Eliminate Your Leg Pain with Sciatica Surgery
People experience leg pain for a variety of reasons. When the pain originates in the lower back or hip and radiates into the leg, it may be due to sciatica. Symptoms of sciatica develop because of irritation or pressure that is applied to the sciatic nerve.
For many, sciatica goes away on its own or responds to conservative treatments. Sometimes, however, surgery may be necessary. Rely on this guide to discover more about sciatica and how surgery can help alleviate your pain.
What is Sciatica?
Sciatica is a set of symptoms caused by compression and/or irritation of the sciatic nerve. There are two sciatic nerves in the body—one for each leg. In fact, these nerves are the largest and longest in the body.
The sciatic nerve originates at the lower back, merging five nerve roots in the lumbar and sacral spine. The sciatic nerve then exits the pelvis through the greater sciatic foramen. It runs along the back of the thigh where it branches off into the knees. Finally, the nerve terminates in each foot.
Sciatica—sometimes known as lumbar radiculopathy—describes a cluster of symptoms in which the sciatic nerve becomes injured or inflamed. Typically, these symptoms are caused by an underlying medical issue, such as a lumbar herniated disc. Some underlying causes are relatively benign, whereas others may point to a more serious medical condition.
Symptoms of Sciatica
Compression or injuries to the sciatic nerve can cause a variety of symptoms, ranging from mild to severe. Symptoms may come and go or linger as persistent, nagging pain. Much of this depends on which nerve root(s) are affected or where the compression occurs. For instance, common symptoms of sciatica include:
- Back & leg pain: Constant to occasional shoot
- Leg cramping: Depending upon what causes your sciatica, cramps in the legs can last for weeks before fading away.
- Leg numbness or weakness: Injury to the sciatic nerve can cause numbness or a “pins-and-needles” sensation along the nerve tract. In addition, the affected leg may experience weakness. It may feel more difficult to lift a foot off the floor (known as foot drop).
- Disturbed sleep: Sciatic pain may increase when lying down for a period of time. This can make it difficult to fall or remain asleep.
Serious Sciatica Symptoms
If your sciatica results from cauda equina syndrome, spinal tumors, or infection, then immediate medical attention may be necessary. Consult a doctor or orthopedic surgeon if you experience:
- Increased weakness or neurological symptoms in the leg
- Sciatica symptoms in both legs (aka, bilateral sciatica)
- Loss of bladder or bowel control
- Sexual dysfunction
Causes of Sciatica
Sciatica is caused by compression, inflammation, or issues with the immune system that affect the sciatic nerve. It is a symptom of an underlying medical condition rather than a standalone issue. For example, conditions commonly associated with sciatica include:
- Lumbar herniated disc: A herniated disc in the lower back is one of the most common causes of sciatica. In fact, an estimated 90 percent of sciatica cases involve a damaged intervertebral disc. As a disc loses its shape, it can apply pressure to the sciatic nerve. In addition, hyaluronan—a chemical in disc material—can leak out of a damaged disc, causing irritation and inflammation near the sciatic nerve.
- Lumbar spinal stenosis: A narrowing of the spinal canal in the lower back. This condition usually affects older adults.
- Spondylolisthesis: When a stress fracture in the spinal column causes one vertebra to slide out of place and over another. As a result, the disc space collapses, causing compression of the sciatic nerve.
- Bone spurs: These bony overgrowths form when there is vertebral degeneration. Bone spurs can apply pressure to the sciatic nerve.
- Less common causes: Diabetes, tumors, and pregnancy may also trigger sciatica.
Risk Factors for Sciatica
In addition, certain individuals are more at risk for developing sciatica. Risk factors include:
- Advanced age: Individuals ages 40 or older are more likely to develop sciatica. As we age, everyday activities and personal habits slowly cause wear and tear on the spine.
- Obesity: Excess body weight places more strain on the spine, causing adverse structural changes.
- Occupations: Laborers, warehouse workers, and those who lift heavy objects or twist the torso may be more at risk for sciatica. In addition, those who sit for long periods of time—like truck drivers or office workers—may develop the condition more easily.
- Sedentary lifestyle: A strong back and core help the body to stay aligned. Those who exercise regularly may be less likely to develop sciatica as long as they exercise and stretch properly.
Luckily, most people only require conservative treatments to relieve their sciatica symptoms. Resting the area and anti-inflammatory medications are usually the first line of defense, especially if symptoms are not very serious. Hot and cold therapy can also aid with any related muscle pain.
Steroid injections may be used to reduce inflammation. An injection of a local anesthetic and steroid—known as a nerve root block—can deliver temporary pain relief.
Physical therapy for sciatica can also work to strengthen and condition the back and core muscles. Physical therapists can educate you on proper lifting techniques, activity modifications, and exercise routines to prevent sciatica.
Surgical Options for Sciatica
If conservative treatments aren’t helping (or you experience some of the serious sciatica symptoms mentioned above), surgery may be necessary to alleviate your pain. For instance, cauda equina syndrome, spinal tumors, or sciatica in both legs may require immediate surgical intervention.
Sciatica surgery typically entails two goals: eliminating painful symptoms and correcting the cause of sciatica. The type of surgery depends on your underlying medical conditions. Common sciatica surgeries include:
- Microdiscectomy: Removing part of a damaged or herniated disc to relieve pressure on a nerve root.
- Laminectomy: If you suffer from lumbar spinal stenosis, removing part or all of the lamina can free up space for the spinal nerves. The lamina is the back part of the vertebra that covers the spinal canal. This procedure is sometimes known as spinal decompression surgery.
- Laminotomy: Similar to a laminectomy, this procedure only removes a small portion of the lamina. In addition, a laminotomy may be used during a microdiscectomy.
- Foraminotomy: Nerves exit the spinal canal through gaps in the spinal joints called foramina. This procedure cuts away bone spurs in the foramina to widen these openings.
- Facetectomy: Degenerated facet joints in the spine may cause a pinched or compressed sciatic nerve. Trimming these joints can relieve pressure on the sciatic nerve.
- Spinal Fusion Surgery: Sometimes an entire disc needs to be removed in order to correct the condition. After the disc is removed, surgical hardware and/or a bone graft helps to fuse the two vertebrae into one. Doing so increases the stability of the spine.
Finding the Right Sciatica Surgeon for You
A proper diagnosis from a board-certified sciatica surgeon will allow you to determine the most appropriate treatment for you.
Luckily, many of the aforementioned surgeries are minimally invasive in nature. Compared to open surgery, a minimally invasive procedure uses smaller incisions and specialized instrumentation. With the aid of a tiny camera and advanced equipment, a skilled surgeon causes minimal damage to the surrounding tissues. This means less scarring, pain after surgery, and quicker recovery times.
If you suffer from sciatic pain, The Advance Spine Center adopts a multidisciplinary approach, offering you the most trusted conservative and surgical options. We take the time to get to know you, your symptoms, and the cause of your pain. Then, based on your recovery goals, we will create a treatment plan tailored to your needs.
If you require surgery, for example, then you can take comfort in the fact our doctors have a combined six decades of surgical experience.
Left untreated, some cases of sciatica can become dangerous. Schedule a consultation today to find out how we can eliminate your pain.