Sciatica
Serving the South Florida and Orlando Areas
Dr. Andreas C. Tomac, MD, PhD, FAANS is a distinguished neurosurgeon specializing in diagnosing and treating Sciatica.
What is Sciatica?
Sciatica refers to pain that radiates along the path of the sciatic nerve, which is the longest nerve in the human body. The sciatic nerve runs from the lower back, through the hips and buttocks, down each leg. Sciatica is not a medical condition on its own but rather a symptom of an underlying issue affecting the sciatic nerve. The most common cause of sciatica is compression or irritation of the nerve roots in the lumbar spine, often due to conditions such as herniated discs, spinal stenosis, or degenerative disc disease. Sciatica is commonly caused by conditions that compress or irritate the sciatic nerve roots. These include herniated discs, spinal stenosis, spondylolisthesis, and piriformis syndrome.
Who can it affect?
Sciatica can affect individuals of various ages and backgrounds, and it is not limited to a specific demographic. While it is more commonly observed in adults, particularly as they age, it can also occur in younger individuals due to factors such as lifestyle, occupation, or underlying health conditions. Occupations that involve prolonged sitting, heavy lifting, or frequent bending may increase the risk of developing sciatica. Additionally, conditions such as obesity, sedentary lifestyle, and degenerative changes in the spine can contribute to the compression or irritation of the sciatic nerve. The risk of sciatica may also be influenced by genetic factors and pre-existing spinal conditions. As such, anyone experiencing symptoms such as lower back pain radiating down the leg should seek evaluation by healthcare professionals, including orthopedic specialists or neurosurgeons, for an accurate diagnosis and appropriate management. Early intervention is crucial for addressing the underlying causes and providing effective treatment to alleviate sciatic nerve-related symptoms.
What are the symptoms?
The symptoms of sciatica typically include:
- Pain: The hallmark symptom of sciatica is pain that radiates along the sciatic nerve pathway. The pain often starts in the lower back or buttock and travels down the back of the thigh, potentially extending into the calf or foot. The pain can be sharp, shooting, or burning.
- Numbness and Tingling: Individuals with sciatica may experience numbness or tingling sensations along the sciatic nerve pathway. This can be felt in the buttock, thigh, or lower leg.
- Muscle Weakness: Weakness in the muscles served by the sciatic nerve may occur. This can affect the ability to move the leg or foot and may lead to a sense of instability.
- Difficulty with Movement: The pain and discomfort associated with sciatica can make it challenging to perform certain movements, such as standing up from a sitting position or walking.
- Worsening Symptoms with Certain Activities: Symptoms may worsen with activities that involve prolonged sitting, standing, or certain movements that put pressure on the sciatic nerve.
It’s important to note that the severity and combination of symptoms can vary among individuals. Additionally, sciatica may affect one side of the body more than the other.
Treating Sciatica
How is Sciatica diagnosed?
Diagnosing sciatica involves a comprehensive evaluation by a healthcare professional, and a neurosurgeon such as Dr. Tomac may be instrumental in the diagnostic process. Dr. Tomac typically begins by collecting a detailed medical history, exploring the onset and characteristics of symptoms, and assessing any relevant risk factors or contributing factors. A thorough physical examination is conducted to evaluate muscle strength, reflexes, and sensations in the affected areas. Imaging studies, including X-rays, Magnetic Resonance Imaging (MRI), or Computed Tomography (CT) scans, may be ordered to visualize the spine and identify the underlying cause of sciatica, such as herniated discs or spinal stenosis. Dr. Tomac’s expertise in neurosurgery allows for a detailed analysis of imaging results and a precise diagnosis. The collaboration between the patient and Dr. Tomac is crucial in developing an individualized treatment plan tailored to address the specific characteristics of sciatica and alleviate symptoms. Seeking timely medical attention is essential for a comprehensive evaluation and appropriate management of this condition.
What treatments are available?
The treatment of sciatica depends on the underlying cause and the severity of symptoms. A neurosurgeon like Dr. Tomac can provide expertise in both non-surgical and surgical interventions. Common treatment approaches include:
- Conservative Treatments:
- Pain Medications: Over-the-counter or prescription medications to manage pain and inflammation.
- Physical Therapy: Targeted exercises and stretches to improve flexibility, strengthen muscles, and alleviate pressure on the sciatic nerve.
- Heat or Cold Therapy: Application of heat or cold to the affected area for pain relief.
- Medications:
- Muscle Relaxants: Prescription medications to reduce muscle spasms.
- Corticosteroid Injections: Injections of anti-inflammatory medications into the affected area to reduce inflammation and alleviate symptoms.
- Surgical Interventions:
- Discectomy: Surgical removal of a herniated disc that is pressing on the sciatic nerve.
- Laminectomy: Removal of part of the vertebral bone to relieve pressure on the nerves.
- Spinal Fusion: Surgical fusion of vertebrae to stabilize the spine.
Dr. Tomac can assess the specific case, discuss treatment options, and recommend the most appropriate course of action based on the cause and severity of symptoms. Surgical intervention is typically considered in more severe cases or when conservative measures are ineffective.