Sciatica: It's a Pain

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Lower back pain is one of the most common forms of injury and disability worldwide.

Statistics from the International Association for the Study of Pain indicate that in 2017, 7.5% of the global population, or about 577 million people, experienced low back pain. It's also been the leading cause of disability since 1990.

person with sciatica

Sciatica, one of the common causes of back pain, is also quite prevalent.

Cleveland Clinic estimates that about 40% of people in the U.S. will experience sciatica during their lives. It occurs when pressure is applied to the sciatic nerve, which runs from the hip to below the knee before branching out into other nerves.

Young Lu, M.D., an orthopedic spine surgeon with the University of Miami Health System, says it's often easy for orthopedic specialists like him and his colleagues to determine when sciatic nerve pain is present in a patient.

"When you're experiencing sciatica, the classic symptom is pain that starts in the back and radiates down the leg," he says.

The American Academy of Orthopaedic Surgeons (AAOS) notes that most cases of sciatica under age 40 are due to a herniated or slipped disk in the lower spine. In older adults, it may occur due to arthritis or bone spurs.

"The disks are located between the vertebrae, or bones of the spine, and resemble jelly donuts that normally cushion the vertebrae and act as shock absorbers," says Dr. Lu. "These disks can degenerate over time, and the soft center of the disk can bulge or push out. This can put pressure on a nerve root, causing radiating leg pain."

What are the symptoms of sciatica?

For the patient experiencing sciatica, the result may be weakness, numbness, or a burning or tingling sensation that starts at the back and radiates down the leg. The pain may feel like a leg cramp and be sharp or electrical. It may last for weeks or get worse when you sneeze, cough or move.

Dr. Lu says that the nature and severity of symptoms can vary based on the cause of sciatica and other factors.

If you suspect sciatica, it's always worth a conversation with your doctor.

If you have more severe symptoms, such as complete loss of feeling in the genital or buttock region and/or loss of bladder and bowel function - It's a medical emergency.

Dr. Lu says this may indicate the presence of a severe disorder known as cauda equina syndrome, which will require fast treatment.

How do you treat sciatica?

The good news about sciatica is that most cases (80 to 90%) get better over time without surgical intervention. Dr. Lu says that non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are often helpful. Prescription medication, physical therapy, or epidural injections may be utilized in more severe cases. Surgery is typically only a last resort if conservative treatment methods have failed.

Some of the issues that lead to sciatica are preventable.

Dr. Lu says that weight, nicotine use, and diabetes are the three primary risk factors for sciatica that patients can control.

"There's no question that losing weight is difficult, but it's important for reducing risk," he says. "And nicotine in the body reduces blood flow to the disks and leads to accelerated disk degeneration."

For those with diabetes, Dr. Lu adds that keeping blood sugar in check to manage diabetes symptoms and complications is critical.

"Diabetes that is not kept under control can lead to aging and promote degeneration of the spine," he says.


Wyatt Myers is a contributing writer for UMiami Health News.


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