Sciatica from a herniated disc is the most commonly diagnosed source of numerous back and leg pain syndromes. Typically, the implicated disc is either L4/L5 or L5/S1, although other discs can be the root symptomatic source, as well.
Intervertebral discs can bulge or rupture into the spinal canal, impinging on the spinal nerve roots of the cauda equina and potentially enacting terrible symptoms.
This study investigates the relationship between herniated discs and sciatica. We will examine why disc pathologies might cause lower appendage pain, as well as the common associated neurological symptoms.
Sciatica is defined as lower back, buttocks and leg pain which may also include neurological symptoms, such a paresthesia, weakness and numbness. True sciatica is diagnosed as coming from a spinal source, such as a pinched nerve root caused by a herniated disc, osteoarthritis or degenerative disc disease. However, in many diagnosed cases, the actual suspected source of pain is often inaccurately identified, leading to a variety of unsuccessful treatment modalities.
In other cases, the sciatica is actually being caused by the bulging disc through the processes of spinal stenosis, foraminal stenosis or chemical radiculitis. When sciatica is indeed sourced from a disc pathology, it is due to either structural compression of a nerve root or chemical irritation from leaking internal disc proteins.
In most patients, the symptoms are explained by saying that the herniation is pinching a spinal nerve root or compressing the entire cauda equina. Many herniated discs push against the thecal sac, which surrounds the cauda equina, yet do not cause any ill effects to the nerves themselves.
Some bulging discs even touch or displace the nerves of the cauda equina, but do not cause any symptoms. Typically, symptoms will only result if the nerve is actually compressed, thereby limiting its proper functionality.
Remember that lower lumbar herniations can affect these nerve roots in the central spinal canal or as they leave the canal through the foraminal openings. Typically, foraminal stenosis is more predictable in its expression, when symptoms do result, while central stenosis might be variable, since one or more nerve roots may or may not be compressed at any given time.
Chemical radiculitis is the most controversial of all sciatica diagnoses and there is little proof that this condition affects more than a few unlucky patients, who are particularly susceptible to the irritating proteins which may be touching their nerve structures. In cases where chemical nerve irritation does exist, the condition usually responds well to appropriate therapies, such as flushing injections or minimally invasive disc-sealing procedures.
Sciatica is perhaps the most common of all lower dorsalgia conditions and is known as being particularly stubborn and treatment-defiant. It is also most commonly blamed on a herniated disc in the lumbar spine.
It is vital to know that most herniated discs are innocent of causing pain and therefore, a great number of sciatica cases are misdiagnosed. Sure, there is a herniation present, but it is merely coincidental to the symptoms experienced.
For sciatica, which is due to a lumbar herniation, the condition should respond to appropriate medical care. However, some disc issues can be problematic to treat, since they may be prone to re-herniation and continuing degeneration, even after the most successful surgical and nonsurgical fixes.
As a final thought, be knowledgeable about your condition and learn whether or not your diagnosis makes sense. Remember that symptoms linked to lumbar nerve roots will affect highly specific areas of the anatomy. If the symptoms do not match, or change often, then there is a good chance that the diagnostic verdict may be null and void. This fact alone explains why so many patients never find relief, despite years of active therapy and several failed surgeries.