Sciatica: Part 1

What is it?

Sciatica is a term we hear quite frequently run through our office. Sciatica is referred to as pain traveling along the sciatic nerve in the leg. The sciatic nerve is one of the largest nerves in the body, originating from nerve roots in the lumbar spine (lower back) down to the knee, and then branching into smaller nerves down to the toes. When these nerves get irritated, a number of symptoms can be present.

These symptoms may include:

• Sharp/ Shooting pain into the glute, back or side of the leg, down into the toes
• Mild or Severe pain radiating down the back or side of the leg
• Numbness, Tingling, or burning in the leg
• Muscle weakness
• Lower Back pain

It has been shown through extensive research that the majority of sciatica/ low back pain causes are mechanical, meaning they are not caused by serious conditions such as arthritis, fractures, etc. More importantly, it is commonly caused by conditions such as disc herniations, canal stenosis, or piriformis syndrome. In our office, the most common driver of sciatic nerve pain that we treat stems from disc irritation, whether that be a true herniation or inflammation. 

Who is at risk?

Studies have shown about 70% of adults experience some sort of back pain in their life. Below are some risk factors that may put patients at more risk for sciatica or back pain.

Risk Factors include but are not limited to:

• Age: Most common age for sciatica symptoms is between the 30-50 age range.
• Occupation: Jobs that require prolonged sitting or increased lifting and twisting often play a role in sciatica patients. These positions put increased pressure on the disc.
• Height and Weight: As height and weight increases, the intervertebral discs take more pressure
• History: Previous history of disc herniations or sciatica symptoms makes one more susceptible to symptoms returning

What is the next step if symptoms present?

It is very common in the medical world that patients presenting with symptoms listed above require pain killers, steroid injections , MRI’s and surgeries. The key to treating sciatica is obtaining an accurate diagnosis. Here at Denver Sports Docs, we are reluctant to send for imaging without doing a trial of conservative care first depending on the mechanism of injury. MRI’s without a trial of conservative care are often unnecessary and can lead to false diagnoses and negative impacts on the patient. Research has shown that if we were to take an image of 100 fifty year old patients, 60% of those patients will have some sort of degeneration with absolutely no symptoms. I am not saying this to scare people, but to inform patients that just because an image shows an abnormality, that doesn’t mean that drugs or surgery is the necessary next step. Conservative care is a great first option in combatting these symptoms.

At Denver Sports Docs, we take pride in performing a thorough examination and assessing the cause of the symptoms present. After obtaining a proper diagnosis, we used a variety of treatment methods to help combat these symptoms. In the next blog post, we will go into how to treat and further prevent sciatica and/or back pain.