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Sciatica – Overview

January 17, 2022


Lumbar radiculopathy, which is otherwise known as sciatica, simply refers to irritations of the nerves in the lumbar spine, the lower lumbar spine, that produce pain that radiates down the leg, typically from the buttock into the back of the thigh into the calf and occasionally into the foot. Lumbar radiculopathy can be associated with numbness and tingling in the leg as well. And occasionally weakness, either in the ankle or in the knee. The causes of lumbar radiculopathy or sciatica can include a variety of things, common of which is a disc herniation in the lumbar spine that pinches the nerve and puts pressure on the nerve and irritates the nerve. Other causes can be spinal stenosis, which simply means that narrowing of the space that’s available for the nerves in the lumbar spine, or scar tissue that’s formed after surgery in the lumbar spine. We typically diagnose sciatica based on the clinical symptoms that people present with, which is again, pain and numbness and tingling that flows down the leg, usually in the distribution of the sciatic nerve.

And once somebody presents with those symptoms, the best diagnostic imaging study we can get is an MRI that demonstrates whether there’s any disc herniation or other tightness around the nerves that’s causing nerve irritation. Treatment of sciatica starts with nonsurgical measures. Time, oral anti-inflammatory medications, physical therapy, occasionally a steroid pack. And if those don’t work, the ultimate answer may be surgery. And the surgery would be a decompressive operation that takes away whatever is causing pressure on the nerve that’s giving the pain down the leg. So that may be a microdiscectomy or it may be a hemilaminotomy or a laminotomy in order to decompress the nerve.

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