When should I see a doctor about sciatica?

Sciatica is extremely common. Most people have a 80 to 90 per cent chance of having back pain in their life time. Of these patients one to three per cent go on to have sciatica. So what is it, how serious is the condition, and how can it be treated? We interviewed leading neurosurgeon Mr Sanj Bassi for the answers.

What is sciatica?

Sciatica usually occurs when a disc in the back 'slips' and presses on the nerves that run down to the legs.

Symptoms

The symptoms may start with mild back pain, however the most disturbing symptom is pain running down the leg. Although the pain is usually down the back of the leg it may occur in the front of the leg.

Patients often describe sciatica as the worst pain imaginable. Most people with sciatica find it hard to get comfortable in any one position for more than 10 minutes. As well as causing sciatica, a slipped disc can also cause tingling, pins and needles and numbness in the leg. In rare instances the nerve being pressed upon can stop working, causing weakness in the foot.

A disc usually slips to one side of the nerves or the other, however if the disc slips straight back into the middle it can press on the spinal cord and cause pain in both legs at the same time, problems with the bladder, bowels and sexual function.

If any of these symptoms occur the patient needs to be seen as an emergency, in order to preserve bladder and bowel function.

How is sciatica treated?

Initially it's reasonable to try simple pain killers such as paracetamol or ibuprofen, maintaining a good posture and ensuring one's weight is acceptable. These measures may relieve symptoms over the course of a few weeks.

Seeking a neurological opinion

If symptoms continue or progress, a neurosurgical opinion should be sought. You are likely to receive an MRI after a clinical examination. If the MRI shows a large disc pressing on the nerve root, this may need removing surgically if the symptoms are persistent.

Medical studies have shown that 75 to 80 per cent of patients are free of leg pain after surgery, and 65 to 70 per cent remain pain free after 5 years. Tingling may also improve. Unfortunately, if the sciatica progresses to numbness or weakness it is unlikely to improve, so timely treatment is paramount.

To find out more about Mr Bassi and the London Neurosurgery Partnership click here.

Arrange a consultation with Mr Bassi regarding your sciatica concerns via his Top Doctors profile, today.