Sciatica

Sciatica describes pain that travels along the sciatic nerve from your lower back through the buttock and down one leg. It happens when the nerve is irritated or compressed by nearby spinal structures, causing pain, numbness, or weakness that can affect daily activities.

This page explains what causes sciatica, common symptoms, and when you should seek orthopaedic care. At Princeton Orthopaedic Associates, our goal is to help you understand the condition and the options available to relieve pain and restore function.

What You Should Know About Sciatica?

Sciatica is not a diagnosis on its own but a description of leg pain caused by nerve irritation in the lower spine. The pain usually affects only one side of the body and can range from mild discomfort to sharp, burning pain that makes it hard to stand or walk.

Many people improve with conservative care such as activity modification, targeted exercises, and anti-inflammatory medications. If pain is severe, persistent, or is accompanied by significant weakness or changes in bladder or bowel function, orthopaedic evaluation may be needed to determine if procedures or surgery are required.

What Causes Sciatica?

• Herniated disc: A disc bulge or rupture can press on a nearby nerve root and generate radiating leg pain.
• Spinal stenosis: Narrowing of the spinal canal can squeeze nerve roots, especially in older adults.
• Degenerative disc disease: Wear and tear of the spinal discs can change spine mechanics and irritate nerves over time.
• Spondylolisthesis: A vertebra that slips forward can narrow the space for nerve roots and cause sciatica.
• Piriformis syndrome: Tightness or spasm of the piriformis muscle in the buttock can irritate the sciatic nerve.
• Trauma or injury: A fall or direct blow to the lower back or buttock can injure structures that affect the nerve.
• Pregnancy: Changes in posture and added weight during pregnancy may increase pressure on the lower spine and nerve roots.

What Are the Symptoms of Sciatica?

1. Pain that follows the nerve path
   • Pain typically starts in the lower back or buttock and travels down the back of the thigh into the calf or foot. The pain can be sharp, burning, or electric in nature.
2. Numbness or tingling
   • You may feel pins and needles or a loss of sensation in parts of the leg or foot supplied by the affected nerve.
3. Muscle weakness
   • Compression of the nerve can reduce strength in the leg or foot, which may make it hard to lift the foot or stand on your toes.
4. Pain that worsens with certain movements
   • Coughing, sneezing, bending forward, or prolonged sitting often increase sciatica pain.
5. Difficulty walking or standing
   • Severe pain or weakness can limit your ability to walk or maintain balance.

When to Seek Orthopaedic Care for Sciatica

• Severe, unrelenting pain: If pain does not improve with home measures and prevents sleep or basic activity, you should see an orthopaedic specialist.
• Progressive muscle weakness: Worsening weakness in the leg or foot may indicate significant nerve compression and needs prompt assessment.
• Loss of bowel or bladder control: Any new difficulty with bowel or bladder function is an emergency and requires immediate medical attention.
• Symptoms after a significant injury: If sciatica begins after a fall or accident, evaluation is important to rule out fractures or other damage.
• Pain that lasts more than a few weeks: Persistent symptoms that do not respond to conservative care may require imaging and a tailored treatment plan from your orthopaedic team.

When you visit Princeton Orthopaedic Associates, we perform a focused evaluation to identify the source of your nerve irritation and discuss treatment options. Most people start with nonoperative care, and surgery is considered when conservative measures do not relieve symptoms or when there is progressive neurological loss.

If you have questions about sciatica or need an orthopaedic evaluation, our team at Princeton Orthopaedic Associates can help guide you through diagnosis and treatment choices based on your situation.

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This blog post is meant to be informative and should not act as a self-diagnosis tool. If you’d like to see one of our doctors, please contact us here.