Boston Red Sox pitcher Tim Wakefield underwent back surgery at Massachusetts General Hospital this week to repair a herniated disc and remove a loose fragment. Many are encouraged to hear early word the back surgery was deemed successful with 4-6 weeks of rehab to begin immediately.
Starting with lower back pain, the pitcher developed weakness in his left leg which led to a season ending limp. All the classic complaints of sciatica, characterized by pain running down the back of the leg, weakness in one or both legs, and even lower back pain.
Interestingly, Tim’s progression from pain and weakness to cortisone shots to back surgery follows a pattern familiar to many back pain sufferers. The good news for those with lower back pain or sciatica – even those with a diagnosed herniated disc – is back surgery is rarely necessary to eliminate back pain. In fact, it should be considered a last resort.
Beating sciatica pain and weakness starts with understanding that sciatica is actually a symptom of a different condition. The four most common conditions leading to sciatica are:
Piriformis syndrome – the most common cause of sciatic pain, where the piriformis muscle places pressure on the sciatic nerve
Herniated disc – a bulging or herniated disc may irritate the sciatic nerve
Spinal stenosis – a narrowing of the spinal canal itself pinches the sciatic nerve
Isthmic spondylolisthesis – a slipped vertebrae may irritate the sciatic nerve during movement as it rubs abnormally against the adjacent vertebrae
Outside of cases of trauma, sciatica almost never develops overnight. While the pain may appear suddenly, the underlying condition usually takes months or years to develop.
Fortunately, most cases of back pain and sciatica pain can be relieved through targeted stretching and strengthening exercises. This non-invasive approach is almost always preferable to back surgery and cortisone shots which don’t treat the actual cause of the condition. Particularly since back surgery is the only category of surgery with a clinical name for failure: failed back surgery!