Most adults immediately recognize that pain shooting through the buttocks and down the back of one leg is a sign of sciatica. When this symptom occurs, its intensity can make it difficult to know what to do to improve comfort. Unlike some other conditions, like a sprain in a muscle in the back, may get better with rest and ice or heat. Sciatica can be more challenging and it may need the care of a specialist to resolve the ongoing problem. Because sciatica can quickly become an ongoing and frustrating problem, it is wise to seek care earlier rather than waiting to see if comfort improves on its own. The specialist you want to see for sciatica is one who is extensively trained to diagnose and treat conditions of the spine. Here, we discuss why you may have this painful problem.
Sciatica is a Symptom, Not a Condition
People refer to sciatica in such a direct manner that it can seem as though the pain is a condition all on its own. It isn’t. Sciatica is a symptom that is telling you that there is a problem in your lumbar spine. Every segment of the spine, the lumbar spine, thoracic spine in the mid-back, and the cervical spine in the neck, has vertebrae and discs. The vertebrae hold the joints of the spine, and the discs are meant to cushion the bones so they do not rub against one another. The discs also create the space that is necessary for the nerve roots that branch off of the spinal cord to exit and travel to all parts of the body. The nerves that travel through the buttocks and legs are located in the lumbar spine at the low back. So, when sciatica pain occurs, we know right where to look. Some of the common conditions that can cause sciatica pain include:
- Osteoarthritis. This condition can affect any joint in the body. It is an issue of wear and tear that comes with just being alive. In the spine, osteoarthritis may cause the discs and other cartilage to deteriorate slowly. This breakdown can lessen the space between two vertebrae, resulting in nerve compression.
- Herniated disc. A herniated disc is an intervertebral disc that has torn or worn down to such a degree that part of the softer nucleus of the disc is leaking out. The material in the nucleus is gelatinous, not watery. The seepage of this material can irritate the nerve with which it comes into contact. The lumbar spine is a common area in which disc herniation occurs. This sometimes results in low back pain and sometimes results in sciatica pain.
- Spinal stenosis. For the nerve roots to live in and exit the spine functionally, there must be sufficient space down the central canal of the spine, as well as in between each pair of vertebrae. Spinal stenosis is the narrowing of that central canal. When this condition develops in the low back, sciatica pain may occur.
- Spondylolisthesis. The spinal column is a row of bone-disc-bone-disc on repeat. For proper function, the spine follows a natural curve as the bones stack one on another, separated by a disc each time. Spondylolisthesis is the condition in which one or more vertebrae shift. This is different than benign misalignment. Spondylolisthesis is the shifting of a bony joint forward, backward, or over an adjacent bone. This shift could result from an injury or it may be present at birth. Without proper treatment that restores space and alignment, the shifted vertebra may continually press on a nerve root, causing pain along that nerve path.
Sciatica can be irritating and even frightening if it becomes severe. Dr. Lipani offers outstanding care that can help you understand the cause of your pain and how to treat it. To schedule a consultation at one of our convenient NJ locations, contact Princeton Neurological Surgery at (609) 890-3400.