Herniated Disc and Sciatica

Back Surgery Information

Herniated Disc and Sciatica

A herniated disc and sciatica are two things that quite often go hand in hand. This is because sciatica, which is the general term used for a number of symptoms such as pain and numbness, occurs when the herniated disc is pressing on a nerve root.

The term sciatica originates from the fact that the herniated disc is pressurizing or compressing one of the nerve roots feeding the sciatic nerve. Sciatica, medically referred to as sciatic neuritis, normally manifests itself as pain which may be felt in the buttocks, lower back and/or down the legs. It is usually felt on only one side of the body, left or right.

Herniated disc and sciatica are often considered together because disc herniation, especially in the lumbar region, is the most common cause of sciatica. Herniation of a disc can be caused when the soft, gel-like center (known as the nucleus pulposus) of the vertebral discs bulges out perhaps due to a tear in the annulus fibrosus, which is the external ring of the discs. The bulging disc may then cause pressure on the sciatic nerve roots causing sciatica.

Herniated disc and sciatica may not always go hand in hand however. Sometimes the sciatic pain is caused by something other than compression from a herniated disc. Sciatica is sometimes caused by disc degeneration or muscle spasms. Disc degeneration may result from normal wear and tear caused by the aging process. Muscles spasms of the piriformis (which results in piriformis syndrome) muscle may also cause sciatica.

Other causes of sciatica include conditions such as spinal stenosis (which reduces the spaces in the spinal canal causing compression of the sciatic nerve), cauda equina syndrome or spondylolithesis (which results in misalignment of the vertebrae).

Diagnosis of a herniated disc and sciatica is made through a physical exam of the patient, review of his medical history as well as running some diagnostic tests such as CT scan or MRI. This is so as to rule out other possible causes of the sciatic pain.

Treatment may not be necessary for a herniated disc and sciatica. This is because the majority of herniated discs resolve by themselves and their resolution causes the resolution of the sciatica. However, if this does not happen, medication such as NSAIDs or analgesics are prescribed to ease the pain and discomfort.

Exercise may be good therapy for a herniated disc and sciatica. The aim of the exercise is to move the pain from the leg and other extremities to the lower back. The exercises are mainly extension exercises such as press ups. Once this has been achieved, exercises for strengthening the lower back and the core (abdominal muscles) are then recommended. Exercises should be carried out under the supervision of a spine specialist to avoid causing more damage. If non-invasive therapies do not give the desired results there may be the need for herniated disc back surgery.