Tuesday, August 16, 2022

How To Determine Sciatic Nerve Pain

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Top 3 Causes of Sciatic Nerve Pain: How to Tell What is Causing It.

At The Spine Institute of Southeast Texas, we provide custom care solutions tailored to the needs of the individual patient. If you’re experiencing pain or other uncomfortable or unusual symptoms, we can help you get the relief you need to feel better. The first step in relieving pain and other symptoms is to schedule an office visit so you can be evaluated. To schedule your evaluation, book an appointment online today.

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Do I Have Sciatica Here Are 5 Ways To Tell

With so many possible causes of sciatica and so many other conditions that can easily masquerade as sciatica, is there ever a way to know for sure? How can you definitively determine if your pain is sciatica or not?

The most definitive way is to visit your doctor and receive an official diagnosis. However if youre just looking to get an idea for yourself before you visit your doctor, here is a guide to help you determine if you are truly experiencing sciatica.

  • Your Knees Feel WobblyWeve discussed how the sciatic nerve gets either pinched or irritated and causes shooting pains down the back of the leg. This irritation or pinching of the nerve might affect your leg in an additional way by causing sudden weaknesses in the affected knee.While the leg pain could come from any number of different causes and could be a symptom of many different conditions, the weakness in one single leg is a very strong indicator sciatica is the culprit.
  • Youre Not a RunnerIf youre a regular runner whos experiencing something like sciatic pain, theres a good chance it actually isnt. The reason for this is runners frequently have problems with their piriformis muscle pressing into their sciatic nerve. As we mentioned, this feels like sciatica, but it technically isnt because of the difference in where the pain originates. However, if you dont run regularly and youre still experiencing symptoms of sciatica, the odds that it is sciatica increase significantly.
  • Can Certain Foods Make Sciatica Pain Worse

    Sciatica related injuries lead to swelling around the restricted nerve roots. Since saturated fats are known to cause inflammation, they will intensify the pain. Until your sciatica has subsided, refrain from eating or drinking anything fried, processed, dairy-based, or containing red meat. Instead stick to an anti-inflammatory diet of fruits, vegetables, fish, grains like oatmeal and brown rice, beans, green tea, and fresh herbs and spices such as garlic and turmeric.

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    Common Questions By The Physician

    The most common questions that you can expect from your physician are as follows:

    • Please rate your pain on a scale from 1 to 10
    • When did the pain begin?
    • How do you think the pain started?
    • What limitations have you noticed on your daily activities?
    • Do you notice a difference in pain level when walking uphill? How about downhill?
    • Have you tried any treatments? If so, which? Were they effective?

    Medical Imaging Tests For Sciatica

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    Medical imaging tests used in diagnosing the cause of sciatica include:

    • Magnetic resonance imaging . An MRI scan allows the doctor to visualize the sciatic nerve, surrounding soft tissues, and facet joint capsules. Tumors, facet joint inflammation, and herniated discs affecting nerve roots may also be seen on MRI scans.
    • Discogram. A discogram test may be helpful in determining abnormalities in an intervertebral disc. A contrast dye injected into the tissues may allow abnormalities in the disc, such as bulging or herniation to be seen on a medical imaging scan .

    A discogram may also be useful in identifying chemically induced sciatic nerve pain.1

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    Factors That Increase The Risk Of Sciatica

    Apart from the painful syndrome, the doctor would also take into consideration various risk factors. Spine conditions like sciatica are comparatively common in the older generation. Obesity means higher stress on the lower spine, and thus the higher risk of sciatica, certain occupations involving load lifting also increase the risk of sciatica, sedentary lifestyle and diabetes are also risk factors as they weaken spinal bones and supportive muscles.

    How Your Doctor Properly Diagnoses Sciatic Nerve Pain

    To diagnose sciatica correctly and develop a list of possible causes, an EMG/NCV is required. MRI/CT scan can show disc bulges or herniations but may not always correspond to your pain pattern. You may have an x-ray or a computed tomography scan. If your doctor thinks it’s possible you have a herniated disc or spinal stenosis that’s causing your sciatica, your doctor may order a magnetic resonance imaging test.

