- 22 Dec, 2022
- Dr. Arun Rajeswaran
- No comment
Why Should Sciatica Pain Never Be Ignored?
Sciatica is a condition where the sciatica nerve or the spinal roots in the lower lumbar spine is irritated or compressed by a herniated disc or outgrown bone putting pressure on the nerve roots leading to inflammation, numbness, and pain in certain areas of the leg or lower back. The sciatica nerve pain gets worse on coughing, sneezing, or laughing. Let’s understand why should sciatica nerve pain never be ignored and what are the symptoms and causes of sciatica.
Symptoms of sciatica
Symptoms of sciatica include shooting pain radiating down the hip, thigh, and leg. Numbness, tingling, and weakness are the nerve-based symptoms associated with sciatica. If the symptoms observed are consistent and severe, then you should consult a neurosurgeon for the diagnosis of the origin of sciatica nerve pain.
Causes of sciatica pain
Sciatica occurs due to compression of the sciatica nerve usually at the fifth lumbar/ first sacral vertebrae.
The most common causes of the sciatica nerve compression
Degenerative disc disease– a weakened spinal disc restricts the vertebrae motion
Disc herniation– the soft inner portion of the disc disrupts through the tough outer corner and presses the nerve
Spinal stenosis– the narrowing of the canal through which the nerve passes
Subluxation– misalignment of the one vertebra over the other.
What are the factors leading to sciatica?
Some of the risk factors involved with Sciatica nerve pain are mentioned below-
Complications of Untreated sciatica nerve pain
Some risks and complications associated if sciatica nerve pain is left untreated can include-
Permanent nerve damage- not treating the cause of compression of the nerve can result in permanent nerve damage. This also leads to severe pain, numbness ad weakness of the foot.
Loss of sensation and motor changes- loss of sensation and weakness can become permanent if the initial sciatica nerve pain caused due to compression is left untreated.
Incontinence- if other sacral spinal nerve roots are also compressed, it may result in bowel and bladder incontinence.
Sciatica nerve pain affecting the quality of life
Sciatica symptoms can become severe to such an extent that it becomes difficult for the person to perform daily activities. The pain becomes disruptive to interfere with sleep and causes discomfort while walking and sitting.
Most cases of sciatica can be treated with medications like anti-inflammatory drugs, muscle relaxants, pregabalin, etc., and physiotherapy after consulting an experienced surgeon for immediate relief from sciatica pain.
If the sciatic nerve pain is severe, not responding to the medications or if there is weakness in the legs or loss of bladder control, you may be offered surgery.
Using advanced technology or innovative and personalized surgical procedures such as minimally invasive discectomy and endoscopic foraminotomy, sciatica can be treated by an experienced neurosurgeon.
Frequently Asked Questions
Untreated or inadequately managed sciatica can lead to serious and sometimes permanent neurological damage. Prolonged compression of a nerve root leads to progressive axonal damage not just pain and numbness, but loss of motor function (e.g., foot drop), reflex loss, and muscle wasting that may not fully recover even after the compression is relieved. The window for best neurological recovery is generally within the first 3–6 months of symptom onset. Delayed surgical decompression in patients with progressive neurological deficit results in significantly poorer functional recovery compared to timely intervention.
Sciatica becomes an emergency in the presence of cauda equina syndrome a condition caused by massive central disc herniation or other pathology compressing the entire bundle of nerve roots at the base of the spinal cord. Warning signs include bilateral (both legs) weakness or numbness, loss of control of the bladder or bowel (urinary retention, incontinence, or inability to feel the urge to defecate), and saddle anaesthesia numbness in the perineum, inner thighs, and genitals. This is a neurosurgical emergency requiring MRI confirmation and surgical decompression within hours to prevent permanent paralysis and incontinence.
For patients who genuinely require surgery (due to neurological deficits or refractory pain), timing matters significantly. Studies have shown that patients who undergo decompressive surgery within 3–6 months of onset have better neurological recovery and faster return to function than those who wait a year or more. Prolonged nerve compression leads to scarring around the nerve root and changes in spinal cord pain processing (central sensitisation) that can make pain harder to treat even after the mechanical cause is removed. Early specialist evaluation helps identify who needs surgery promptly and who can safely continue with conservative management.
