, are a non-surgical option.
When sciatica pain is severe and debilitating, then a surgical option may be necessary to relieve the underlying disc problem. Fortunately, today, there are minimally invasive surgical options for treating this issue, many of which are available right in your own community. With minimally invasive surgery, smaller incisions are made, and that means patients recover faster, with less pain, blood loss and disruption to their daily lives.
If you’re suffering from sciatica pain, the biggest takeaway is don’t suffer in pain for an extended period of time. Get a leg up…and save yourself from sciatica!
Dr. Jeff Pravda.
MidState Medical Center-affiliated physician who practices with Comprehensive Orthopaedics, with offices in Meriden, Wallingford, Cheshire, and Southington.