Questions To Answer Before Considering Sciatica Surgery
Sciatica is the type of pain that originates in your lower back and typically radiates down one or both of your legs. It results from the inflammation of the sciatic nerve in your lower back. The medical term for sciatica is lumbar radiculopathy: pinching of a nerve as it exits the spine.
Surgery is one of the treatment options for sciatica, but itâs not for everyone. Below are some important questions to consider before making your decision, addressed by orthopaedic surgeon Brian Neuman.
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Difficulty Or Impaired Leg Mobility
Individuals with sciatica may find it difficult to walk, stand or sit in due to the pain and other neurological manifestations of sciatica such as weakness or numbness of the lower extremities.
The signs and symptoms listed above may manifest for a couple of weeks or may last for many years. However, it is essential to note that not everyone will experience the same sciatica symptoms because causes of sciatica may differ from one person to another.
When Is It A Medical Emergency
Part of the problem with sciatic nerve pain is that it can obscure other more serious conditions. For instance, a recent article in World Neurosurgery indicated that lumbar radiculopathy can mask tumors growing alongside the nerve. If pain persists when palpating the cleft between the buttocks, further scans may be necessary. Any abnormal readings on those scans may indicate the presence of tumors.
As mentioned above, sciatic nerve pain symptoms can include weakness along the legs, urinary problems, and/or incontinence. These may indicate a serious medical condition, particularly if they occur suddenly. The most likely culprit would be cauda equina syndrome, a severe compression of the bundle of nerves at the end of the spine. The American Association of Neurological Surgeons notes that cauda equina syndrome most commonly results from a massive herniated disc in the lumbar region. A single excessive strain or injury may cause a herniated disc. However, disc material degenerates naturally as a person ages, and the ligaments that hold it in place begin to weaken. As this degeneration progresses, a relatively minor strain or twisting movement can cause a disc to rupture.
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Proper Diagnosis Essential To Treatment
The doctor will ask you about your symptoms, such as:
- When the pain started
- Where you feel the pain
- Activities that reduce or worsen pain and symptoms
- Whether the pain goes all the way down your leg or stops at the knee
- Is there weakness or tingling in your legs and/or feet?
- How severe your pain is, on a scale of 1 to 10
The doctor may perform a straight-leg test to see if you have an inflamed nerve. You lie on your back while the doctor lifts each leg. If lifting a leg causes, or produces sciatic-like pain and sensations, you may have a bulging or ruptured disc.
The doctor may ask you to walk as you normally do, then on your heels and next, your toes. This helps the doctor to check your balance and aspects of lower-body strength. Compression of the nerve can cause muscle weakness in the foot which will be revealed by these tests.
Pinched Nerve In The Back
A pinched spinal nerve may cause all kinds of pain. When associated with arthritis or herniated lumbar discs, the pain occurs due to the pressure on the spinal column. Moreover, the pain can travel down the thigh, despite the fact that it normally occurs in the lower back at first.
Symptoms are quite diversified. The pain can also occur in the front of the thigh, but it may come with tingling sensations and numbness as well. Weakness in the thigh is just as common, not to mention facing difficulties while trying to stand up or sit down.
You know you have a pinched nerve in the back if the thigh pain changes in intensity based on the position of your back.
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Bending Over When Lifting Heavy Objects
Whether you are carrying groceries to your kitchen from your car, picking up your child from the bed, or moving flowerpots in your garden, you are placing large amounts of workload on your lumbar discs. When your lumbar discs are overworked, there is an increased risk for developing herniated discs. This, in turn, can compress or irritate the sciatic nerve.
What Complications Are Associated With Sciatica
Most people recover fully from sciatica. However, chronic pain can be a complication of sciatica. If the pinched nerve is seriously injured, chronic muscle weakness, such as a drop foot, might occur, when numbness in the foot makes normal walking impossible. Sciatica can potentially cause permanent nerve damage, resulting in a loss of feeling in the affected legs. Call your provider right away if you lose feeling in your legs or feet, or have any concerns during your recovery time.
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Know More About Various Treatment Options For Sciatica
Sciatica treatment plans and methods may vary from patient to patient. Some may benefit more from exercise, but others may not. Treatment therapy can only be effective if you know the underlying cause of your sciatica.
If you have no idea what causes your sciatica, discuss possible diagnostic or assessment procedures with a doctor to fully understand the causes, symptoms, complications, and appropriate treatment modalities for your Sciatica.
