Sciatica is characterized by pain that sometimes becomes worse when you sit or exert pressure by coughing or sneezing.
Sciatica is a common, nerve-based symptom that’s often related to something going on within your lower spine. In order to find out what that “something” might be, you may be referred to a sciatica specialist in Los Angeles.
A Comprehensive Examination
Because sciatica is a symptom and not a condition, the first step a sciatica specialist in Los Angeles often takes is to find a source of nerve irritation. This process typically involves a review of your medical history, a discussion of your symptoms, a physical exam, and various image tests to look for a nerve compression source. Common culprits include herniated discs, irritation stemming from a “pinched” lower spinal nerve, spinal narrowing (stenosis), and vertebral slippage (spondylolisthesis).
Making an Accurate Diagnosis
In order to make an accurate diagnosis, a sciatica specialist in Los Angeles often takes extra steps to pinpoint or confirm a source. For instance, a straight-leg-raise (SLR) test would require you to slowly lift your leg while resting on your back. You would then be asked to let the specialist know when you feel pain. Making an accurate diagnosis may also involve:
- Nerve conduction studies
- A myelogram performed with a contrast dye injected between vertebrae to determine if problems with spinal bones are contributing to your symptoms
- An MRI specifically performed to determine if an irritated piriformis muscle in the buttocks is affecting the sciatic nerve
Sciatica Management and Treatment
The two main goals of sciatica treatment are to relieve or decrease pain and increase mobility. Unless discomfort is severe, initial symptom management and treatment efforts will likely involve medication such as non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and pain-relievers to ease related tissue swelling and pain. A customized physical therapy (PT) exercise program may also be recommended by a sciatica specialist in Los Angeles. Such a program typically includes:
- Stretching exercises
- Walking and other forms of aerobic exercise
- Massage therapy
- Hot/cold applications
If sciatic nerve pain is preventing you from fully participating in your physical therapy program, you may be advised to consider spinal injections. These are injections containing anti-inflammatory medicine that are administered directly into the affected area. The medication reduces swelling around the affected nerve root, which may then provide enough pain relief to allow you to benefit more from PT exercises.
The experienced relief may also improve your mobility enough so you can exercise more on your own time without distracting pain. Being able to exercise more can strengthen the muscles that provide extra support for your lower back, which is where the sciatic nerve begins.
Surgery for Sciatica
Should conservative treatments fail to provide sufficient relief, surgery may be discussed. Options include the removal of herniated spinal disc fragments (microdiscectomy) and removal of a bone that covers the spinal cord (laminectomy).
A sciatica specialist in Los Angeles is also committed to helping patients prevent future instance of sciatic nerve pain as much as possible. Prevention often involves getting regular exercise that targets your core muscle groups, staying within a healthy weight range, and paying attention to your posture while sit, stand, and sleep.