The Bonati Institute Glossary: Sciatica

The mission of The Bonati Institute is to provide hope to people suffering with chronic pain from a back or neck condition. We believe that a well-informed patient is vital to restoring hope and finding answers to pain. We developed this web site primarily to help educate pain sufferers and their families. We’ve found that the more individuals in pain learn about their anatomy, their condition and the options available to them the more likely they will be to choose the advanced arthroscopic procedures offered by The Bonati Institute.

Sciatica

Sciatic Pain results from the inflammation of the sciatic nerve and is usually marked by pain and tenderness along the course of the nerve on through to the thigh and leg. Sciatic pain usually starts in the buttocks and extends down the rear of the thigh and lower leg to the sole of the foot and along the outer side of the lower leg to the top of the foot. Pain may also be present in the lower back.

Several nerve roots leave the spinal cord and exit through holes in the sacrum to combine and form the sciatic nerve, which then passes between layers of the buttock muscles into the deep muscles of the back of the thigh.

A primary cause of sciatica is a herniated or bulging lower lumbar intervertebral disc that compresses one of the nerve roots before it joins the sciatic nerve. Sometimes, irritation of a branch of the sciatic nerve in the leg can be so severe as to set up a reflex pain reaction involving the entire length of the nerve. For example, if the nerve is pinched or irritated near the knee, you may feel the pain in the hip and buttock.

Sciatic Pain from a Ruptured Intervertebral Disc

Sciatica is usually a symptom of a bulging lumbar disc. Its distinguishing feature is greater pain in the posterior thigh and lower leg or foot over time, rather than in the lower back. Usually, no specific trauma can be blamed. An action as simple as bending over may bring on sciatic pain. Standing, lifting, sitting or straining may aggravate it.

This may be the most painful, yet easiest, condition to identify. A ruptured or herniated disc is one that bulges and extends into the spinal canal, pressing on the nerve roots. This causes the nerve root to become irritated. On occasion, a ruptured disc can occur after bending over and lifting, however, it usually occurs for no apparent reason.

A ruptured disc may cause back pain and muscle spasms, but a more common complaint is sciatic pain. This is severe pain spreading down one leg and often into the foot. Sometimes, it is the only symptom of a ruptured disc. A ruptured disc can generally be detected by a physical examination alone. Occasionally, a myelogram, CT scan or magnetic resonance imaging (MRI) are necessary to confirm diagnosis and determine if surgery is required.

Probable Treatment

The Bonati Arthroscopic Laser Discectomy

The procedure is designed as an answer to stenosis, herniated discs, disc disease and spinal instability from previously failed open surgeries.

In this procedure the portion of the disc that is causing nerve compression can effectively be removed through a small incision. With the patient awake, a needle is placed into the area of the disc that is producing symptoms. A small incision is made on the patient’s back and the endoscopic tube is inserted.

Using specially adapted endoscopic instruments the diseased disc material is removed and then a laser vaporizes the surrounding problem tissue. A laser is then used to shrink and remodel the remaining disc. A small dressing is used to cover the incision.

Often patients feel immediate relief following this procedure. Rehabilitation begins within hours of surgery, and involves gait training, back or neck support, and walking. Post-operative pain management program avoids narcotics in favor of a Transcutaneous Nerve Stimulator that blocks pain messages to the brain.

• Fewer risks, local anesthesia, a small incision
• Minimal blood loss
• Short recuperation time
• Minimal damage to tissues
• Surgeries are done in an outpatient setting
• Patient sees a faster return to a normal lifestyle