Dispelling Common Sciatica Myths to Help You Get the Relief You Need.
Ravi R. Patel, MD
To dispel the myths and help you get back on the road to spine health, here are the sciatica facts you need to know.
1. Sciatica is a description, NOT a diagnosis
The Sciatic Nerve is the largest nerve in the human body. It is formed when the nerve roots from the vertebrae L4-S3 merge together after exiting the spine. The nerve then passes through the buttock and along the back of the leg where it will divide into three main branches. These branches provide the majority of the sensation and strength in our lower extremities.
The term Sciatica describes a set of symptoms that may occur along the path of the sciatic nerve. These symptoms can include pain, numbness, tingling, and even muscle weakness. The pain is often described as shooting, searing, or electric-like. Patients with Sciatica usually experience low back pain but some will not.
Sciatica is caused by the nerve compression that can result from a variety of disorders, the most common of which is lumbar disc herniation or bulging. Other possibilities include degenerative disc disease, bone spurs, lumbar stenosis, and piriformis syndrome.
2. Sciatica can occur at any age
Contrary to what many people believe, Sciatica can occur at any age. It is not just a condition that affects the elderly. In fact, the peak incidence of Sciatica from a lumbar disc herniation is in people who are in their 40s and 50s. Men are affected by Sciatica three times more commonly than women. In my practice, I have had patients as young as 20 years old visit with me for treatment of Sciatica symptoms.
3. An abnormal spine MRI does not mean you have a symptomatic spine problem. And Vice-Versa!
One of the most important tasks for a spine specialist is to make the connection between a patient’s symptoms and the findings on that same patient’s MRI. It has been proven that abnormal MRI findings may occur in patients who are not experiencing any symptoms of the condition found on the MRI. This is can be a source of frustration for the patients with low back pain, Sciatica, or other symptoms.
Lumbar disc herniations are a prime example. Lumbar disc herniations occur commonly and can be identified easily on MRI. However, only about 5% of all lumbar disc herniations ever result in the patient feeling the associated Sciatica symptoms.
4. Sciatica rarely requires surgery
Most cases of Sciatica are caused by lumbar disc herniations. While Sciatica can be excruciatingly painful, the silver-lining is that most cases will resolve with time and conservative care. In fact, 90% of patients will have improvement of Sciatica within 3 months. Conservative care includes activity modification, medication, physical therapy, and chiropractor treatment. Only 10% of patients will continue to have chronic or persistent Sciatica. Yet even these patients’ pain can be well-managed, often through the administration of epidural steroid injections. Only under rare or severe circumstances will a patient need surgery for Sciatica.
Did these Sciatica facts surprise you? The most important thing for people to remember about this and any other spine condition is that no one should just “suffer through” the pain or allow it to rob them of an otherwise healthy, active life. If you or someone you know is experiencing the debilitating effects of Sciatica or other back pain, find a spine health expert who can help you get to the bottom of what is causing the pain.