    Together, all these various exams and tests, with the EMG Testing the most specific and accurate test, will give your doctor a more complete picture of your sciatic nerve pain or pinched nerve. Using this information, he or she will be able to make the best, accurate diagnosis of the underlying cause of your sciatica. Often this test is ordered very late in the patients condition and symptom history, this a mistake. The test should be ordered after 1 month of symptoms of numbness, tingling, weakness in the leg or foot, persistent referred pain from the back to the hip or leg or overall history of leg and or back pain for over 3 months with no relief from other therapies.

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    Is Sciatica A Serious Condition

    Sciatica is not a condition, but a symptom of lower back impairments. Most sciatica-related injuries resolve on their own with conservative treatment. However, rare cases may result in permanent nerve root damage. If you experience notable leg weakness or lose control of your bladder and bowel, you should reach out to your doctor immediately. These severe symptoms often require the attention of a specialist and sometimes, surgical intervention.

    The 5 False Facts Your Doctor Mistakenly Promotes How To Determine Sciatic Nerve Pain

    Is Your Sciatic Pain From Your Piriformis? 3 Quick Tests To Do

    The medical community is largely responsible for this misinformation being passed on to the suffering patient. In my view it is the job and responsibility of the family doctor to teach the patient about their neuropathy problem. It is also the doctors job to train the patient in what they can do to improve and manage their neuropathy case successfully.

    ===> How To End Peripheral Neuropathy < < <

    Many neuropathy patients, suffering with foot or hand pain, tingling, numbness, burning, and other evasive and hard to describe neuropathy symptoms, dont even know the name of their condition! And while others do, that is essentially all they know. With this in mind I want to address some of the most commonly INCORRECT facts that suffering neuropathy patients have been told, or come to understand, due to the lack of patient education by the medical community.

    1. Neuropathy comes with age, and there is nothing you can do about it.This statement is only partially correct, inasmuch as aging can contribute to the increased onset and intensity of the neuropathy condition. There are however, many simple techniques and procedures that any person can learn which will offset many of these effects of aging as they relate to peripheral neuropathy.

    4. Neuropathy just gets worse with time, and you have to accept that you are stuck with it.

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    What Is The Next Step

    This can vary from person to person but in my experience with online clients around the world there is a similar pattern among many individuals with disc herniations or sciatica that is commonly missed. The majority of my clients in the RehabFix Online Low Back Program have had low back issues for years and have tried Chiro, PT, medication, injections, orthopedists – you name it! It seems like they all were missing some key components….. First I would recommend my FREE Low Back Webinar that discusses multiple factors that contribute to lower back pain!

    Then if you still feel like you are

    • unsure

    • missing out on your life at 100%

    • wasting thousands $$$ on interventions that aren’t producing results

    • working with someone you feel does NOT care about YOUR GOALS

    • worried about this leading to drugs or surgery

    Then it’s time to take action! No time to waste!

    â Ready to ATTACK Low Back Pain or Sciatica?

    â Are you sick of guessing your way through this low back pain?

    â Want to prevent drugs or surgery?

    Are Restless Leg Syndrome Multiple Sclerosis Carpal Tunnel Syndrome Plantar Fasciitis Shingles Or Bursitis Related To Sciatica

    While all these conditions affect either the spinal cord, nerves, muscles, ligaments or joints and all can cause pain, none are directly related to sciatica. The main causes of these conditions are different. Sciatica only involves the sciatic nerve. That being said, the most similar condition would be carpal tunnel syndrome, which also involves a compression of a nerve.

    A final word about sciatica. . . .

    Most cases of sciatica do not require surgery. Time and self-care treatment are usually all thats needed. However, if simple self-care treatments do not relieve your pain, see your healthcare provider. Your healthcare provider can confirm the cause of your pain, suggest other treatment options and/or refer you to other spine health specialists if needed.

    Last reviewed by a Cleveland Clinic medical professional on 03/25/2020.

