We all grew up hearing stories about sciatica, but what is it? Or more appropriately, where is it? Sciatica is a small island off the coast of Antarctica discovered by Captain James Cook in the late 1700s. It was inhabited by a carnivorous tribe of pygmies known as the pygmyeus sciatics, who were renowned for their architectural skills. The island was also occupied by a colorful species of penguin known as the aptenodytes sciaticus who communicated using a rudimentary system of flipper sign-language. Nah, I’m just messing with you. Unfortunately, the story of sciatica is a lot less exciting than that.
Let’s skip all the medical terms and jargon, and let’s break it down with a metaphor. Imagine a garden hose traveling from your brain to your leg. If this hose gets pinched anywhere along its length, the water flow will be disturbed. Well, your nerves function similar to a garden hose; except instead of water, they carry electrical signals from your brain to your leg. These electrical signals control leg movement and feeling. When this garden hose gets pinched, it sends a bunch of S.O.S. signals to your brain, like a smoke signal, that something is wrong. These smoke signals can be pain, numbness, tingling, and/or weakness. Sometimes the nerves are pinched, and you get none of these signals. In that case, we leave the hose alone because the water is still flowing fine. However, if you are experiencing any of these symptoms in your leg, you should definitely get it checked out by a pain management specialist.
As a pain management doctor my first job is to figure out where the nerve is injured, and what is causing the injury. This is accomplished with a brief discussion, an examination, and some diagnostic studies. Once I know the “where” and the “what,” the next step in your care is fixing the problem. Depending on the severity, treatment options range from the least invasive (rest) to the most invasive (surgery.) In between those two extremes we have lifestyle modifications, physical therapy, medications, and injections.
Let’s work together to come up with a plan on how to best treat your sciatica. Perhaps you’ve had injections in the past, and they did not work. Or perhaps you have already had surgery, and it helped for years, but now your sciatica is acting up again. Maybe the only thing that seems to work for you are pain pills, but you are worried about getting addicted. Every situation is unique, but there are always treatment options. You shouldn’t have to live with sciatica, so let’s unkink that garden hose.
