Sciatica and Radiculopathy

Sciatica refers to the pain that begins in the hip and buttocks and travels into the legs. Typically this condition is also accompanied by low back pain. True sciatica occurs when a herniated disc compresses one of the roots of the sciatic nerve. Often a patient will have a previous history of lower back pain beginning a few days or weeks before the leg pain occurs, then the leg pain becomes worse than the back pain, and in some cases the back pain will completely disappear. Lying down is usually the most comfortable position, while sitting, standing, heavy lifting, or sneezing can aggravate the pain.

Treatment Options

A thorough history and physical examination is an important part of the diagnosis of sciatica. Nerve root tension tests can be used to confirm the presence of sciatica by attempting to reproduce the discomfort with certain motions and body positions. These tests are performed by a doctor and involve moving the legs in certain ways that slightly stretch the sciatic nerve. If the patient experiences pain during these tests, an irritated sciatic nerve is likely to be a source of the pain.

Many patients will recover from this disorder spontaneously, and those that require medical assistance are usually offered a course of conservative treatment. This can include rest and limitation of certain activities, accompanied by anti-inflammatory medications. Physical therapy is very useful in allowing a patient to return to full activity. In some cases, certain types of injections can help to relieve some of the pain associated with this condition as well.

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