    References

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    Diagnostic Nerve Block Injections For Sciatica

    Selective nerve block injections are considered an accurate and effective method in diagnosing sciatic nerve pain. An anesthetic solution is injected around the sciatic nerve root to numb the pain transmitted by the nerve. The injection is performed under the guidance of fluoroscopy , ultrasound, or computed tomography . These techniques allow the physician to guide the needle to the accurate location where the medication needs to be deposited. If pain relief is experienced, sciatica may be confirmed.

    See Selective Nerve Root Block Injections

    As with any injection technique, a small risk of bleeding, nerve damage, and spinal cord tissue damage may be possible with diagnostic nerve block injections.

    Once the cause of sciatica is diagnosed, a structured treatment approach for the specific condition is formulated. Both nonsurgical and surgical treatments are used to treat sciatica.

    Watch: Sciatica Treatment Video

    When Should I Contact My Healthcare Provider

    Chronic Back Pains â Cervical Spondylosis, Disc Herniation ...

    Get immediate medical attention if you experience:

    • Severe leg pain lasting more than a few hours that is unbearable.
    • Numbness or muscle weakness in the same leg.
    • Bowel or bladder control loss. This could be due to a condition called cauda equina syndrome, which affects bundles of nerves at the end of the spinal cord.
    • Sudden and severe pain from a traffic accident or some other trauma.

    Even if your visit doesnt turn out to be an emergency situation, its best to get it checked out.

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    Are Piriformis Stretches Useless

    So I’m not saying that glute or piriformis strengthening/stretching movements or exercises won’t help. It certainly will. Anyone with low back issues or nerve related issues down the leg can certainly benefit by addressing the hips and addressing the strength of the glutes and things of that nature. But it ultimately will not be resolved completely and long term if you do not get an accurate assessment on your low back. You need get the low back moving the way it’s meant to, and the right interventions needed to resolve that issue.

    Guide To Sciatic Nerve Pain

    Approximately five to 10 percent of people who have low back pain have sciatica. Although sciatica can be painful and disruptive, most people who have it will recover within six to 12 weeks with the proper treatment. If you think you might be suffering from sciatic nerve pain, this guide will help you understand what sciatica is, the different types of sciatica, the various causes, the symptoms and the treatment options.

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    How Should I Sleep With Sciatica

    With sciatica, always use a high-quality mattress and pillows so your body can rest on a proper foundation.

    A comfortable position for sciatica is back sleeping with the knees elevated. In this position, any pressure is removed from your lumbar spine and your spine can rest naturally. You can also test side sleeping with a pillow between your knees as it reduces tension from your hips and shoulders and keeps your spine neutral.

    Avoid sleeping with your body twisted or on your stomach as both aggravate symptoms.

    Dr. Nayantara Santhi says, Sleep and pain have a two-way relationship. Poor sleep can intensify the pain and conversely, pain can worsen sleep. A good sleeping position can help relieve pain, and a good mattress or pillow can go a long way in facilitating this.

    Randomised Controlled Trials Not Yet Included In Systematic Reviews

    How To Diagnose Sciatica

    Two additional randomised controlled trials have been published comparing disc surgery with conservative treatment. One trial compared microdiscectomy with conservative treatment in patients who had had sciatica for six to 12 weeks. Overall, no significant differences were found for leg pain, back pain, and subjective disability over two years of follow-up. Leg pain, however, seemed to initially improve more rapidly in patients in the discectomy group. The large spine patient outcomes research trial and related observational cohort study was carried out in the United States. Patients with sciatica for at least six weeks and confirmed disc herniation were invited to participate in either a randomised trial or an observational cohort study. Patients in the trial were randomised to disc surgery or to conservative care. Patients in the cohort study received disc surgery or conservative care based on their preference. In the randomised trial both treatment groups improved substantially over two years for all primary and secondary outcome measures. Small differences were found in favour of the surgery group, but these were not statistically significant for the primary outcome measures. Only 50% of the patients randomised to surgery received surgery within three months of inclusion compared with 30% randomised to conservative care. After two years of follow-up 45% of patients in the conservative care group underwent surgery compared with 60% in the surgery group.

