Book Appointment

Understanding Sciatica: Key Insights from Neurosurgeon Dr Colum Nolan’s Discussion on Every Body Knows

Understanding Sciatica: Key Insights from Neurosurgeon Dr Colum Nolan’s Discussion on Every Body Knows

Sciatica is one of the most common causes of lower back and leg pain, yet many people remain unsure what it truly means. In a recent episode of Every Body Knows, hosted by Mike Kasem and Catherine Robert, neurosurgeon Dr Colum Nolan, who specialises in spine conditions, shared clear and practical insights on how sciatica develops, what symptoms to look out for, and the steps involved in managing it.

The episode also featured radio personalities DJ Denise Tan (Gold 90.5FM) and DJ Sajini (Oli 96.8FM), who openly discussed their own experiences with sciatica and the challenges it brought to their daily lives.

This article draws from the key highlights of that discussion, offering an easy-to-read summary of the insights shared.

Watch the full episode here:

What Exactly Is Sciatica?

What Exactly Is Sciatica?

One of the first clarifications Dr Colum made was that sciatica is not a disease by itself. Rather, it is a collection of symptoms that occur when the sciatic nerve becomes irritated, inflamed, or compressed.

The sciatic nerve: where it runs

  • It is the largest and longest nerve in the body
  • Formed by nerve roots in the lower spine
  • Travels through the buttock and down the back of the leg
  • Branches into smaller nerves near the foot

When this nerve is compressed, pain can travel along its entire pathway — a hallmark feature of sciatica.

Recognising the Symptoms

On the programme, the hosts and guests described symptoms commonly experienced by individuals with sciatica, which matched Dr Colum’s clinical insights:
  • Sharp, shooting, or “electric-like” pain down the leg
  • Pain that begins in the lower back or buttock
  • Tingling, numbness, or burning sensations
  • Difficulty sitting or standing for long periods
  • Leg weakness in more severe cases
  • Rare but urgent signs: changes in bowel or bladder control
These symptoms typically affect one side of the body, though both sides can be involved depending on the underlying cause.

What Causes Sciatica?

According to Dr Colum, several conditions can lead to sciatica. The most common include:

1. Slipped Disc (Disc Herniation)

A spinal disc acts as a cushion between vertebrae. When part of the disc’s inner gel pushes through its outer ring, it may press on the nerve roots that form the sciatic nerve. This is one of the most frequent causes of sciatica.

2. Spinal Stenosis

As part of the natural aging process, the spine may undergo changes such as:
  • Disc thinning
  • Bone spurs
  • Thickened ligaments
These can narrow the spinal canal — a condition known as spinal stenosis — leading to nerve compression.

Other contributing factors discussed include:

  • Spondylolisthesis: one vertebra slipping forward over another
  • Prolonged standing or repetitive heavy lifting
  • Long periods of sitting or poor ergonomics
  • Degenerative spine changes
  • Diabetes, excess weight, and smoking
  • Genetic predisposition
Even simple movements — like bending over to pick up a light item — may trigger symptoms if the spine is already strained.

When Should You See a Spine Specialist?

Dr Colum highlighted specific signs that warrant a review by a spine specialist, spine surgeon, or neurosurgeon specialising in spine care:
  • Persistent or recurring leg pain
  • Numbness, tingling, or burning sensations
  • Pain that affects daily function
  • New or worsening leg weakness
  • Bowel or bladder changes (urgent evaluation required)
These symptoms suggest meaningful nerve irritation or compression.

How Sciatica Is Assessed

Most people do not realise they have a spine problem until symptoms appear. A typical assessment may involve:
  • A physical examination
  • Understanding where the pain travels
  • A trial of conservative treatment
If symptoms persist or weakness is present, an MRI scan may be recommended. MRI can detect:
  • Disc herniation
  • Nerve compression
  • Spinal stenosis
  • Degenerative changes
  • Structural conditions such as spondylolisthesis

How Sciatica Is Treated: Step-by-Step

A key point from Dr Colum’s interview is that treatment rarely starts with surgery. Most people begin with non-invasive approaches.

1. Conservative Treatment

Common first-line treatments include:
  • Medication for pain and inflammation
  • Physiotherapy to improve mobility, posture and core strength
  • Heat or cold therapy
  • Activity modification
  • Ergonomic adjustments at work
  • Supportive options such as acupuncture or TCM
Many individuals experience meaningful improvement with these measures.

2. Minimally Invasive Spine Surgery (When Indicated)

For individuals with persistent symptoms or significant nerve compression, minimally invasive spine surgery may be considered. These modern techniques involve small keyhole incisions, allowing the surgeon to decompress the affected nerve with:
  • Minimal tissue disruption
  • Lower complication risk
  • Faster recovery
  • Earlier return to activity
This approach may be suitable for conditions such as slipped disc, spinal stenosis, or certain cases of spondylolisthesis, depending on the individual’s MRI findings and symptoms.

Tips to Reduce the Risk of Sciatica

Dr Colum also shared several practical prevention tips:

  • Maintain good posture while sitting and standing
  • Use safe lifting techniques
  • Keep a healthy weight
  • Stay active within comfortable limits
  • Manage conditions such as diabetes
  • Avoid smoking
  • Optimise desk ergonomics or use a standing desk
  • Strengthen the back and core with guidance

These habits support long-term spinal health and may help reduce the recurrence of symptoms.

Key Takeaway

Sciatica can significantly affect daily life, but many people improve with timely assessment and conservative care.
 Understanding the underlying cause — whether a slipped disc, spinal stenosis, or structural change — helps guide appropriate treatment.

If symptoms persist, interfere with movement, or are accompanied by weakness, consulting a spine specialist, spine surgeon, or neurosurgeon specialising in spine can help ensure that the right steps are taken early.

Share this article
WhatsApp