Sciatica or sciatic neuralgia is a commoncondition in which one of the spinal nerve roots of the sciatic nerve is compressed resultingin lower back, buttock and leg pain. Sciatic nerve is a large nerve derived from 5 spinalnerve roots: L4, L5, S1, S2 and S3. It runs from the lumbar spine through the buttockdown the leg and the foot on the posterior aspect. There is one sciatic nerve on eachside of the body. Typically, only one side of the body is affected.A typical sciatica pain is described as a sharp shooting pain in the lower back, downthe buttock, thigh and leg on one side of the body. There may also be numbness, burningand tingling sensations. The pain can get
worse with sitting, moving, sneezing, or coughing.The patterns of pain depend on which nerve root is compressed, and follow the dermatomedistribution. The most common cause of sciatica is a herniatedspinal disc. The spinal disc is a soft elastic cushion that sits in between the vertebraeof the spine. With age, the discs become rigid and may crack, the gellike center of thedisc may protrude out and become a herniation outside the normal boundaries of the disc.Disc herniation presses on the nerve root as it exits the spine.In majority of the cases the condition resolves by itself after a few weeks of rest and conservativetreatment. Pain relief, nonsteroidal antiinflammatory
drugs and muscle relaxants may be prescribed.Stretching exercises and physical therapy may be recommended.Surgery may be needed if the pain doesn't go away after 3 months or more of conservativetreatments. The herniated disc may be removed in a procedure called discectomy. Or, in anotherprocedure called laminotomy, part of the bone of the vertebrae may be cut to make room forthe nerve.
Treating Sciatic Pain Daniel Yadagar Interventional Pain Management Physician
Hi, I'm Daniel Yadegar,Â I'm anInterventional pain management specialist with the Orlin and Cohen Orthopedic Group.More often than not people ask me what exactly is interventional pain managementéInterventional pain management is a discipline of medicine devoted to the diagnosis and treatmentof pain related disorders. Â Our goal is to relieve, reduce, or managepain and improve a patient's overall quality of life. This is accomplished by utilizinga multidisciplinary approach,Â in which a team of health care professionals workÂ togetherÂ toprovide a full range of treatment optionsÂ and services for patients suffering from chronicandor acute pain.Â
Common musculoskeletal pain disorders include:Back, Hip, and Leg Pain Neck, Shoulder and Arm Painâ€œWhiplashâ€� Injuries Work Related InjuriesSports Injuries Failed Back Surgery and Other Post SurgicalPain Syndromes Myofascial PainFacet Syndrome Sacroiliac Joint Pain Today I will be briefly talking about backpain with sciatica (or pain radiating down the leg).Â This is a common complaint thatwe encounter on a daily basis. Sciatic pain
results when injury or pressure have compressedthe spinal roots or nerves that branch off the spinal cord in the lower region of thespine.Â Sciatic painÂ can be described as sharp, dull,burning, tingly, numb, continuous, or intermittent and usually affects only one side of the body.Â There may be associatedÂ weakness in the affected limb as well.Sciatic pain is most often the result of aÂ herniated disc,Â spinal stenosis, orÂ narrowing of thespinal canal associated with arthritis or bony overgrowth, or in extremely rare cases,infection or tumor. An initial work up including a detailed andcomprehensive history and physical examÂ is
the first step in diagnosis.Â Further workup may be needed such as imaging studies (which include xrays, MRIs CT scans) and or nervestudy testing. Once the diagnosis of the cause of sciaticahas been determined, a treatment plan is then established.Â Most cases of back pain resolvewith nonsurgical treatment. Â Some of the most common nonsurgical treatment optionsthat we utilize are physical therapy and exercise, medication management and spinal injections.As an interventional pain physician, I am trained through the use of xray guidanceor flouroscopy to deliver potent medications targeted specifically to the affected siteof inflammation in the spine. Â The use of
flouroscopy allows the medication to be placedsafely and precisely.Â These procedures are done as an outpatient in our accredited flouroscopysuite, which is fully staffed with certified personnel and licensed anesthesiologists.Â Other common procedures that we are trained to administer for appropriate musculoskeletalproblems include: Cervical, thoracic, and caudal Epidural SteroidInjections Facet Joint InjectionsÂ Medial Branch or Nerve Blocks Radiofrequency AblationÂ SacroiIiac Joint injections Hip InjectionsTrigger Point Injections
Bursa InjectionsLumbar Discography Spinal Cord StimulationPercutaneous Disc Decompression For more information on musculoskeletal conditionsyou can visit our patient education section on our website.Â orlincohen To make an appointment with me or any of our sub specialists, please call our office (5165362800)or visit us online.