Sciatica pain can be mild to intense. Many with lumbar herniated disc and sciatica often wonder whether or not they require a surgery. Needless to say, it is never an easy decision. But the good news is that micro discectomy surgery has a higher rate of success when it comes to relieving sciatica pain. When compared to many other options, this one is relatively minimally invasive. It doesn t alter the structure of the spine permanently since it works by removing a small portion of the disc, which has herniated or extruded out of the disc.

When your sciatica pain stems from lumbar disc herniation, a small open surgery with the help of magnification is the prevalently opted surgical approach. On the other hand, a laminectomy is done when the bone or disc pinching the nerve root is required to be removed.

When should you consider undergoing surgery for sciatica?
Typically, neurosurgeons recommend considering surgery for sciatica in a host of situations which include the following:

Severe pain in the leg lingering for more than six weeks, which mainly affects one side of the leg or buttock
Intense pain in the low back and buttock, which continues through the course of the sciatic nerve andextends to the lower leg and even foot. This pain can be described as sharp and searing rather than a dull thud.
When pain has not alleviated even after non-surgical treatments that may include non-steroidal anti-inflammatory drugs (NSAIDs),oral steroids, injections, manual manipulations, and physical therapy
When the patient is not able to take part in the day to day activities due to intense lower back pain and the symptoms tend to become severe during movements like sneeze and cough.
When the symptoms are continuing to worsen, thereby indicating nerve damage, particularly when the progressive signs have their root in neurological issues
It is important to note here that surgical intervention may only be needed when the patient experiences progressive weakness in the lower portion of the body or sudden loss of bladder or bowel movement, which may stem from cauda equina syndrome. Two surgeries, namely lumbar laminectomy and microdiscectomy are performed on the basis of the cause as well as the duration of the sciatica pain.
In some cases, the symptoms are unique on the basis of the underlying causes of sciatica. For instance, trying to bend the body backward or walking a longer distance than normal may trigger unbearable symptoms. On the other hand, when the affected individual tries to bend the body forward, it can lead to symptoms stemming from the lumbar herniated disc.
In case sciatica occurs after an accident, injury or trauma, or if it happens in tandem with other symptoms, then it requires an immediate medical attention.
Thus, choosing to go for a surgery depends on several factors that only your doctor can assess and decide upon.

Sciatica - When Do You Have To Go For Surgery?

Sciatica pain arises from the sciatic nerve which is the single largest nerve in our body. It consists of individual nerve roots, which branching out from the lower back of the spine to the back of each leg and combining together forms the sciatic nerve. The origination of the sciatic pain lies in the lower back of the body and radiates down the buttock to the sciatic nerve.

Causes of the sciatica pain

Arthritis: If an individual is diagnosed with arthritis, then he or she can expect a throbbing pain or numbness down till the leg.
Herniated disc: Another cause could be a herniated disc in the lower back of the body.
Spondylosis: Spondylosis in the lower back would also be a reason for the development of the sciatica pain.
PIVD/DISC bulge
Other causes are a spinal injury, diseased degenerative disc, infection on and around the lower back. The pain would worsen, if an individual is in an occupation where he or she has to stand or sit for hours at length. The lifting of heavy things would strain the sciatic nerves as well.

How to identify sciatica pain?
Sciatica pain varies from infrequent to a constant throbbing down the lower back. So initially it is difficult to detect whether it is sciatic pain or not. But when the constant pain in the lower back leads right down till the toes and foot, it is really time for an individual to get in touch with a doctor. The pain can give a burning sensation almost searing making it difficult for the person to stand up or walk properly. Along with the pain, one can feel fatigued. An involvement of the spinal cord is rare in the sciatic pain but is possible.

Treatment for sciatica pain
Sciatica can be treated in both surgical and non-surgical way. Surgical treatment is rare as sciatica tends to respond well with non-surgical treatments. If the pain continues for over a month despite treatment, surgical treatment will be considered. The non-surgical pain treatment would include physical exercises and oral medications along with natural treatment.

Medications: Painkiller medications prescribed by the doctor can be used to reduce sciatica. Medicines like aspirin, non-steroidal or oral steroids can help reduce the pain.
Steroid injection: Epidural steroid injection acts faster as it is injected in the affected area, thus providing relief from the pain quickly.
Exercise: Early morning exercises can be quite helpful.
Percutaneous Endoscopic Discectomy: The surgical treatment of Percutaneous endoscopic disc dissectomy constitutes a large part of interventional pain physicians and it has evolved considerably in terms of surgical technique and instrumentation. Percutaneous endoscopic discectomy is a relatively new technique for removing lumbar disc herniation. It involves using an endoscope to visualize the disc removal. The discectomy is performed through a posterolateral approach using specially developed instruments. The advantage of percutaneous endoscopic discectomy is that the disc is approached posterolaterally through the triangle of Kambin without the need for bone or facet resection thus preserving spinal stability. The procedure is day care and is done under local anaesthesia.

