Sciatica: Quick fire questions

Sciatica is a condition which has been reported to affect around 40 per cent of the UK population sometime in their lifetime. Mr Khalid Salem, renowned consultant orthopaedic spinal surgeon, is here to answer your frequently-asked-questions about the condtion.

What is sciatica?

Sciatica, also known as sciatic pain, is a term used to describe pain that travels down the leg due to pressure on the nerve roots in the lower back.

What are the causes of sciatic nerve pain?

This pain usually happens when a nerve is compressed. Various issues like disc degeneration, disc herniation (when a disc bulges out), or even the movement of one spinal block over another can lead to pressure around the nerve roots.

What can worsening sciatic pain and numbness indicate?

Normally, sciatica should improve over time if its underlying cause is getting better. However, if the pain and numbness are getting worse, it could mean that the pressure on the nerves is increasing. In such cases, seeking medical help is a good idea.

What does treatment involve?

Treatment depends on what's causing the sciatica. If it's from common issues like disc herniation or spinal stenosis (narrowing of the spinal canal), there are three main options:

• Changing activities and using specific pain medications.
• Targeted spinal injections.
• Surgical decompression to relieve nerve pressure.

How many spinal injections are given for sciatica?

In the past, people often had three injections over several weeks or months for treatment. However, this isn't strictly based on scientific evidence. The decision to repeat injections depends on the patient's response. If the response is positive and sustained, another injection might be considered. However, if the relief is short-lived, repeating injections might not be very effective.

Is surgery always considered?

Surgery is not always the first choice and depends on the underlying problem. For issues like disc herniation, doctors often try pain medication and injections for a few months before considering surgery. Surgery can help when conservative treatments fail and there's persistent pressure on the nerves.

What type of exercise can help to relieve sciatica?

During non-surgical treatment, one useful exercise involves moving the symptomatic leg. By gently moving the leg within a certain range of motion, it encourages the nerve to slide over any problematic areas, reducing inflammation. These exercises are simple and can be done while sitting. For example, extending the knee and bringing the foot towards the face before returning the leg to the floor.

Why might sciatica persist?

Even with conservative treatments, sciatica can continue due to ongoing pressure on the spine or the nerves within it. In such cases, considering surgical options might become necessary.

If you would like to book a consultation with Mr Salem simply visit his Top Doctors profile today.