Sciatica

Sciatica pain can vary from a mild ache to a sharp, burning pain. Sometimes it can feel like a jolt or electric shock. It can be worse when coughing, sneezing or sitting for a long time. Usually, sciatica affects only one side of the body.

Some people also experience numbness, tingling or muscle weakness in the leg or foot. One part of the leg can be in pain, while another part can feel numb.

Please seek medical care for the following:

• Sudden, severe pain in the lower back or leg and numbness or muscle weakness in a leg
• Pain after a violent injury, such as a traffic accident
• Trouble controlling bowels or bladder

Sciatica occurs when the sciatic nerve becomes pinched. The cause is usually a herniated disc in the spine or an overgrowth of bone, sometimes called bone spurs, forming on the spinal bones. More rarely, a tumour can put pressure on the nerve.

During the physical exam, your doctor may check muscle strength and reflexes. For example, you may be asked to walk on your toes or heels, rise from a squatting position, and lift your legs one at a time while lying on your back. Pain from sciatica will usually worsen during these movements.

Those with severe pain or pain that does not improve within a few weeks may need the following:

• An X-ray of the spine to see if there is an overgrowth of bone pressing on a nerve.
• An MRI produces detailed images of bone and soft tissues, so herniated discs and pinched nerves show on the scan.

Most cases of sciatica resolve on their own. Nonsurgical treatment options include:

• Rest
• Medications
• Physiotherapy
• Steroid injections

Spine surgery is considered when sciatica causes severe weakness, loss of bowel or bladder control, or pain that does not improve with other treatments.

Postoperative care

• No lifting more than 5kg, no bending or twisting for six weeks
• No driving for two weeks
• Keep the wound dry for five days. You can get wet in the shower, but pat the area dry rather than rub.
• GP review postoperatively for wound review on day seven
• Monitor for any wound redness, discharge or fevers
• Monitor for new symptoms, including worsening back or neck pain, arm or leg pain, pins and needles or numbness
• Six-week review with Dr Shivav