Sciatica Doctors

What Is Sciatica Pain

The Sciatic nerve is the largest and longest nerve in the body. The nerve diverges into the left and right nerves on both sides of the body. It extends through the hips and buttocks and continues down the leg, ending right below the knee. At the knee, the nerve branches off into other nerves, which continue into the feet.  

Sciatica occurs when there is pressure or damage to the sciatic nerve. Each case of Sciatica can vary in terms of how long it lasts or whether treatment is necessary. Some people only experience pain from Sciatica for about one to two weeks before it clears up on its own. Others will have pain lasting several years, with multiple flare-ups occurring yearly. 

Many people can clear up their pain with at-home care, which includes hot/cold packs, over-the-counter anti-inflammatory medication, and safe stretches. Anyone who cannot see improvements after trying home remedies may need to see a doctor to manage or alleviate their pain. 

What type of doctor treats sciatica?

There are several types of sciatica pain doctors who can treat sciatica, each with their own specific expertise:

• Orthopedists
• Neurologists
• Chiropractors
• Pain Management Specialists

What Is The Cause Of Sciatica

Pressure or damage to the nerve can occur for a variety of reasons. Sciatica can include: 

• Lumbar Herniated Disc: A bulging or herniated disk that is pressing on the nerve. Discs are the cushions between the vertebrates that make up the spinal column. Disc bulging occurs when the disc extends outside its common space. A disc herniation is when the 'inner jelly-like substance' pushes out of the disc because of tears or defects in the outer cartilage layer. 
• Lumbar Spinal Stenosis: Spinal Stenosis is a narrowing of the spinal canal that puts pressure on the nerve. It can happen in any part of the spine but most often occurs in the neck and the lower back. Lumbar Spinal Stenosis is the type of Stenosis present in the lower back, and the lumbar area comprises five lumbar vertebrae, where Stenosis can set in. Lumbar Spinal Stenosis is usually the result of the damages caused by Osteoarthritis. 
• Degenerative Disc Disease: Aging can lead to the breakdown or degeneration of the spinal discs, causing irritation or pressure on the sciatic nerve. 
• Bone Spurs: Bone spurs can also cause the sciatica nerve in neck to become compressed. Bone spurs are essentially an overgrowth of bone, which can occur on the bones that make up the spinal column. Also known as Osteophytes, these growths often start in the joints, which connect the bones, but when the jagged-edged bones occur in the right spot along the spine, they can quickly narrow the space and pinch the spinal cord or nerve roots. 
• Cauda Equina Syndrome: This is a rare but serious condition that occurs when the bundle of nerves at the end of the spinal cord, known as the cauda equina, is compressed. This syndrome is a serious condition that requires immediate medical attention, as it leads to a loss of control of the bowels and bladder.  
• Pelvic Fractures: Injuries like pelvic fractures can also lead to Sciatica. A fracture or dislocation can stretch or compress the sciatic nerve, causing pain and dysfunction similar to symptoms of Sciatica.
• Sometimes, no specific cause can be found. 

What is Sciatica Symptoms

Sciatica is typically marked by discomfort originating in your lower spine and traveling down the back of your leg. Here are some common signs and symptoms:

1. Pain: This symptom can range from mild aching to a sharp, burning sensation or excruciating discomfort. Often, it worsens with prolonged sitting or sudden movements.
2. Numbness or Muscle Weakness: You might experience numbness, tingling, or muscle weakness in the affected leg or foot.
3. Loss of Bowel or Bladder Control: This is a rare but serious symptom that requires immediate medical attention.
4. Hip Pain: Sciatica can cause pain in the hip area, which may be confused with hip arthritis.
5. Reduced Reflexes: You may have reduced knee-jerk or ankle-jerk reflexes.

Variations in Symptoms Based on Severity

The symptoms of Sciatica can significantly vary in intensity:

• Mild Sciatica: Symptoms are often intermittent and annoying but manageable. They may include mild pain accompanied by tingling, numbness, or weakness.
• Moderate Sciatica: Symptoms are more persistent. This can include constant pain, especially when sitting, and numbness and tingling down the leg.
• Severe Sciatica: Symptoms may be debilitating and significantly interfere with daily activities. This includes severe pain radiating down the leg, significant weakness, and potential bowel or bladder control loss.

Types of sciatica pain

Sciatica generally progresses through Acute, Subacute, and Chronic stages.

Acute Stage (0-6 Weeks)

The acute stage of Sciatica is characterized by the sudden onset of pain in the lower back or hip that radiates to the buttocks and down the leg. The pain can vary from mild discomfort to severe, debilitating pain. You may also experience numbness, tingling, or muscle weakness in the affected leg or foot. During this stage, conservative treatment options like pain relievers, anti-inflammatories, and physical therapy are typically recommended.

