Sciatica

What is sciatica?
Sciatica is a symptom. It consists of leg pain, which might feel like a bad leg cramp, or it can be excruciating, shooting pain that makes standing or sitting nearly impossible.

The pain might be worse when you sit, sneeze, or cough. Sciatica can occur suddenly or it can develop gradually. You might also feel weakness, numbness, or a burning or tingling ("pins and needles") sensation down your leg, possibly even in your toes. Less common symptoms might include the inability to bend your knee or move your foot and toes.

What causes sciatica?
Sciatica might be a symptom of a "pinched nerve" affecting one or more of the lower spinal nerves. The nerve might be pinched inside or outside of the spinal canal as it passes into the leg.

Conditions that cause sciatica:

A herniated or slipped disc that causes pressure on a nerve root. This is the most common cause of sciatica.
herniated disc

Piriformis syndrome. This develops when the piriformis muscle, a small muscle that lies deep in the buttocks, becomes tight or spasms, which can put pressure on and irritate the sciatic nerve.
Spinal stenosis. This condition results from narrowing of the spinal canal with pressure on the nerves.


Spondylolisthesis. This is a slippage of one vertebra so that it is out of line with the one above it, narrowing the opening through which the nerve exits

Treatment
Nonsurgical Treatment
The condition usually heals itself, given sufficient time and rest. Approximately 80% to 90% of patients with sciatica get better over time without surgery, typically within several weeks.

Nonsurgical treatment is aimed at helping you manage your pain without long-term use of medications. Nonsteroidal anti-inflammatory drugs such as ibuprofen, aspirin, or muscle relaxants may also help. In addition, you may find it soothing to put gentle heat or cold on your painful muscles. It is important that you continue to move. Do not remain in bed, as too much rest may cause other parts of the body to feel discomfort.

Find positions that are comfortable, but be as active as possible. Motion helps to reduce inflammation. Most of the time, your condition will get better within a few weeks.

Sometimes, your doctor may inject your spinal area with a cortisone-like drug.

As soon as possible, start stretching exercises so you can resume your physical activities without sciatica pain. Your doctor may want you to take short walks and may prescribe physical therapy.

Surgical Treatment
You might need surgery if you still have disabling leg pain after 3 months or more of nonsurgical treatment. A part of your surgery, your herniated disk may be removed to stop it from pressing on your nerve.

The surgery (laminotomy with discectomy) may be done under local, spinal, or general anesthesia. This surgery is usually very successful at relieving pain, particularly if most of the pain is in your leg.