Need Help How Can A Hip Pain Professional Help
Your Hip Pain Professional can:
- provide a skilled assessment
- help figure out the actual source of the problem and if you have more than one area contributing to the problem
- develop a comprehensive plan to help the problem If your pain is lumbar-referred or radicular, you may need treatment on your back and not your hip or if you have two problem areas, both will need to be addressed within a comprehensive management plan
- recommend further tests or refer you to another specialist if the problem does not appear to be in the musculoskeletal system.
Search For A Hip Pain Professional Here.
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Treatment For Groin Pain
It is crucial to never be shy or embarrassed about seeking help for any pain, regardless of your fears or reservations. Groin pain is often easily treated, as long as the condition is diagnosed properly. There is always the chance that groin pain can indicate a serious health issue, such as cancer or organ failure. Therefore, seeking a professional diagnostic opinion is always advised.
Once a diagnosis has been achieved, then proper care can be provided. As long as the diagnosis is accurate, then therapy should resolve the pain in the predicted time frame. Patients who can not find lasting sciatica relief from a variety of seemingly ideal treatment options may want to reconsider the validity of their diagnosis and seek out a second opinion. In fact, since there is such a diversity of theories as to the true nature of sciatic nerve complaints, I routinely suggest seeking multiple opinions from a variety of care providers before seeking any treatment whatsoever.
Sciatica Groin Pain Nightmare
Many, many cases of groin pain, either by themselves, or in combination with back pain, have a causative or contributory psychoemotional component. These conditions will not usually respond to medical care and any relief found is likely to be based on the placebo effect and will be short lived. Psychoemotional issues causing groin pain will often involve an unhappy relationship, a history of physical or sexual abuse or a feeling of being unfulfilled in life.
Hip Pain And What Might Be Causing It
Hip pain is often much less serious than sciatica, as its not caused by nerve damage. Hip pain refers to any pain or irritation you may be feeling in the outside of your hips, upper thighs, your hip joint, or buttocks. This pain is often caused by damage to the muscles, ligaments, or tendons. It is a pain that radiates from the soft tissue instead of from the nerve.
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Is Sciatic Pain Permanent Or Will It Go Away
There are few things worse in the world than chronic back pain, if youre currently suffering from sciatica or you have suffered in the past youll know how quickly it can take over your life and rob you of the ability to do even the most mundane day-to-day activities.
Over time this can have a serious impact on your physical and emotional wellness, so its more than valid to wonder if the pain will ever go away or if youre going to suffer from it for life.
Sciatica is known as the pain associated with the sciatic nerve in the body. This nerve is one of the largest nerves of the body. This nerve is made of many individual nerves that branch out from the lower part of the spine normally from 3rd lumbar segment. A single nerve root comes out of every level in the lower spine and all of them form a single large sciatic nerve. This large nerve then runs down through the buttock to the backside of each leg. In the leg, the portions branch out to the thigh, calf and then to the toes through the foot. This sciatic pain is very rare before the age of 20 and becomes common during the Middle Ages i.e. normally between the ages of 40-50. This pain is so common that some researchers have even gone to say that this pain will affect 43% of the population at one or the other point in their life.
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Sciatica Symptoms Or Something Else
Sciatica isnt the only reason for pain in the legs, ofcourse. Other conditions can mimic sciatica:
- Vascular disease: Narrowing of the bloodvessels in the legs can cause pain and cramps and might make it hard to walk.
- Peripheral neuropathy: Small nerves inthe legs can become damaged, causing burning, pain, tingling or numbness in thefoot or lower leg. This type of nerve damage is often related to diabetes,alcohol use disorder or other medical conditions.
- Peroneal neuropathy: An injury to the peroneal nerve below the knee can cause weakness and make it hard to lift the foot.
How can you tell if youre dealing with sciatica orsomething else? Sciatica tends to affect the length of the leg, not just thefoot. And most often, that pain radiates downward from top to bottom, Dr.Thomas says.
Another clue: Sciatica usually strikes just one side. If you have pain in both legs, it is less likely a disc herniation, but more likely due to degenerative changes like spinal stenosis, he says.
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What Are The Symptoms
Classic sciatic pain starts in the low back and buttocks. It affects one leg traveling down the back of the thigh, past the knee, and sometimes into the calf and foot. The pain feels worse in the leg than in the back. It may range from a mild ache to severe burning or a shooting pain. Numbness or tingling can occur in your leg and foot. This usually is not a concern unless you have weakness in your leg muscles or foot drop.
Sitting usually causes the most pain because of the weight this position puts onto the discs. Activities, such as bending or twisting, worsen the pain, whereas lying down tends to bring relief. Running or walking may actually feel better than sitting or standing for too long.
