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Q. My doctor recently diagnosed
me with Sciatica. What is sciatica?
A. Sciatica is a general term
for pain along the sciatic nerve. It is usually a sharp pain
is sometimes described as an electrical-like shock starting in
the buttock that travels down the back of thigh and leg. The
most common cause is a herniated disc in your back, although
there are other causes as well. An MRI scan of your lower back
may help in making the diagnosis.
Q. What if the MRI scan shows
a herniated disc? What do I do then?
A. You should get a referral
to an spine specialist, preferably one who operates on the spine.
He will evaluate you and look over your x-rays to determine the
proper course of treatment.
Q. What if I don't have a
herniated disc?
A. As I mentioned before, there
are other causes of sciatica such as:
- 1. Sacroiliitis
- 2. Lumbar Facet Joint Syndrome
- 3. Piriformis Syndrome
- 4. Iliolumbar Syndrome
- 5. Lumbar Spinal Stenosis
Q. Wow, Doc! You're blowing me
away with these fancy terms. Can you explain what they mean?
A. Sure.
- 1) Sacroiliitis is an inflammation
of your sacroiliac joint. That's the joint where your hip meets
the spine. Inflammation caused by trauma or just plain arthritis
can give you sciatica-like symptoms. Sometimes an injection of
an anesthetic and an anti-inflammatory medication can take away
the pain.
- 2) Lumbar Facet Joint Syndrome
is pain that comes from the joints of your back causing not only
back discomfort, but also it can give you sciatica-like symptoms.
The facet joint is like any other joint of your body, like the
knee or elbow that can get inflamed and cause pain.
- 3) Piriformis Syndrome is simply
pain caused by the piriformis muscle that may be in spasm, inflamed,
or irritated. This muscle is in your buttock and lies right on
top of the sciatic nerve as it exits the spine and goes down
your leg. As you can imagine, if this muscle is having a problem,
it will cause pressure on the nerve, giving you the sciatica-like
symptoms.
- 4) Iliolumbar Syndrome is simply
inflammation or a tear of the iliolumbar ligament. This ligament
extends from the spine to the iliac crest, which is the back
of your pelvis.
- 5) Last, but not least, spinal
stenosis, which is narrowing of the spinal canal, can cause sciatica-like
symptoms. The narrowing can be caused by disc problems as well
as arthritis of the spine.
Q. Thanks a lot, Doc! You
really helped me learn about sciatica.
A. You're welcome. I wish you a
speedy recovery.
Albert I. Rodriguez, M.D., F.A.B.A.,
F.A.P.M. is Board Certified by The American Board of Pain Medicine
and American Board of Anesthesiology. His practice is based in
Palm Beach County Florida. He is associated with Bethesda Memorial
Hospital, JFK Medical Center, and Palm West Hospital. His practice
focuses on the diagnosis and treatment of disorders related to
the spine. If you have any questions for Dr. Rodriguez regarding
the treatment of back pain, please feel free to Email him at
SpineUniverse.com.
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