Sciatica occurs when the sciatic nerve is pinched. The sciatic nerve runs from your lower back into your hips and buttocks and into each leg. Often a herniated disk in your spine is the culprit although it can also be caused by a bone spur on your vertebrae.
In some rare cases, the nerve compression could be caused by damage due to conditions such as diabetes or a tumor. It can be very painful and interfere with your activity level and quality of life. If you suffer from sciatica, you might be looking for the quickest possible relief. Here we explore possible treatments, including surgery.
WHAT ARE THE SYMPTOMS OF SCIATICA?
The most common symptom of sciatica is pain from your lower spine radiating through the buttocks and down the back of your leg. It can be very distinct pain, an ache or even a burning sensation. Some describe their pain as excruciating while others experience sudden jolts like a shock. Symptoms tend to affect only one side of the body and can get worse with long periods of sitting. Other symptoms include:
- Numbness
- Tingling
- Muscle weakness
- Pain in the area when you sneeze or cough
Many people experience a combination of symptoms while others might be isolated to pain or numbness.
WHAT ARE COMMON SCIATICA TREATMENTS?
Once sciatica is confirmed, your doctor will explore your treatment options. This often requires a multidisciplinary approach using physical therapy, medications, therapeutic injections, and alternative therapies to find the right combination to alleviate or eliminate pain. Most doctors prefer to try nonsurgical treatment before recommending surgery.
WHEN IS SURGERY RECOMMENDED?
Surgery is recommended when patients meet any of the following criteria:
- Failure to respond to other treatments over a six- to eight-week period
- Presentation of worsening symptoms such as numbness and/or weakness
- Symptoms that interfere with daily activities
- The presence of a condition that can be successfully treated by surgery such as a herniated disc, spinal stenosis, or spondylolisthesis
- The presence of a cyst, tumor, or spinal cord compression
Your doctor will recommend initial treatments, track progress, and reassess your symptoms and causes before recommending surgery for sciatica.
DOES SURGERY FOR SCIATICA WORK?
Studies have shown that patients who undergo surgery can see better outcomes than patients who use non-surgical treatments. However, this depends on an accurate diagnosis so that the right type of surgery is performed. The medical cause of sciatica determines possible outcomes while ensuring the right procedure is performed. Studies also show that one to two years after treatment, patients who had surgery and those who had nonsurgical care see the same long-term results.
WHAT TYPES OF SURGERY ARE USED TO TREAT SCIATICA?
As mentioned above, the recommended surgery depends on the underlying cause of sciatica. For some patients, a microdiscectomy is needed to treat a herniated disc; for others, a laminectomy is recommended for spinal stenosis. Surgeons prefer less invasive procedures because they allow patients to heal faster and reduce the risk of complications after surgery. Endoscopically guided procedures also reduce risks compared to open surgeries.
WHAT IS A MICRODISCECTOMY?
Also known as a discectomy, this procedure removes herniated disc material causing the symptoms. Only the portion of the disc causing pressure is removed, leaving the rest of the disc intact. It can be very effective in alleviating leg pain, tingling and numbness.
WHAT IS A LAMINECTOMY?
A laminectomy is designed to widen the spinal canal to create more space for nerves. The surgeon trims the lamina of the vertebra to alleviate weakness, pain, and numbness caused by spinal stenosis.
HOW LONG IS RECOVERY?
Complications are very uncommon for these types of surgeries. There is limited risk for nerve damage, infection or blood clots. In most cases, patients can usually return to work or daily activities free of any strenuous activity within two to four weeks. Within six to eight weeks, patients can resume physically strenuous activity. Although your healing will be gradual, you should be able to sit up and walk within 24 hours. Pain medications can help manage postoperative pain, and following your surgeon’s instructions is the best way to recover quickly.
