In musculoskeletal pain, sciatica is one of the most common diagnoses out there. Chances are, if you’ve been to your primary care physician with any back pain that radiates, you’ve been diagnosed with sciatica. Although sciatica as a symptom set is simple, sciatica as a diagnosis is incomplete and non-specific. Sciatica is any neurologic symptom that travels down your leg. It can be burning, tingling, numbness, or some combination of both. Sciatica does not have to feature lower back pain, although you may experience that as well.
Spinal sciatica occurs when a space-occupying lesion, typically a disc or stenotic foramen, impinges on a nerve root that travels down your leg. This usually occurs at the L4-L5 and L5-S1 levels. You may feel this all the way down your leg, into your foot, or just in your foot, ankle, or calf. You may also experience inflammatory sciatica where inflammation touches a nerve root due to irritation in a tissue at your spine.
Extra-spinal sciatica occurs when the sciatic nerve gets trapped down in your leg, most commonly at your glutes or in your hamstrings. This can also be known as “piriformis syndrome” as the site at which it gets stuck in your glutes is close to the piriformis. This often accompanies immobility in the hamstrings. Symptomatically, the burning, numbness, and tingling rarely travel past the knee.
Inflammatory spinal sciatica should get better within 7-14 days as your body processes the inflammation. This assumes that you give it adequate rest. Avoid any irritative movement and sitting down for prolonged periods of time.
Space occupying spinal sciatica will not improve on its own. Extra-spinal sciatica will not improve on its own. It’s best not to get caught up in differentiating the two on your own. If your sciatica is constant, seek immediate medical help. If it is intermittent, try this exercise and this exercise for 4-6 weeks to see if it improves. If either causes pain or your symptoms do not improve your condition after 4-6 weeks, seek medical help.
At Wildcard, we can provide you with a more specific diagnosis than sciatica by differentiating where the root cause of your issue is. If it’s spinal, we can help determine if conservative care is something you can explore or if surgery really is your best option. By breaking up adhesion and decompressing the lower back, there’s a chance that your space-occupying lesion will reduce. Extra-spinal sciatica is never surgical and can be fixed by breaking up the adhesion that’s sticking your nerve down. Patients typically experience permanent pain relief in 3-5 visits.
At Wildcard Spine and Sport, we specialize in fixing pain that’s lasted longer than six months, even if you’ve seen two or more providers. We are the only practitioners in the five boroughs certified to diagnose and remove adhesion. Click the button below or call the office today at 917-908-0055.