Sciatica is an often painful condition stemming from the compression of a large nerve that starts in the lower back area and extends downward. The irritation of this nerve can produce pain, numbness, and tingling sensations felt in the buttocks, hips, thighs, and legs. Symptoms related to sciatica can also be frustratingly stubborn and resistant to treatment. Why does this sometimes happen?
Not Treating the Right Problem
Doing your own research online can give you an idea of what may be causing your pain, but this DIY approach to diagnosis shouldn’t be a substitute for an actual evaluation by a doctor or Beverly Hills spine surgeon. Schedule a consultation if you’re experiencing:
• Little or no relief from self-care efforts
• Pain that’s getting worse, not better
• No meaningful improvement after several weeks
Failing to Treat the Right Nerve Segment
Even if you’ve already been diagnosed, consider getting a second opinion or requesting additional testing if treatment isn’t working for you. The problem may be that the wrong segment of the sciatic nerve is being treated, which is surprisingly easy to do since the sciatic nerve is the longest single nerve in the human body. The correct nerve segment can be identified with tests that include:
• Nerve conduction studies
• A CT myelogram performed with a special dye that identifies the affected area
• An MRI scan to closely look at nearby soft tissues for signs of inflammation to get a better idea of what segment is being affected
Not Treating the Correct Nerve-Related Problem
There are many reasons the sciatic nerve may be irritated. It can be compressed directly, or the nerve can be sticking or adhering to a nearby muscle. If this is what’s happening, you may experience symptoms related to certain movements involving the affected muscle. It’s not possible to know the specific problem with your sciatic nerve until you’ve had a thorough evaluation. It’s also possible for the sciatic nerve to be affected by irritation of the nearby piriformis muscle, which is located deep within the buttocks. It also runs adjacent to the sciatic nerve.
Trying Conservative Care Options that Just Aren’t Working
Many people with sciatica do experience relief with conservative care options that typically include medication, physical therapy, and therapeutic injections. However, there are times when sciatic nerve irritation doesn’t go away with non-surgical treatment efforts. Should this be the case for you, surgery may be the better option. Procedures that could ease or eliminate sciatica-related discomfort may involve:
• Removal of all or part of a damaged spinal disc with minimally invasive techniques (microdiscectomy)*
• Surgical removal of a tumor that’s compressing the sciatic nerve
• Removal of part of a bony vertebral covering (laminectomy)
• Removal of a bony overgrowth to create more space for the irritated part of the nerve (foraminotomy)
• Trimming of part of a facet (spinal) joint (facetectomy)
*Research suggests nearly 90 percent of sciatica patients experience relief after having a microdiscectomy.
Even if your sciatica pain is fairly mild or not too disruptive, it’s not something you should ignore. If nerve-related pain goes untreated, you may get into the habit of shifting the way you move to avoid triggering discomfort, which could result in entirely new issues with spine-related pain. Once an accurate diagnosis has been made, you’ll be more likely to respond well to a personalized treatment plan.
In addition to sciatica, there are several spinal conditions that may require a fusion procedure or an alternative to spinal fusion. Beverly Hills residents can reach out to The Spine Institute today to see what their options are for relieving chronic pain. Call 310-828-7757 today to schedule an in-person evaluation.