Sciatica, a form of nerve dysfunction (peripheral neuropathy), occurs when there is compression on, or damage to, the sciatic nerve. This sciatic nerve innervates the muscles behind the knee and lower leg. It provides sensation to the back of the thigh, part of the lower leg and the sole of the foot. Sciatica arises most frequently because of pressure being placed on the sciatic nerve caused by a degenerative spine condition such as a herniated disc, a bulging disc, a protruding disc or a bone spur. The condition often is diagnosed as radiculopathy. This means that the damaged disc or excess growth of bone is positioned in such a way that it places pressure on the nerve root. Sciatica might also be caused by an injury, including a fracture of the pelvis or trauma to the buttocks or thigh. Another factor could be prolonged external pressure on the nerve, and pressure on the nerve from nearby anatomical structures, including certain muscles. Sciatica might also arise in cases of nerve entrapment, which entails pressure on the nerve where it passes through an opening (foramen) between two vertebrae to exit the spinal column. The underlying cause of the symptoms is the prevention of the passage of proper motor and sensory impulses along the length of the nerve. Diseases that affect the entire body, such as diabetes, can damage many different nerves, including the sciatic nerve. The sciatic nerve also may be harmed by pressure from a tumor, abscess or other mass, or by bleeding in the pelvis. Sciatica symptoms include sensation changes, numbness, tingling, burning and pain in the buttocks, down the back of the legs and/or into the soles of the feet. Sciatica can also cause weakness in the legs, knees and feet, and, in severe cases, can cause a loss of mobility. In many cases, sciatica affects just the right or left side of the body, but it can affect both. Traditionally, the only surgical option for addressing sciatica was open back surgery. Open back surgery involves high risks and many complications. Procedures such as discectomy, a foraminotomy, laminotomy, disc replacement, or spinal fusion are possible surgical interventions of last resort to treat people with a herniated disc, bulging disc or bone spur that is pressing against the sciatic nerve and causing the symptoms of sciatica. By removing or shrinking the herniated disc or bulging disc we can decompress the nerve. After excess disc and bone material are removed, the symptoms of sciatica generally disappear.
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