Sciatica

Sciatica is a general term for pain along the sciatic nerve, caused by compression of that nerve by the bones in the spine, or one of the surrounding soft tissues, such as the sacroiliac or lumbar joints, the Piriformis muscle, or the Iliolumbar ligament.

Numbness or sharp, stabbing, burning, electrical, and shocking pain are all words that are used to describe the pain associated with Sciatica. The discomfort stems from the lower back, and often passes all the way down the leg.

Usually a thorough history and a comprehensive physical examination will tell the story. But X-rays, a CT scan, an MRI scan may help show a bony or soft tissue abnormality. And special nerve conduction studies may help in assessing how the condition has affected the nerve.

Sciatica is a common condition, and as the Sciatic Nerve is the major nerve supplying the foot, a patient with sciatica often gets the symptoms in the foot, particularly on the heel and weight-bearing surface. Thus, a great number of patients present to the podiatric office with foot and leg problems which actually stem from Sciatica. So podiatrists frequently treat the symptoms associated with this condition.
Abnormal mechanical problems with the foot and leg can worsen Sciatica--and may even be its primary cause.

Any force that causes abnormal or excessive forces on the lower back can cause Sciatica. Uncompensated leg length differences, excessively pronated feet and other biomechanical forces caused from, or associated with, the feet can be responsible for producing those abnormal or excessive forces.

Yes. Podiatrists often treat the symptoms in the foot caused from this condition. And podiatrists often treat the cause of the condition when sciatica has an underlying biomechanical abnormality caused from the lower extremity (foot, knee, leg).

When other causes are involved, or when surgical intervention of the spine, disk or nerve are required, a specialist in back surgery (usually an orthopaedic surgeon or neurosurgeon) would be called in.

First, for any severe symptoms, make an appointment to see an orthopaedic or neurosurgeon specializing in the back to thoroughly assess your spine.

An appointment with a podiatrist can be helpful in assessing whether a foot or leg problem is associated with the condition.

But regarding treatment in the mean time, for severe episodes, it's often best to rest on a firm mattress for 2 or 3 days, getting up only to use the bathroom. Applying ice packs may ease the pain, as can massage and physiotherapy.

But current thinking is that prolonged inactivity worsens the condition. So, it's best to try to keep moving when possible, though it's best not to bend, lift anything, or sit in soft chairs.

Oral pain medications, muscle relaxants and anti-inflammatory drugs (such as aspirin or ibuprofen) can be helpful, as can injections of anaesthetics and anti-inflammatory medications into the spine. Additionally, physiotherapy, massage, acupuncture, chiropractic and exercise may all be useful to address symptoms.

Most of the time, the pain gradually goes away with use of only these conservative measures, yes. But if severe pain persists, more aggressive and invasive measures may be required. Part of a disk or vertebra may be cut away surgically to stop the pressure, or an enzyme may be injected into a disk to make it shrink.

As sciatica can recur, it is best to try to avoid putting any undue strain on your back. Try not to sit in one position too long. Try not to lift heavy objects, but when you do lift something, lift with your legs. You can strengthen the muscles that surround and support the spine with swimming, walking and other exercises.

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