Interventional pain management specialist Navid Farahmand, M.D., provides treatment and management of chronic pain conditions like sciatica in his Beverly Hills, California, clinic. Among the services he offers are interventional treatments like epidural steroid injections and medications for symptom control.
Sciatica is the medical term to describe pain radiating down one or both legs. It is neither a disease nor a medical diagnosis, but a way to describe a collection of symptoms. The bones of the back are separated and cushioned by spongy discs of cartilage. When a disc between two vertebrae ruptures (herniates), it can protrude into the spinal canal and put pressure on the spinal cord. The pressure causes irritation of the nerve, which can result in back pain, sciatica or both.
Sciatica involves pain radiating down the leg. It can originate in the lower back and may cause pain anywhere along the length of the sciatic nerve, which runs from the middle of the buttock to the foot. Pain is often worse when sitting and may be constant or intermittent. Patients may describe the pain as burning, shooting, searing or like an electric shock. Numbness, tingling or weakness of the affected leg may also occur.
Treatments for sciatica depends on the cause of the pain and the severity of the problem. Sometimes, surgery is required to remove a herniated disc. Thankfully, most cases can be successfully treated without surgery. Physical therapy can help strengthen muscles to support the low back and reduce muscle spasm. Anti-inflammatory medication, medications designed to specifically reduce nerve-related pain, and in select cases, brief use of muscle relaxers and/or narcotics may help reduce sciatica. Epidural steroid injections reduce inflammation of spinal nerves, resulting in pain relief that can last months, and in some cases results in permanent pain relief.
Poor posture and improper lifting can stress the back. Physical therapy encourages sound body mechanics to reduce the risk of injury. It is often taken for granted, but few patients are counseled on the appropriate application of heat and ice, to encourage blood flow and reduce inflammation, respectively. Proper stretching, exercise, and strengthening of the core abdominal muscles and support muscles of the lower back encourage stability of the spinal column and prevent malalignment with range of motion. Patients can learn what forms of exercise and activity can provoke sciatica and should be minimized, and conversely which should be encouraged.