Description of Sciatica
Sciatica describes a collection of symptoms that can arise with sciatic nerve compression. This nerve is the largest and longest in the body, running from the base of the spine and down through both legs. Sciatic nerve compression can lead to pain that begins in the lower back and moves through the buttocks, legs, and feet. It is also characterized by other symptoms like burning, cramping, muscle weakness, tingling, and numbness. Sciatica generally occurs on one side of the body, but it can affect both sides.
The sciatic nerve is about an inch wide and consists of multiple nerve bundles. Sciatica is produced when this nerve is being compressed, or pinched. Compression is often caused by herniated disc or a bone spur, most commonly in the area where the nerve passes out of the spinal column in the lumbar (lower back) region.
Most sciatica treatment methods are nonsurgical. These methods might include brief periods of rest, specialized exercises and stretching, physical therapy, and non-steroidal anti-inflammatory drugs (NSAIDs). However, in some cases, these conservative treatments only provide temporary relief, leading some patients to explore surgery as an option. Today, sciatica can be managed through safe, effective endoscopic procedures at Laser Spine Institute. In many cases, these minimally invasive procedures render highly invasive open back surgeries unnecessary.
Sciatica, which is a form of nerve dysfunction (peripheral neuropathy), occurs when there is compression on, or damage to, the sciatic nerve. This nerve innervates the muscles behind the knee and lower leg. It provides sensation to the back of the thigh, part of the lower leg, and the sole of the foot.
Sciatica arises most frequently because of pressure being placed on the sciatic nerve caused by a degenerative spine condition such as a herniated disc, a bulging disc, a protruding disc, or a bone spur. The condition often is diagnosed as radiculopathy. This means that the damaged disc or excess growth of bone is positioned in such a way that it places pressure on the nerve root.
Sciatica might also be caused by an injury, including a fracture of the pelvis or trauma to the buttocks or thigh. Another factor could be prolonged external pressure on the nerve, and pressure on the nerve from nearby anatomical structures including certain muscles. Sciatica might also arise in cases of nerve entrapment, which entails pressure on the nerve where it passes through an opening (foramen) between two vertebrae to exit the spinal column. The underlying cause of the symptoms is the prevention of the passage of proper motor and sensory impulses along the length of the nerve.
Diseases that affect the entire body, such as diabetes, can damage many different nerves, including the sciatic nerve. The sciatic nerve also may be harmed by pressure from a tumor, abscess, or other mass, or by bleeding in the pelvis.
Sciatica symptoms include sensation changes, numbness, tingling, burning, and pain in the buttocks, down the back of the legs, and/or into the sole of the foot. Sciatica can also cause weakness in the legs, knees, and feet, and in severe cases can cause a loss of mobility. In many cases, sciatica affects just the right or left side of the body, but it can affect both.
Treatment of Sciatica
Traditionally, the only surgical option for correcting sciatica was open back surgery. Open back surgery involves high risks and many complications, but Laser Spine Institute offers minimally invasive, outpatient procedures as an alternative. Our safe, effective endoscopic procedures can address the causes of sciatica and leave the patient free of the painful, debilitating symptoms. Our procedures – called a percutaneous endoscopic discectomy, a foraminotomy, or a laminotomy – are for people with a herniated disc, bulging disc, or bone spur that is pressing against the sciatic nerve and causing the symptoms of sciatica. By removing or shrinking the herniated disc or ulging disc with the laser, we can decompress the nerve. After excess disc and bone material are removed, the symptoms of sciatica generally disappear.
Once the Laser Spine Institute surgeon has completed the procedure, the patient (with a companion) is free to go after one to two hours of monitoring. We generally encourage patients to take a long walk the afternoon or evening of their procedure. The patient then returns the following day for a post-operative visit to get clearance from the doctor to return home.