Sciatica Pain - 5 Ways You Can Treat It!

Sciatica refers to the pain one experiences due to the irritation or compression of nerve roots contributing to formation of Sciatic nerve. The sciatic nerve is the longest and widest nerve in the body, running from the lower back, down to the back of each leg. The pain can occur in the lower back and spread to the hips, buttocks and leg. Sciatica generally affects one side of the body. There are numerous causes of irritation of the sciatic nerve and sciatica.
 
Some of them are:
 
1. Spinal Stenosis
The narrowing of the spinal canal caused by natural wear and tear of the vertebrae (individual bones in the spine protecting underlying nerves) of the spine is known as spinal stenosis. The narrowing may put pressure on the roots of the sciatic nerve, causing pain.
 
2. Herniated Disc
A disc is made up of cartilage and acts as a cushion between vertebrae, allowing flexibility of the spine. A herniated or slipped disc occurs when a disc is temporarily pushed out of place, putting pressure on the sciatic nerve.
 
3. Spondylolisthesis
It is a condition where one of the lower vertebrae slips forward over another. This also causes a collapse of the disc space between both, causing the nerve to get pinched. This may cause sciatica.
 
4. Piriformis Syndrome
Piriformis is a muscle found deep inside the buttocks, which connects the lower spine to the upper thighbone, running directly over the sciatic nerve. Spasming of this muscle can pressurize the sciatic nerve, triggering symptoms of sciatica.

5. Sacroilitis
Sacroillac joints are the place where the lower spine meets the pelvis and inflammation of one or both of these joints causes sacroilitis. This can give rise to symptoms of sciatica as it causes pain in the lower back, buttocks and legs.
 
6. Spinal tumors
Very rarely, tumors growing inside or along the spine may put pressure on the sciatic nerve.
 
7. Infection or injury
Muscle inflammation, infections, fractures or any other spinal injury may lead to irritation or compression of the sciatic nerve.
 
8. Pregnancy
Pregnant women may suffer from sciatica due to weight gain, expansion of the uterus or increased fluid retention or other changes occurring in the body, which put pressure on the sciatic nerve.
 
9. Other causes
Osteoarthritis and fractures caused by osteoporosis may also affect the sciatic nerve, producing symptoms of sciatica.

Top 9 Causes Of Sciatica Nerve Pain - You Need To Know About

The longest nerve in the body is the sciatic nerve. The sciatic nerve starts from the lower part of the spine, through your hip to the back of the leg. So when it is said sciatica, we refer to pain in this nerve. Since the nerve covers the spine, hip and leg, sciatic pain is felt in the areas through which it passes. The lower leg muscles and sensation in the legs, thighs and feet are controlled by this nerve.

Symptoms usually include
1. Pain that radiates from the lower back to the hip and to the leg
2. Sharp, tingling, dull, constant or burning pain
3. Loss of bladder or bowel control
4. Sneezing or coughing increases pain
5. Moving the leg gets difficult so usual activities like walking, sitting and standing become painful

Homeopathic remedies are easy and gentle on the body. Homeopathy aims to boost the body's immune system so it can fight all its weaknesses. The following remedies may prove to be useful:

A) ammonium muriaticum: it is taken for chronic pain in the heel or for chronic backache or when straightening the knee gets difficult as hamstrings contract. It is also taken for limping.

B) bellis perennis: in periosteum injuries, stiffness and deep aches in the spine bellis perennis is used. It is also used for tailbone injuries. It is also helpful for nerve pains during pregnancy.

C) calcarea fluorica: if the vertebra degenerates after trauma to the spine, then calcarea fluorica can be useful.

D) cicuta: the worst back injuries with serious trauma and muscles spasms are treated with cicuta.

E) hypericum: hypericum is suggested for tailbone injuries, temporary paralysis, spinal concussions and for sharp pain that tingles and moves upwards.

F) rhus tox: if after lifting weights, overexerting muscles and exposure to anything wet, you feel tearing and burning pain, then rhus tox is beneficial. Cramps that get better after heat application, but get worse after exposed to the cold are also treated with rhus tox.