Subacute Stage (6-12 Weeks)

If symptoms persist beyond six weeks, the condition enters the subacute stage. During this phase, the pain may lessen in intensity but continue to limit daily activities. The focus of treatment at this stage often involves a combination of continued medication, physical therapy, and possibly injections to reduce inflammation and pain.

Chronic stage (12+ Weeks)

Sciatica is considered chronic when it lasts for 12 weeks or longer. At this stage, the pain may come and go, but it tends to be more persistent. Treatment may involve a more integrated approach, including medication, physical therapy, lifestyle modifications, and potentially surgical intervention if the pain is severe and other treatments have not been effective.

Remember, sciatica symptoms can be similar to those of other conditions. That's why seeking professional help for a sciatica differential diagnosis and treatment plan is crucial. 

When To See A Doctor

While it is possible your pain will clear up on its own, if it is a mild case, you may need to see your doctor if: 

1. You do not see improvements in your symptoms after trying home remedies. 
2. The pain does not go away after one to two weeks. 
3. Your pain is worse than it has been in the past or starts to intensify over time. 

You should seek immediate medical attention if these situations occur:

1. You start to feel pain after an accident or injury, such as a severe fall. 
2. You are unable to control your bladder or bowels. 
3. You have excruciating pain or muscle weakness originating in your lower back or the legs.

Sciatica Diagnosis

Our board-certified sciatica doctors will carefully examine you to diagnose the cause of your symptoms. Our sciatica specialists follow a comprehensive approach that includes reviewing your medical history, conducting diagnostic imaging tests, performing necessary nerve tests, and using diagnostic nerve blocks when applicable.

Review of Medical History

Your journey with us begins with a thorough review of your medical history. We take into consideration any previous injuries or illnesses, lifestyle habits, and current symptoms. Understanding your past health experiences and present complaints helps us get a clearer picture of your condition.

Diagnostic Imaging

We employ state-of-the-art diagnostic imaging techniques to visualize your spinal structures. These may include X-rays to show the alignment of your vertebrae and whether you have a herniated disc or bone spurs. In some cases, we may use MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scans to provide detailed images of your spine, helping us identify any abnormalities causing your Sciatica.

Nerve Tests

If necessary, nerve tests such as Electromyography (EMG) may be performed. This test measures the electrical impulses produced by the nerves and the responses of your muscles. It can help confirm whether you have Sciatica and pinpoint the affected nerves.

Diagnostic Nerve Blocks

In some instances, we may use diagnostic nerve blocks to determine the specific source of pain. This involves injecting an anesthetic around the suspected nerve(s), such as in a facet joint injection, epidural steroid injection, SI injection, or medial branch block. If the injection relieves your pain, it can confirm the specific nerve root causing your symptoms.

Once we have an accurate diagnosis, we will work together with you to create a treatment plan tailored specifically for you.

Treatments for Sciatica at Pain and Spine Specialists

At Pain and Spine Specialists, we offer a comprehensive range of treatments for Sciatica. We aim to alleviate your pain, improve your mobility, and enhance your overall quality of life. Here's an overview of the treatments we offer:

Injection Therapies

Injection therapies can offer non-invasive treatment approach for Sciatica. We offer a variety of injections, such as Epidural Steroid Injections, which can reduce inflammation around your nerve roots, and Facet Joint Injections or Medial Branch Block, which can help diagnose the source of your pain and treat it. Sacroiliac Joint Injections are also available to treat pain originating from the sacroiliac joint that may be causing Sciatica.

Advanced Interventional Procedures

For more severe cases of Sciatica, we offer advanced interventional procedures. Sciatica treatment devices, such as Spinal Cord Stimulation, can help manage chronic pain by sending electric signals to the spinal cord. The Minimally Invasive Lumbar Decompression (MILD) procedure can remove excess ligament tissue, causing nerve compression. The Intracept Procedure targets the basivertebral nerve to relieve chronic low back pain. Radiofrequency Ablation is another option that uses heat to hinder the nerve's ability to send pain signals to the brain.

Conventional Treatments

We also offer conventional treatments, including Medication Management Programs to ensure you take the most effective medications for your condition in the safest manner possible. For some patients, an Intrathecal Pain Pump may be beneficial, delivering medication directly to the fluid around the spinal cord. We also provide Referrals to Physical Therapy. Sciatica treatment physical therapy can help strengthen the muscles supporting your spine, improve flexibility, and promote better posture.

Sciatica Alternative Treatment

In collaboration with our sister company, Shakthi Health and Wellness Center, we offer alternative therapies to complement our conventional treatments. These include Acupuncture, which can help relieve sciatica pain, and Infrared Sauna or Amethyst Biomat therapy, which uses heat to help relax muscles and soothe aches.

Surgical Treatment for Sciatica

If conservative and non-invasive treatments do not provide relief, our board-certified surgeons will evaluate your condition. Depending on the severity of your Sciatica, you may be a candidate for a Spinal Fusion or Laminectomy procedure. The type of surgery most appropriate for you will depend on the cause of your sciatic nerve compression and pain.