Seek medical help immediately if you have extreme leg weakness, numbness in the genital area, or loss of bladder or bowel function. These are signs of a condition called cauda equina syndrome.
How To Treat Foot And Ankle Pain Caused By Sciatica
There are many treatments for sciatica, but they fall into two categories: non-operative treatment and surgical treatment.
Non-operative treatments for sciatica include Physical Therapy , medications like non-steroid anti-inflammatory drugs or opioids, injections, and rest. These treatments are often successful, but you may need to continue with them over some time before your symptoms fully resolve.
As experienced Physical Therapists with a long history of helping patients resolve sciatica and foot and ankle pain without dangerous surgery, we consider surgical treatments an absolute last resort. With sciatica, there are two main options for surgical intervention:
- Microdiscectomy: This surgery specifically relates to disc herniation. During the surgery, the damaged disc is either partially or entirely removed to relieve pressure on the sciatic nerve. Your surgeon may also need to remove a small piece of bone.
- Laminectomy: During this surgery, your surgeon removes the lamina the arched part of your spinal bones to make space for your sciatic nerves, or other associated nerves, to pass through without compression or restriction.
We only recommend surgery in very rare cases when patients do not respond to non-operative treatment. These patients continue to have significant leg numbness, pain, weakness, and sensory dysfunction even after physical therapy, rest, and medication.
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What Happens If Sciatica Is Not Treated
There are several issues that can arise from untreated sciatica. You may experience: Nerve damage If you dont seek medical treatment for your condition, then you run a very high risk of suffering nerve damage that may be permanent. If that happens, then the pain in the back and legs may only get worse
Orthopedic Experts In Missouri
If you are experiencing back pain that doesnt resolve with rest or exercise, turn to the orthopedic specialists at Advanced Bone & Joint for relief.
Call us today at or request an appointment online for a consultation. We are dedicated to helping you relieve your pain and improve your overall health.
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What Are Sciatica Causes
Sciatica is caused by irritation of the sciatic nerve. Usually, there is no specific injury that is related to the onset of sciatica. Occasionally, the pain will suddenly begin after lifting something heavy or moving quickly. The following are causes of sciatica:
- A herniated disc : Disc herniation is the most common cause of sciatica. When a disc herniates near the spinal nerve roots that form the sciatic nerve, it can cause pressure on the nerve, or irritation, which results in the symptoms of sciatica.
- Discs are the cushions between the bones in the back. They act like “shock absorbers” when we move, bend, and lift. They are the size and shape of checkers.
- There is a tough ring around the outside of each disc and a thick jellylike center inside . If the outer edge of the disc ruptures, the center can push through and put pressure on the sciatic nerve, leading to the pain of sciatica .
How Is Hip Pain And Leg Pain Treated
Hip pain and leg pain can get better even if you do not know the cause. We offer injection and non-injection therapy to treat chronic hip pain and leg pain. Possible treatment options that your doctor may send you to us for include:
- Hip Joint Injection
- Lumbar Selective Nerve Root Injection
- Sacroiliac Joint Injection
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Sciatic Nerve Hip Pain Location
Sciatica is nerve pain that begins in the hip and deep in the buttocks and travels down the leg. The largest nerve that supplies the lower body is the sciatica nerve. It comes off the lower spinal cord.
Can sciatica cause leg bruisingThe swollen veins produce pains that radiate to the buttocks and make sitting very difficult. Sometimes, they can be itchy and may result in rectal bleeding. Treatment for buttock pain. You can employ different approaches to treat or relieve buttock pains. The methods will vary and will also depend on the diagnosis for the cause of the pain.
When Should Someone Seek Medical Care For Sciatica
- The pain is not improving after several days or seems to be getting worse.
- If the affected person is younger than 20 years of age or older than 55 years of age and is having sciatica for the first time
- The affected individual presently has cancer or has a history of cancer.
- The affected individual has lost a large amount of weight recently or has unexplained chills and fever with back pain.
- The affected individual is HIV positive or uses IV drugs.
- Someone has trouble bending forward after more than a week or two.
- The affected individual notices weakness is getting more pronounced over time.
Go to a hospital’s emergency department if any of the following occur along with sciatica.
- The pain is unbearable, despite trying first aid methods.
- The pain follows a violent injury, such as a fall from a ladder or an automobile crash.
- The pain is in the back of the chest.
- The affected individual is unable to move or feel his or her legs or feet.
- The affected individual loses control of his or her bowels or bladder or has numbness in his or her genitals. These may be symptoms of cauda equina syndrome .
- The affected individual has a high temperature .
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