Daily Checkup: Back pain due to sciatica and other problems can be managed with medicine or treated with surgery, says Dr. Andrew Casden of Mount Sinai

By Katie Charles

The Specialist

An associate professor of orthopedic spine surgery at Mount Sinai, Dr. Andrew Casden treats adults and children with various spinal disorders, including scoliosis, herniated discs, and spinal stenosis from the neck to the lower back.


As millions of Americans know firsthand, back pain is one of the most common complaints that leads people to seek medical attention — though the exact source of garden variety cases of back pain usually remains undetermined, sometimes doctors can pinpoint exactly what is wrong. “Sciatica is a particular type of back pain that goes down the leg as well as occurring in the back,” says Casden. “The root cause of sciatica is a usually herniated disk, when a piece of the disk has ruptured and presses on the nerve, irritating it.”

What causes the herniated disk in the first place? “Usually, it’s a wear and tear phenomenon that occurs gradually over time due to the weakening of the fibers that normally hold the disk in place,” says Casden. “In some cases, there can be a specific event the patient recalls — like lifting something heavy and then noticing the onset of pain down the leg. But it’s pretty common that patients will say, ‘I didn’t do anything!’”

Sciatica affects all parts of the population. “As a rule, it’s pretty universal-men and women are both affected, and we see patients of every age, but most commonly young young and middle age adults says Casden. “Most of the time, there aren’t really risk factors associated with a case of sciatica, but some professions — like jackhammer operators, or truck drivers — do have a higher incidence.”


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