Sciatica: Causes, Symptoms, and Treatment Options

As any Pain Doctor will tell you, sciatica refers to pain which derives from the sciatic nerve. It normally comes about due to a back injury, spinal stenosis, or spondylolisthesis.
Of note, sciatica is not actually a condition within itself, but rather a symptom of another issue involving sciatic nerve. Receiving an accurate diagnosis from a Pain Specialist as soon as possible, and then being given a Personalised Treatment Plan, is key to getting back on track in the shortest amount of time

In a Nutshell

Did You Know?

“The sciatic nerve is the longest and widest nerve in the human body. It starts just outside the spine, and runs down from the lower back, travelling through the pelvis, and down the back of each thigh to the legs, ending just below the knee
This sciatic nerve controls several muscles in the lower legs, and supplies sensation to the skin of the foot and the majority of the lower leg” [1]

• Sciatica describes pain which derives from an irritated sciatic nerve. Common symptoms include tingling and numbness
• The sciatic nerve is a mixed nerve. – This means that it has both motor (movement) and sensory (sensation) fibres.
• Sciatica can be due to a compressed nerve in the lower spine, however, symptoms can radiate throughout the back and legs
• There are a broad spectrum of treatments which are provided by Pain Doctors who work with multi-disciplinary teams. These can include: pain block injections (a nerve block refers to an injection of local anaesthetic and corticosteroid around the nerve(s) that are causing problems. This is often termed a ‘nerve block’ because it interrupts pain signals that are being sent to the brain). As well as various types of pharmaceuticals (e.g., anti-inflammatories, corticosteroids, antidepressants, and anti-seizure medications; and personalised physical therapy sessions, tailor-made exercise programs which can be done at home, and more [1]

So What Sciatica Symptoms Should I Report to the Pain Doctor?

• Pain anywhere along the length of the sciatic nerve (this can encompass the lower back, through the buttocks, to down the back of either leg)
The pain experience may include feeling:
• shooting
• stabbing
• burning
• numbness
• tingling
• weakness [1]

The level of severity of this pain is variable, and may become worse when moving [1]. To that end, it is a good idea to compile a ‘Pain Dairy,’ which you can show to your Pain Doctor on your initial in-person, or online consultation. Organise the Pain Dairy into daily pages, with separate sections for each hour. This will give you enough space to write a detailed entry as to the type of symptoms you are experiencing, how long they go on for, what you were doing when they came on, and if you did anything which ameliorated the pain (for example, lied down), etc.

What is the Most Common Cause of Sciatica?

The answer to this, is: a herniated (or bulging) disk. – A condition which Pain Doctors frequently diagnose. Note: a herniated disk comes about when a spinal disk is pushed out of place. This can generate pressure on one (or a few) of the spinal nerves which make up the sciatic nerve [1].

Other Causes of Sciatica Regularly Seen By Pain Specialists

These comprise:

• Lumbar spinal stenosis (the narrowing of the spinal cord in the lumbar spine)
• Spondylolisthesis: a disorder whereby a disk slips forward over the vertebra below it
• A back injury
• General wear and tear [1]

Reference

[1]. Medical News Today (2023). “What you need to know about sciatica.”
https://www.medicalnewstoday.com/articles/7619