Q&A Topic: Getting a Leg Up on Sciatica

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John Abrahams, MD, FAANS

Q. Do I have sciatica?

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A. You probably do if you feel a sudden and severe pain, along with numbness and weakness, radiating from the buttock down the back of one leg to the foot. The pain can be crippling. It is usually intense when you walk, diminishing when you lie down.

Q. What causes sciatica?

A. The sciatic nerve branches from the spine in the lower back through the hips and buttocks and runs down the back of each leg to the foot. Sciatica occurs when this nerve is pinched in the lower back by herniation—protruding disc material—or a larger fragment of disc material. Disc herniation usually occurs during normal activities, such as rising from bed.

Q. Am I at risk for sciatica?

A. Sciatica is common in the U.S. More than three million Americans are diagnosed with the condition annually. Apart from the fact that 10 to 15 percent of patients have a family history of back problems, there are no risk factors. No behavior predisposes you to it

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.Q. What are my treatment options?

A. Unless you have severe sciatica, you’ll first receive oral steroids. Once you’re more mobile, you’ll engage in physical therapy, and then be re-evaluated. If symptoms persist, you may receive an injection of steroids at the nerve root. If this regimen fails, we offer surgery. However, if a patient comes in unable to stand—basically bed-bound—we advise surgery sooner. Note that 80 to 90 percent of patients get better without surgery.

Q. What can I expect from surgery for sciatica?  

A. This minimally invasive procedure takes under an hour, and consists of removing the disc material pressing on the nerve. Most patients are pain-free following surgery. Sciatica recurs in 10 percent of people. NWH’s experienced nursing staff streamline the outpatient surgery process. We often see patients who arrived at NWH crippled—unable to stand or walk for more than a few minutes—walking out the same day, completely asymptomatic.

Northern Westchester Hospital
Chief, Neurosurgery
Co-Director, Orthopedic & Spine Institute, Spine Section
Learn More About Dr. Abrahams

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Read Past Topics from Dr. Abrahams:
Chronic Back Pain and Advanced Surgical Solutions
Dealing With A Pain In The Neck

Northern Westchester Hospital is a proud member of Northwell Health (formerly North Shore-LIJ Health System).

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