Sciatica is a general term that refers to an injury involving the sciatic nerve. This nerve can become pinched in the low back and cause pain to run down the buttocks, back of the thigh, calf and foot. Causes of sciatica include:

• Disc bulge

  • A bulging disc can press on a nerve in the low back​

  • Most common cause of sciatica

• Narrowing around the spinal cord (spinal stenosis)

• Compression by the piriformis muscle

• Tumors around the pelvis

• Arthritis in the low back or bone spurs

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What type of pain can you experience with sciatica?

The typical path that the sciatic nerve takes is down the back of the thigh and back of the calf. This pain can present like:

• Sharp burning pain

• Pins and needles pain

• Numbness

• Tingling

• Pain in forearm

• Electric pain

• Muscle weakness or wasting

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How can our St. Louis pain doctors help diagnose your sciatica pain?

• Thorough history and physical exam

• X-ray

  • To look for arthritis or bone spurs​

• MRI

  • To look at the discs that could be bulging and pressing on a nerve​

• CT Scan

• Nerve conduction study and electromyography (EMG)

  • Used to find the nerve that is being pinched

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What are your treatment options?

Most sciatica pain resolves on its own with time but there are many treatments available to help with the pain while the sciatica improves such as: 

• Interlaminar epidural injections

• Transforaminal epidural injections

• Steroid injections

  • A piriformis injection can be done if the piriformis muscle is responsible for the sciatica

• Non-steroidal anti-inflammatory medications (NSAIDs)

• Antidepressants

  • Help block pain signals​

• Anticonvulsant

• Muscle relaxants

• Opioid medications

  • ​When used appropriately, studies have shown that risk of addiction is extremely low

• Heating pads

• Cold packs

• Physical therapy

 

What can you do to avoid or decrease sciatica pain?

• Weight loss to decrease pressure on the low back

  • Every pound of excess weight puts 7 pounds of pressure on your back​

• Regular exercise

  • Concentrate on strengthening back muscles and abdominal muscles​

  • Weak back muscles put more pressure on the back itself

• Use proper techniques for lifting heavy objects safely

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For more information or to discuss an appropriate treatment plan for your sciatica pain with one of our specialized pain management physicians, call Saint Louis Spine and Joint Pain Specialists today.

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