FAQ’s on Sciatica and Radiculopathy Treatment in Las Vegas

Pain that originates from the sciatic nerve and travels down the buttocks, back of the thigh, and leg is known as sciatica. Also called radiculopathy, this condition arises from irritation, inflammation, and/or irritation of the sciatic nerve.

Who is at risk for sciatica and radiculopathy?

Certain people are at increased risk for sciatica. Risk factors include:

  • Age between 30 and 50 years
  • Having a herniated disc
  • Family history of this condition
  • Increasing height
  • Having degenerative disc disease or spinal arthritis
  • Obesity
  • Bone spurs causing spinal canal narrowing
  • Trauma to the spine
  • Having diabetes

How common is radiculopathy?

Not all patients who have an aging spine develop radiculopathy. According to research, lumbar (low back) sciatica affects around 4% of the U.S. adult population. Of those diagnosed with radiculopathy, only 20% people develop chronic symptoms that last for more than six weeks. Men are more likely to have radiculopathy, especially during the fourth decade.

What causes radiculopathy?

The largest nerve in the body is the sciatic nerve. When this nerve is irritated or compressed the symptoms of radiculopathy occur. Conditions that contribute include:

  • Spinal stenosis – Narrowing of the spinal canal leads to stenosis, arthritis, and bone spurring.
  • Herniated lumbar disc – The inner gel-like material of the disc protrudes out the tough outer layer and puts pressure on the sciatic nerve.
  • Advanced scoliosis – Constriction of one or more nerves occurs with this condition.
  • Spondylolisthesis – When one vertebra moves out of alignment and over the one below it, impingement of nerves occurs.

What symptoms are associated with sciatica?

Each person with sciatica has different symptoms. Some may only experience one symptom, while others have all. The symptoms include:

  • Pain, electric-shock sensations, and tingling of the buttocks, foot, and/or leg
  • Leg weakness and numbness on the affected side
  • Cramping pain that radiates down one leg

How is radiculopathy diagnosed?

When you go to the pain specialist, he/she will conduct a physical examination, take a complete medical history, and order some diagnostic tests. X-rays are used to assess bones and certain structures. However, magnetic resonance imaging (MRI) scans produce images of the nerves to assess damage.

What is the treatment of sciatica?

The treatment for sciatica depends on the condition causing the symptoms. The pain specialist often uses a combination of treatments to treat the associated symptoms. Options for treatment are:

  • Physical therapy – For pain relief, the doctor uses ultrasound, electrical stimulation, heat/cold therapy, and massage. To improve movement spinal movement, the therapist uses strengthening and stretching exercises.
  • Medications – For mild pain, the doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen and ketoprofen. Analgesics are used for pain, such as tramadol, acetaminophen, and hydrocodone. Because radiculopathy is associated with nerve pain, antidepressants (amitriptyline and nortriptyline) are used, as well as anticonvulsants (Baclofen and Robaxin).
  • Facet joint injection (FJI) – The pain specialist may inject a long-acting anesthetic, with or without a corticosteroid, into the facet joints. This medication is delivered onto the spinal nerves to alleviate pain. Based on a clinical study, FJI offers both short-term and long-term pain relief for people with radiculopathy.
  • Epidural steroid injection (ESI) – The epidural space lies between the spinal cord and the sac, which surrounds it. The doctor uses fluoroscopy (x-ray guidance) to inject a corticosteroid into this space. According to research, this procedure has a 90% success rate.

Resources

Boswell MV, Colson JD, Sehgal N, Dunbar EE, & Epter R (2007). A systematic review of therapeutic facet joint interventions in chronic spinal pain. Pain Physician,10(1):229-53

Lee JW, Park KW, Chung SK, Yeom JS et al. (2009). Cervical transforaminal epidural steroid injection for the management of cervical radiculopathy: a comparative study of particulate versus non-particulate steroids. Skeletal Radiology, 38(11):1077-82.

Radhakrishnan K, Litchy WJ, O’Fallon WM, Kurland LT. Epidemiology of cervical radiculopathy. A population based study from Rochester, Minnesota, 1976 through 1990. Brain. Apr 1994;117 (pt 2):325-35.