Common symptoms, causes and treatment of sciatic nerve pain and discomfort.

Numbness, tingling and discomfort through the buttocks and legs are all signs a patient may be suffering from sciatica. Sciatica is associated with pain that runs along the route of the sciatic nerve. While common side effects are felt in the lower half of the body, the issues actually begins in the back. The source of sciatica comes from pressure of pinching of this nerve at the spine, usually due to inflammation or physical compression from a bone spur, arthritis or disc bulge.

Symptoms and diagnosis

Patients experiencing true sciatica feel the numb and tingling side effects below their knees and sometimes into the big toe. Some patients describe feeling as though their ankle is dragging or their foot is slapping the ground when they walk. While the source of sciatica begins in the back, those suffering from the condition will not always experience back pain. Any radicular pain — radiating discomfort into the lower extremities directly along the course of a spinal nerve root — is a component of a more severe nerve compression issue at play.

There are many other issues that can mimic sciatica and present themselves similarly, but are not caused by a problem with the back and do not specifically involve the sciatic nerve. Anyone feeling such pains should see a physician to properly identify the cause.

Treatment

Today’s sciatica treatments are based on physical approaches that encourage movement and little bed rest. It’s important for patients to be taking an active role in their own rehabilitation.

Often, treatment plans will begin with physical therapy, ice and heat, and some medications — anti-inflammatories, muscle relaxers or a nerve pain remedies. Acupuncture and chiropractic care have also been shown to help.

The good news is that most of the time, sciatica gets better and resolves itself on its own. Most symptoms will diminish in two or three months, and most back pain associated with it will get better in four to six weeks.

Some extreme cases of sciatica will require surgery to fix the source of the issue. Patients are often referred to surgeons if they have progressive weakness in their lower body, there is a significant acute disc herniation or their pain can’t be relieved with conservative measures. But, they must have a correlating abnormality on imaging that would respond to surgery.

Back pain is usually something everyone has at some point in their life. It’s estimated that back pain affects 50 percent of the population every year. Sciatica is not always as common, but a simple combination of activity modification, exercise and even something as simple as postural change can be easy treatments. Exercise should be the primary medicine.

Remember, other abnormalities in a person’s biomechanics, posture or hips can radiate pain into the leg. If you have pain — especially if it’s not getting better — it’s important to get it checked out and not just assume the issue is sciatica.

Leslie Hillman, M.D., is a physician who specializes in physical medicine and rehabilitation. Dr. Hillman is medical director of the Courage Kenny Spine Centers and the non-surgical spine program for Allina Health in Minneapolis, Minnesota. She works with patients who have neck and back pain to improve function and improve their quality of life.