Sciatica is defined by two major symptoms: low back pain and sharp pain that shoots down one leg. By the time you experience the radiating leg pain, a spinal condition has pinched the sciatic nerve in your lower spine, causing nerve inflammation and damage.
Richard B. Kim, MD, frequently helps patients overcome sciatica’s debilitating pain, whether they’re seeking medical care for the first time or have struggled with the pain for months and need advanced treatments.
Here, he explains five common causes of sciatica.
A bulging or herniated disc is the most common cause of sciatica, accounting for about 90% of all cases. The discs between each vertebrae are made of a cushiony, gel-like center enclosed in a strong, fibrous outer layer. Their job is to absorb shock and stabilize your spine, which means they take on a substantial amount of wear and tear.
Over time, the outer layer degenerates and weak areas develop. As you bend and move, the vertebrae push the inner gel out through the weak spot. At first the gel bulges out, but eventually, the area tears and the gel leaks out. That’s when you have a herniated disc.
When the disc bulges, it pushes against the sciatic nerve. And when it herniates, the gel irritates the nerve and causes inflammation. In both cases, you can end up with sciatica.
Degenerative disc disease is caused by wear and tear together with dehydration, two changes that naturally occur as you get older. The deterioration makes the disc collapse, resulting in vertebral instability and sciatic nerve compression.
If a vertebra slips out of place, you have a condition called spondylolisthesis. The vertebra may move if it has a stress fracture or when disc degeneration causes instability. As the vertebra moves out of place, it can put pressure on the sciatic nerve.
Spinal stenosis occurs when openings in the vertebrae become narrow. An opening in the center of each vertebra protects the spinal cord, while smaller openings on the sides of the vertebra allow nerves to leave and return to the spinal cord.
While a traumatic injury could narrow the opening by damaging the bone, spinal stenosis most often develops when age-related conditions cause tissues to protrude into the opening. The most common culprits include thickened ligaments, bone spurs, herniated discs, degenerative disc disease, and spondylolisthesis.
It only takes a small spinal tumor in your lower spine to put pressure on the sciatic nerve. Spinal tumors may be malignant (cancerous) or benign (noncancerous).
However, benign tumors and masses originating in the spine are rare compared to malignant tumors that begin elsewhere in your body and spread to your spine.
In fact, 30-70% of people with cancer develop metastatic spine cancer. Lung, breast, and prostate cancers most often metastasize to the spine.
The first line of sciatica treatment includes medications, physical therapy, and steroid injections. But if your pain doesn’t improve, you may need spine surgery to ease pressure on the nerve or repair the spine condition.
As a specialist in minimally invasive surgery, I have years of experience performing surgeries to decompress the spine and treat problems like herniated discs and slipped vertebrae.
Minimally invasive procedures cause less trauma to the surrounding tissues. As a result, you have less postsurgical pain and you heal faster. And in many cases, you can have outpatient surgery and go home the same day.
If you need help for back and leg pain, don’t wait to schedule an appointment. Call Richard B. Kim, MD, or use the online booking feature today.
