Symptoms of sciatica
- Altered sensation
- Pins and needles
- Burning
- Numbness or even weakness of the muscles in the leg that the nerve supplies
- Symptoms are typically only felt on one side of the body
The lumbar spine has a central canal through which the nerve roots and the cauda equina pass. To each side of the canal, spinal nerve roots branch out at every level. The cauda equina and nerve roots are surrounded by cerebrospinal fluid (CSF) and are all contained within a membrane (dura).
There are five bones (vertebra) in the lumbar spine (lower back). In between each bone is an intervertebral disc, which acts as both a spacer and a shock absorber. Over time, as degeneration (wear and tear) occurs, the intervertebral disc can lose its flexibility, elasticity and shock absorbing characteristics.
It is important to get the right treatment at the right time. Our experienced specialists and modern equipment are the best basis for this. We can arrange an urgent assessment and imaging to reach a diagnosis.
Few people who have a lumbar disc prolapse need surgery. A significant number of people will improve naturally. This can happen if the disc or swelling around a nerve decreases with time or is helped by image-guided injection.
Six out of ten patients can get better spontaneously after six weeks, while 70-80% of patients will feel better by three months.
There is a balance of waiting while nature gets you better, versus waiting too long which might prolong your suffering and pain or compromise nerve function (weakness, numbness or pain recovery). In rare cases, the nerves which control your bladder, bowel and sexual function can be compressed. This is known as cauda equina syndrome (CES) and often requires urgent surgical intervention. Fortunately, immediate spinal surgery is only necessary in a few cases.
If conservative methods or pain medication alone are not sufficient, our specialists may carry out a microdiscectomy spine surgery.
This is performed through an incision in the lower back. First the muscles are held apart to gain access to the bony arch and roof of the spine (lamina). Your surgeon is then able to enter the spinal canal by removing a membrane in between the lamina and over the nerve roots (ligamentum flavum). Often, a small portion of the inside facet joint is removed, both to enable access to the nerve root and to remove pressure on the nerve. A microscope is used to give a greater magnification of the structures. The nerve root is then gently moved to the side and the disc material is removed from under the nerve root.
It is very normal to experience some level of discomfort pain after the surgery. The experienced nursing and medical staff at Schoen Clinic will help you to control this with appropriate medication. The symptoms in your legs may fluctuate due to increased swelling around the nerves. As the nerves become less irritated and swollen, your leg pain should settle. This can take a few weeks. The ward physiotherapist will visit you after the operation to teach you exercises and help you out of bed. They will show you the correct way to move safely. Once you are confident and independently mobile, you will be encouraged to keep as mobile as possible. In many cases, you will be able to go home the day after surgery.
Our multidisciplinary team of spinal specialists at Schoen Clinic London are experts in providing effective treatments for sciatica pain and all conditions of the back.
Schoen Clinic London is a state-of-the-art hospital focussed on specialisation. With an award winning approach to clinical data and research, there is a reason why 100% of our patients in 2019* would recommend us to friends or family. Find your treatment for sciatica with one of our highly experienced spine specialists.
*Average across inpatients, day cases and outpatients in 2019 (n=1221).
66 Wigmore Street
London W1U 2SB
Tel: + 44 20 3929 0801