“Sciatica” is a term that many people use loosely without truly understanding what it is or what its ramifications might be. Some people immediately assume their back/leg pain means surgery is in their future; others simply try to diagnose and treat it on their own.
Shane Mangrum, M.D. of Polaris Spine & Neurosurgery Center in Atlanta, Georgia.
In this Polaris Mythbuster, we one of our expert spine doctors, Dr. Shane Mangrum, debunks three common myths about sciatica.
Sciatica is described as pain resulting from undue pressure on the sciatic nerve, the large nerve connecting the lower back to the leg. The pain typically emanates from the lower back and shoots down the back of the leg, although this pain can manifest in other ways, as well.
A variety of conditions may cause sciatica, some more serious than others, but condition is usually quite treatable.
“Sciatica means different things to different people,” explains Dr. Shane Mangrum, M.D, an expert on sciatica here at Polaris Spine & Neurosurgery Center. “Some people come in and they say they have sciatica, and they point to their thigh or their low back and say that’s where they’re feeling pain. But the pain shooting down the back of their leg may not necessarily come from an area being compressed from the back. There are other things that can give people leg pain.”
THE TAKEAWAY: Don’t automatically assume your leg pain is sciatica, which is caused by compression of a specific nerve. Your doctor is the best person to narrow down the source of your pain and recommend treatment options.
Sciatic pressure quite often points one of several larger issues, such as spinal stenosis or spondylolisthesis. However, Dr. Mangrum says these are by far not the only causes.
“Most people assume that if they have sciatica they’ve got a compressed nerve in their back,” he says, “but that’s not the only thing that can cause it. Sometimes people can have pain from muscles in the butt or posterior hip. For example, there’s an issue called piriformis syndrome, where people can get a tightness or irritation to the sciatic nerve that passes through the bottom posterior hip and down the leg. Sometimes just compression from that muscle could give them leg pain totally independent of what’s going on in the back.”
THE TAKEAWAY: Sciatica is a symptom having a number of possible causes, and only a doctor can help pinpoint the actual cause in order to prescribe treatment.
“Just by the numbers, most people with sciatica don’t need surgery,” says Dr. Mangrum. “Most of the time, sciatica can be managed with exercise or non-surgical tools. That would include chiropractic care, physical therapy, exercise… sometimes we’ll use epidurals or steroid type injections. If people have symptoms that persist despite those non-surgical interventions, then surgery is explored as an option.
Typically, patients only need surgery if they’re developing weakness in the leg, numbness or other signs of nerve injury. This is why we caution patients to not let sciatica persist without treatment.
As Dr. Mangrum explains, “If somebody has long term compression of the nerve then they can develop a weakness or numbness that sometimes can be irreversible or permanent.”
THE TAKEAWAY: If you are suffering from sciatica, you have many options for treatment before surgery is recommended.
Our team of spine doctors and specialists take a holistic approach to treating sciatica in patients — one that involves physical therapy, exercise, chiropractic care, and, in some cases, epidural or steroid injections. We recommend surgery only when it is absolutely necessary, and those recommendations are based on a thorough analysis of the patient’s unique medical history, physical exams, and radiological studies.
If you’re suffering from leg pain and you suspect sciatica may be the cause, we can help. Call Polaris Spine and Neurosurgery Center at 404-256-2633 for an evaluation.