Questions and Answers about Sciatica

Q. My doctor recently diagnosed me with "Sciatica." What is Sciatica?

A. Sciatica is a general term for pain along the sciatic nerve. It is usually a sharp pain is sometimes described as an electrical-like shock starting in the buttock that travels down the back of thigh and leg. The most common cause is a herniated disc in your back, although there are other causes as well. An MRI scan of your lower back may help in making the diagnosis.

Q. What if the MRI scan shows a herniated disc? What do I do then?

A. You should get a referral to an spine specialist, preferably one who operates on the spine. He will evaluate you and look over your x-rays to determine the proper course of treatment.

Q. What if I don't have a herniated disc?

A. As I mentioned before, there are other causes of sciatica such as:

• 1. Sacroiliitis
• 2. Lumbar Facet Joint Syndrome
• 3. Piriformis Syndrome
• 4. Iliolumbar Syndrome
• 5. Lumbar Spinal Stenosis

Q. Wow, Doc! You're blowing me away with these fancy terms. Can you explain what they mean?

A. Sure.

• 1) Sacroiliitis is an inflammation of your sacroiliac joint. That's the joint where your hip meets the spine. Inflammation caused by trauma or just plain arthritis can give you sciatica-like symptoms. Sometimes an injection of an anesthetic and an anti-inflammatory medication can take away the pain.

• 2) Lumbar Facet Joint Syndrome is pain that comes from the joints of your back causing not only back discomfort, but also it can give you sciatica-like symptoms. The facet joint is like any other joint of your body, like the knee or elbow that can get inflamed and cause pain.

• 3) Piriformis Syndrome is simply pain caused by the piriformis muscle that may be in spasm, inflamed, or irritated. This muscle is in your buttock and lies right on top of the sciatic nerve as it exits the spine and goes down your leg. As you can imagine, if this muscle is having a problem, it will cause pressure on the nerve, giving you the sciatica-like symptoms.

• 4) Iliolumbar Syndrome is simply inflammation or a tear of the iliolumbar ligament. This ligament extends from the spine to the iliac crest, which is the back of your pelvis.

• 5) Last, but not least, Spinal Stenosis, which is narrowing of the spinal canal, can cause sciatica-like symptoms. The narrowing can be caused by disc problems as well as arthritis of the spine.

Q. Thanks a lot, Doc!!! You really helped me learn about sciatica.

A. You're welcome. I wish you a speedy recovery.

Albert I. Rodriguez, M.D., F.A.B.A., F.A.P.M. is Board Certified by The American Board of Pain Medicine and American Board of Anesthesiology. His practice is based in Palm Beach County Florida. He is associated with Bethesda Memorial Hospital, JFK Medical Center, and Palm West Hospital. His practice focuses on the diagnosis and treatment of disorders related to the spine. If you have any questions for Dr. Rodriguez regarding the treatment of back pain, please feel free to Email him at SpineUniverse.com.