G) ruta: stiffness and pain from back injuries, twisting the wrong way and bruises are prescribed with ruta.

Best Homeopathic Remedies for Sciatica Pain

The term Sciatica is used to describe leg pain, tingling, numbness or weakness that travels down the low back via the sciatic nerve to the back of leg. Sciatic nerve arises from each side of lower spine and passes deep in the buttock along the back of thigh and legs. The pain of Sciatica may be irregular/ infrequent or persistent causing severe agony to the patients. The pain of Sciatica may be confined to low back or hips or may extend up to toes. The pain of Sciatica can be excruciating and "not relieved by painkillers".

What causes Sciatica?

Pain in Sciatica is due to irritation or pinching of Sciatic nerve within the spine. This occurs most commonly due to prolapsed intervertebral disc (slip disc) causing nerve compression resulting in pain.

Is surgery the only treatment for Sciatica?

Most patients can be managed with medication/exercises. So surgery is not the only way out. Patients who have severe pain can also benefit from "Epidural Steroid Injection". This treatment has proven to be effective in avoiding spine surgery in such patients.

What is Epidural Steroid Injection?

Epidural Steroid Injection is a procedure done by a Specialist (Interventional Pain) in an Operation Theatre using X-Ray (Image Intensifier) to locate exact level of injection. A drug mixture consisting of Steroid with Local Anaesthetic is injected at the epidural space of affected nerve root. The steroid washes away inflammatory mediators from the epidural space which decreases the pain. Steroid also decreases the inflammatory response of body to the prolapsed disc. As a result the pain arising from nerve inflammation is decreased. This is a day care procedure i.e. the patients are discharged the same day.

How is the possibility of surgery ruled out?

Epidural Steroid Injection is a proven, safe and an effective treatment that works on the concept of Interventional pain management - to provide relief from persistent and chronic pain of Sciatica. Generally, a single injection is sufficient to relieve patients of the pain. The procedure can be repeated for a maximum 3 times in a year, depending on the patient's response. With effective pain relief, surgery is negated.

Non-Surgical Treatment For Sciatica

Sciatica, which is pain along the huge sciatic nerve that runs through the lower back to the back of each leg, can bring about serious, weakening pain. The term sciatica depicts indications of leg pain along with potential shivering, weakness, or numbness that starts in the lower back and goes through the butt cheek and down the vast sciatic nerve in the back of every leg. However, here are some top ways to get pain relief from sciatica:

1. Chiropractic/manual control
Spinal adjustment and manual control performed by properly trained health experts, for example, chiropractors and osteopathic doctors, are centered around giving better spinal cord alignment. These are intended to address various basic conditions, which can bring about sciatic nerve pain.

2. Acupuncture
This practice is based on the goal of achieving or keeping up the strength through an open stream of energy by certain pathways in the body. Hair-thin needles (which are generally not felt) are embedded into the skin, close to the zone of pain.

3. Subjective behavior therapy
This treatment for taking control and evolving self-defeating behaviors can be useful in overseeing sciatica pain, especially in the short term. Sessions with an advisor might be face-to-face or on the web.

4. Massage treatment
Certain types of back rub treatments have proven to have various advantages for back pain, including expanded blood flow, muscle relaxing, and release of endorphins (the body's regular pain relievers).

5. Strengthening activities
Many activities can strengthen the spinal cord and the surrounding muscles, tendons, and ligaments. The greater part of these back exercises center around the lower back, as well as the (stomach) muscles and gluteus (butt cheek) and hip muscles.

6. Stretching
Stretching is usually prescribed to mitigate sciatic pain. Stretching for sciatica is intended to target muscles that cause pain when they are tight and unyielding. Hamstring stretch is very often an essential part of a sciatica exercise program. As part of everyday exercises, many people do not stretch these muscles, which extend out from the pelvis to the knee in the back of the thigh.

7. Low-impact aerobic activity
Some types of low-impact cardiovascular workout, for example, walking, swimming, or pool therapy, are generally parts of the recovery, as high-impact action increases the exchange of liquids and nutrients to make a better environment for healing.

8. Micro-disectomy
In situations where the sciatica pain is because of a lumbar disk herniation, a microdiscectomy is the most widely recognized surgical approach. It is an open surgery done using magnification techniques. In this surgery, just the bit of the herniated disk that is squeezing the nerve is evacuated. Whatever is left of the plate is left in place.

Top Eight Ways To Get Pain Relief From Sciatica!

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