Sciatica

Migraines one day, sciatica the next. – from the movie Amelie

Since I appear to have a medical theme this week, I’ll keep the theme going with something I knew nothing about when it happened to me a dozen years ago. I had incredible pain in my left leg which was worst when sitting; the only thing that lessened the pain was lying down. I kept hoping it would go away but an acquaintance of my wife thought it was “sciatica” and recommended I see a doctor.

The sciatic nerve is the largest nerve in the body and begins at the spinal cord in the lower back and extends through the buttock and down each leg to the feet. When the nerve is “pinched” or squeezed in the lumbar region of the back, it sends pain signals down the limb. And oh what a pain it is! The usual cause for a pinched nerve is a herniated disc in the spine; the disc ruptures and cartilage oozes out pressing against the sciatic. Less common is pressure from a tumor, infection, or internal bleeding; injury and inflammation; or irritation from rubbing against a nearby bone spur or muscle.

The initial prognosis was bed rest, pain killers, and a cortisone shot to shrink internal swelling; i.e. the classic “take two aspirin and call me in morning”. This is effective for many and the pain subsides within 12 weeks. But a doctor is just guessing unless they see an X-ray, CT scan, or MRI scan to check for internal damage. My X-ray showed I had a marble sized herniation from a disc low in my back. This made the doctor extremely nervous because with enough pressure, the sciatic could be permanently bruised or damaged; rending me paralyzed below the waist. I was rushed to surgery within days and felt wonderful afterwards (that is after six weeks of recovery for the muscles in the back to repair themselves from the incision.)

Without surgery, treatment for sciatica is limited to what you might do for any pain – take a pain killer and apply heating pads or ice packs. Lie down and rest or go walking (whichever works for you.) After my surgery I was prescribed Physical Therapy which helped. I have very tight calf muscles and stretching exercises helped release pressure. There were also exercises to strengthen the back muscles.

Bottom Line

Sciatica is not usually a medical emergency. At least not until the sciatic nerve is under severe and damaging pressure. If you experience difficulty with bowel or bladder function, decreased sensation around the genitals, or progressive leg weakness or numbness contact your doctor or go to the emergency room immediately. These are the warning signs that paralysis is pending.

Web Sites

http://www.medicinenet.com/sciatica/article.htm
http://orthopedics.about.com/cs/backpain/a/sciatica.htm

Back Pain

"Low back pain is common and affects people of all ages. It is second only to the common cold as the most common affliction of mankind, and it is among the leading complaints bringing patients to physicians’ offices."-Cleveland Clinic Journal of Medicine

The sixth of the seven Warning Signs from Women's Health magazine is back pain with tingling toes. This sign I can personally relate to.

As a computer progamer I sit for hours at my PC with less than perfect posture. Some 15 years ago I began experiencing awful back pain. It got worse and worse but I did nothing about it. Then one day it went away. Hurray, I thought. Not long thereafter a stange, new experience began - a shooting pain down my leg that became worse over time. I had no clue what this meant until a friend of my wife gave it a name, Sciatica. My first visit to the doctor was odd - I was in so much pain that it hurt to sit and was easier for me to lie on the floor. The prescription was an x-ray, take some asprin, and rest. Nothing to worry about - until the x-ray results came back. Then the doctor was seriously worried.

A cartiledge disk in my lower back had ruptured. The original pain was the disk being squeezed, then relief when it popped, and new pain as the protruding disk began pushing on my spinal column. A Neuralogist tapped my knees and toes to see if there was any nerve damage (no thankfully) and I was scheduled for surgury within days. There was great concern that the protrusion would bruise or damange my spinal column causing paralysis from the waist down.

The operation was simple with a scar only a few inches long and I was sent home early morning after an overnight stay on some powerful pain medications. The recover took six weeks before I was allowed to drive or go back to work. Physical therapy lasted many months to rebuild the back muscle and strengthen other muscles.

Bottom Line

If I had gone to a doctor earlier, during the back pain stage, I could have avoided later pain and surgery by early application of steroids and physical therapy. I was lucky that the surgery was successful. Sometimes it is not and the pain remains.