What is Sciatic Nerve Compression?
The sciatic nerve is a large nerve that originates in the lumbar spine or lower back, running along the hip and back of the leg and branching off at the knee. It is made up of 5 sets of paired nerve roots located in the lumbar spine that combine to form a left and right sciatic nerve. Compression or damage of this nerve as a result of an underlying medical condition is defined as sciatic nerve compression.
Causes of Sciatic Nerve Compression
Some of the common causes for compression of the sciatic nerve may include herniated disc (damage to intervertebral disc), bone overgrowth (bone spurs), piriformis syndrome (piriformis muscle compresses the sciatic nerve), or injury and tumors of the lumbar spine. Other conditions of the lumbar spine that may cause sciatic nerve compression include degenerative disc disease (degeneration of vertebral discs), spinal stenosis (narrowing of the spinal canal), and spondylolisthesis (vertebra slips out).
Risk Factors for Sciatic Nerve Compression
Some of the risk factors that increase your chances of developing sciatic nerve compression include:
- Poor posture
- Obesity
- Diabetes
- Prolonged sitting
- Occupational hazards
- Advanced age
- Previous injury to lower back
- Inactive lifestyle
- Osteoarthritis
- Smoking
- Weak core muscles (muscles of your abdomen and back)
Signs and Symptoms of Sciatic Nerve Compression
The main symptom of sciatic nerve compression is pain that radiates from your lower back down the buttocks to your legs. The intensity of pain varies from mild pain to sharp or burning pain. This may also be associated with numbness, tingling, muscle weakness or burning sensation in the hip, leg, and foot. The pain is usually intensified with prolonged sitting, and exaggerated by coughing, laughing, or sneezing. In rare cases, bladder and bowel function may also be affected (cauda equine syndrome) requiring emergency medical intervention.
Diagnosis of Sciatic Nerve Compression
In order to diagnose sciatic nerve compression, your physician will review your medical history and conduct a physical examination to evaluate muscle weakness, numbness, and abnormal reflexes, which may indicate sciatic nerve compression. Imaging tests such as X-rays, CT, and MRI scans may be ordered to evaluate if any soft tissue structures surrounding the nerve are pressing on it and to help confirm the diagnosis.
Treatment for Sciatic Nerve Compression
Most cases of sciatic nerve compression can be treated with conservative approaches such as physical exercises, over-the-counter drugs, ice or hot packs, prescription medications, epidural steroid injections, massages, and manual manipulation.
However, if symptoms of sciatic nerve compression do not respond to a conservative approach, surgery may be indicated to relieve pressure on the compressed nerve. The two most common surgeries employed for decompression of the sciatic nerve include a microdiscectomy, which removes a portion of the herniated disc pressing on the nerve, or a laminectomy, which removes a section of the vertebra to make more space in the spinal canal for the nerve to exit freely without any hindrance.