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    Do I Have Sciatica Or Something Else

    Dr. Kaliq Chang explains back conditions that may mimic sciatica and how to tell the difference.

    Back pain accompanied by pain radiating down one or both legs is sciatica, right? While that’s often the case, several other back problems can be confused for highly common sciatic type pain, according to Kaliq Chang, MD, of Atlantic Spine Center.

    First, what is sciatica? It’s not a condition in itself, but actually a term used to describe symptoms caused by compression of the sciatic nerve, explains Dr. Chang who is an interventional pain management specialist. All sciatica cases have one thing in common: The pain begins in nerve roots located on either side of the lower spine, but radiates down the spine in a way that can be much worse than back pain alone.

    “This radiating pain can worsen while sitting or it can show up as a sharp, constant pain on the back of the leg that hinders standing or walking,” Dr. Chang says. “Some cases of sciatica result in numbness or tingling down one leg, and severe cases, which are rare, can include weakness or loss of motor function in the leg or foot.”

    Causes of sciatica:

    When the sciatic nerve is compressed, the resulting pain is due to one of several underlying common conditions, Dr. Chang says. These include:

    • Bulging spinal disc
    • Spinal stenosis
    • Scar tissue
    • Spinal bone spurs

    Conditions mimicking sciatica and how doctors can tell the difference:

    3 min read

    Treatment Options For Sciatica

    An appropriate treatment plan for sciatic nerve pain is determined based on the cause and severity of symptoms.

    Treatment options may include:

    Medications such as over-the-counter NSAIDs can be taken to reduce inflammation and pain. Muscle relaxants, anti-inflammatories, narcotics, tricyclic antidepressants, and anti-seizure medications may be prescribed to lessen symptoms.

    Ice and heat can be used to alleviate symptoms and reduce inflammation. Ice packs and heating pads can be applied to the buttock or back of the leg for twenty minute intervals every few hours.

    Physical therapy can help relieve symptoms and prevent further damage. A therapy program will typically include various exercises to strengthen muscles, correct posture, and improve flexibility.

    Massage therapy or acupuncture can help relax the muscles and alleviate pain.

    Corticosteroid medication, commonly known as steroid injections, may be recommended. These injections can help to decrease inflammation surrounding the nerve and relieve pain.

    Surgery may be recommended in more severe cases or when symptoms continue despite therapy or other non-surgical treatment options.

    Sciatica is a fairly common condition that can manifest over time and cause permanent nerve damage if not treated properly. Our specialized team of orthopedic doctors are here to provide you with the diagnosis and treatment options you need to get back to your daily life. Call today!

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    What Should I Avoid Doing If I Have Sciatica

    Avoid putting added pressure onto your lumbar spine and sciatic nerve as much as possible. Activities such as sitting with bad posture, heavy lifting, difficult or strenuous exercise, and sitting or laying down for prolonged periods can aggravate your body.

    Be sure not to rest too much when you have sciatica, as your back can weaken and worsen your pain. With this in mind, dont ignore your pain signals or fight through them. Taking a few minutes to sit down and let your pain pass is perfectly okay.

    Piriformis Syndrome Self Test

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    While your doctor can fully evaluate you to determine if you have piriformis syndrome, you can also conduct a preliminary self-test at home. Here are some tips for doing that. First, you should determine if the pain is worse when you are sitting down. Pay attention to if you have pain or numbness in the buttocks and/or back of your legs. If you dont have this pain or discomfort, then it is unlikely that you have piriformis syndrome.

    If you answered yes to these questions, then its time to move forward with the rest of your self-test. Try pressing on the muscle in each buttock. Press slightly in the middle of the cheek. If you experience pain on one or both sides, then you may have piriformis syndrome.

    You can also try what is referred to as the straight leg test. You should ask a family member or friend to help you with this test. Lie flat on your back on a hard surface. WIth someone helping you, raise your legs one at a time. As you do this, let the person helping you know when you feel pain. If you notice pain at the 30 and 90-degree angles, then it is likely that your sciatica is irritated, which could be a sign of piriformis syndrome.

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