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Sciatica: Disease or Symptom?
Many people believe that sciatica is a disease, but that’s not true. Sciatica is a symptom of an underlying medical problem that is related to the sciatic nerve. The largest nerve in the body, it begins in the spinal cord and run down through both buttocks and legs to the feet. When the sciatic nerve is damaged, pain can radiate from the lower back all the way to the feet.
The most common cause that Dr. Fischer finds for sciatica is a lumbar disc herniation, which is when a disc that supports the lumbar vertebrae ruptures. The disc may press on the sciatic nerve and cause pain or numbness. Other causes can be a slipped disc in which a vertebra slips forward over another one, disc degeneration related to age or other issues, or arthritis. Less common causes for sciatica can be infection, tumors, or trauma.
The most common symptom of sciatica that Dr. Fischer treats is pain. This may appear as pain that radiates from the back down to the leg and foot or sharp pain when walking or standing, which is often worse when sitting. Numbness or loss of sensation in the lower limbs is another symptom, as well as difficulty moving the lower limbs. Some patients experience neurological symptoms like loss of bowel or bladder control or progressive loss of feeling in the legs.
Sciatica symptoms may dissipate in a few weeks and some patients don’t even choose to see a doctor. In other cases, pain can be so debilitating that they seek help from an experienced spine surgeon like Dr. Fischer in New York City. The goal of treatment is to eliminate pain and most doctors seek to do that non-surgically. One method is administering steroid injections directly into the lumbar region to relieve pain and inflammation. Another option is massage to promote healing and circulation, relax muscles, and release endorphins. Acupuncture is another treatment method that gives some sciatica patients relief. Each of these methods tend to have rather short-lived effects. Dr. Fischer may also recommend special exercises that target lumbar spine alignment and help relieve pain. A consistent regimen of stretching and exercises for a few months can improve sciatica symptoms. As a last resort, surgery on the sciatic nerve may be advised for patients with significant symptoms who don’t get relief in other ways. This is especially true if the patient loses sensation in the lower limbs or has trouble moving.