Doctor's Notes on Sciatica
Sciatica refers to a type of is nerve pain from irritation of the sciatic nerve, the largest nerve in the body. The sciatic nerve begins from nerve roots in the spinal cord in the low back and passes through the buttock and branches down the lower limb. Sciatica is most commonly caused by lumbar disc herniation, but any condition that irritates or causes inflammation of the sciatic nerve can lead to the symptoms of sciatica.
Characteristic signs and symptoms of sciatica include burning pain that radiates from the lower back and upper buttock down the back of the thigh into the back of the leg. Numbness and tingling may also be present. Associated symptoms can include hip pain if the pain radiates around the hip or buttock and low back pain. In severe cases, walking may be difficult. Sometimes, symptoms are relieved by lying down.
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Nearly everyone has low back pain at some time during their life.
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Chronic Pain
Chronic pain is pain that persists for a period of six months or longer, and is the result of a long-standing medical condition(s) or damage to the body. Common sources of chronic pain include headaches, back pain, and arthritis. There are several types of pain including general somatic pain, visceral pain, bone pain, muscle cramps, neuropathy, circulatory problems, and headache pain. Chronic pain may be managed with over-the-counter or prescription medications. -
Hip Pain
There are many causes of hip pain, such as arthritis, trauma, strains, sprains, and other conditions that cause referred hip pain. Hip pain can be sharp, sudden, gradual, or may come and go. Diagnosis and treatment of hip pain will depend upon the cause. -
Leg Pain
There are a variety of causes of leg pain. Some of the common causes include fractures, strains, sprains, bleeding, diseases such as gout, peripheral artery disease, and cancer. Leg pain can also be caused by blood clots, sciatica, neuropathy, joint pain, muscle injury, and skin abnormalities. Treatment of leg pain depends on the cause. -
Low Back Pain
Back pain may be caused by sciatica, a herniated disc, spinal stenosis, fibromyalgia, injury and pregnancy. The pain usually radiates down the legs, pain that gets worse with activity or at night, or numbness or weakness in the leg. Treatment may involve sleeping with a pillow between the knees or taking ibuprofen or acetaminophen. -
Lumbar Disc Disease
Lumbar disc disease refers to three degenerative diseases that may cause low back pain: internal disc disruption, degenerative disc disease, and segmental instability. Symptoms include lower back pain that lasts more than six weeks, pain that worsens over time and with motion, and pain in the buttocks and thighs. Treatment may involve medications, surgery, or physical therapy. -
Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging (MRI) is a scanner that takes cross-sectional images of the body. It is used to evaluate tissues of the head, neck, chest, limbs, abdomen, and pelvis. MRI is a very safe procedure; sedation may be used for infants, small children, or adults who are claustrophobic. -
Osteoarthritis
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Osteoporosis
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Sciatica Pain Relief
Sciatica is an irritation of the sciatic nerve that causes pain and insomnia. Treatment includes physical therapy and pain medication. -
Skin Abscess
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Slipped Disc (Herniated Disc)
An abnormal, injured, or degenerated vertebral disc that has protruded against nerve fibers is called a slipped, prolapsed, ruptured, or herniated disc. A slipped disc may cause symptoms such as pain down the back of the leg (sciatica), numbness or weakness. Treatment may include applying hot or cold packs, limiting activity, taking pain relievers, stretching, performing strengthening exercises, physical therapy, massage, or surgery. -
Spinal Stenosis
Spinal stenosis is defined as an abnormal narrowing of the spinal canal. The most common cause of spinal stenosis is degenerative arthritis. The types of spinal stenosis depend on the location along the spine, cervical, thoracic, or lumbar. Symptoms are generally experienced to the areas of the body that is regulated by that portion of the nerves in the spinal chord. Possible symptoms include worsening balance, falling, dropping objects, difficulty buttoning buttons or picking up small coins, loss of control of the bowel and/or bladder, pain, numbness, tingling, weakness along the path of the nerve being compressed, myelopathy (spinal cord compression), weakness or cramping in the arms and hands, and weakness or cramping in the legs and feet, particularly progressively with walking and being relieved with resting. Treatment for spinal stenosis is generally surgery.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.