What Is The Sciatic Nerve
The sciatic nerve is part of the nervous system and categorized as a major nerve that starts in the lower back, runs down the back of the thigh and branches off just above the knee into smaller nerves that run the length of the legs to the feet. What most people do not realize is that the sciatic nerve has the largest circumference of any nerve in the human body. It is no wonder that when damaged it can cause excruciating pain.
When Should I See A Nerve Doctor Specialist
You should make an appointment to see a nerve doctor specialist if you have any type of ongoing pain that stems from a nerve condition. Even if you do not know what is causing the pain, a specialist can help you to diagnose and understand it. After the cause of your nerve condition has been determined, they can provide you with appropriate treatment, and ongoing support afterwards where necessary.
At Pain Treatment Specialists, our belief is that pain stemming from nerve conditions should not necessarily be managed by constantly taking prescribed narcotics. This method of treatment does not fix the root cause of the pain and it can cause other health concerns of its own, such as an opiate addiction. We also believe that surgery is not always the best option to treat nerve issues, and there are many non-invasive procedures that can be attempted first that achieve the same result. We focus on understanding what is causing your ongoing pain, and then providing alternative treatments to ensure that you can return back to your normal life free of health concerns as soon as possible.
What Doctor To See For Sciatica
Sciatica is the term used to describe pain caused by irritation of the sciatic nerve. This nerve, located in your lower back, is formed by a bundling of nerves that emerge from the lower lumbar region of the spine.
The sciatic nerve is the major neural pathway between your brain and your legs and feet. If the sciatic nerve is pinched or irritated, the pain can radiate down the nerve and cause pain or tingling in your legs.
It may be hard to determine what doctor should treat your sciatica since the pain is felt in various locations. Taking a closer look at the causes of sciatica pain can help us determine the appropriate specialist to treat it.
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Ix Referred Pain To The Lumbar Spine
Pain in the area of the lumbar spine may be due to important problems that are actually unrelated to the back.Referred pain occurs when a problem in one place in the body causes pain in another place. The pain travels down a nerve. For example, a pinched nerve in the neck may cause pain that is felt in the arm or hand. Sources of referred pain may include abdominal aneurysm , tubal pregnancy, kidney stones, pancreatitis, and colon cancer. Clues to these maladies include pain that waxes and wanes over a short period, with frequent peaks of intense pain, weight loss, abnormalities found during abdominal exam, and trace amounts of blood in the urine.
When Your Sciatica Warrants A Visit To Your Doctor
Its important to recognize when at-home therapies arent easing your sciatica. If these treatments dont help you, it may be time to see your personal doctor or spine specialist.
People avoid the doctor for a variety of reasons. Maybe youre unsure about how to use your health insurance or you dont have any. Or perhaps you simply dont like visiting the doctor and prefer an ignorance-is-bliss approach.
Whatever the reason, some sciatica symptoms truly warrant medical attention. In rare cases, delaying medical care could lead to or cause permanent nerve damage.
If you experience any of the following, please see your doctor as soon as possible:
- You have severe pain in your low back and legs
- You experience nerve-related symptoms, such as weakness, numbness, tingling, or electric shock-like pain
- Your pain doesnt improve after 2 weeks
- Your pain gets worse, even when using at-home therapies
- You have loss of bowel and/or bladder control
Easing the extreme pain of sciatica doesnt always require an extreme treatment approach. Relieving sciatic nerve pain at home with gentle exercise, ice and heat therapy, proper posture, and medication may go along way to speed your recovery. But the most important thing you can do for your low back and leg pain is to take it seriouslyalways call your doctor if you arent experiencing relief.
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Who To See For Leg Pain
In an emergency setting, the attending emergency department physician or a triage nurse will assess you and determine what type of care you need and who should deliver that care, such as an for a broken bone.
Primary care physicians can treat most leg causes that are not emergencies, but you may need a referral to a different type of specialist if the problem is beyond the scope of your doctors practice.
Here are some specialists who can treat leg pain and injuries:
Do Orthopedic Doctors Treat Nerve Pain
Orthopedic doctors can help reduce pain
This includes muscles, nerves, bones, joints, tendons, ligaments, cartilage, and other connective tissue. There are many musculoskeletal conditions and injuries that can cause pain, and often, orthopedic specialists can help reduce or eliminate pain.
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Xii Treatment Options For Acute Lower Back Pain
Most low back pain is due to muscle strain and spasm and does not require surgery. To treat the pain, medications such as acetaminophen , nonsteroidal anti-inflammatory agents , gabapentin or pregabalin and opioids can be used. NSAIDs suppress inflammation, pain and fever by inhibiting certain inflammation-causing chemicals in the body. Acetaminophen reduces pain and fever, but does not inhibit inflammation. Gabapentin and pregabalin, medications that have been used for antiseizure activity, also has the ability to block pain. Opioids provide pain relief and may be prescribed to manage severe acute and chronic back pain. However, opioids have many problems, such as habituation, constipation and lightheadedness, and are avoided when possible and used for the shortest possible duration. Epidural injection is an option if the back pain does not respond to these treatments. Each person is different in terms of response to medication.
Other nonsurgical treatments for lower back pain include IntraDiscal Electrothermal Therapy , nucleoplasty, and radiofrequency lesioning.
Medical Imaging Tests For Leg Pain
Imaging tests help identify herniated discs, abnormal bone growths , bone fractures, and tumors among others.
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Sensations That Might Indicate A Medical Emergency
1. Sharp pain rather than a dull ache: This could indicate a torn muscle or ligament, or a problem with an internal organ in the back or side.2. Radiating pain: This pain “moves” or shoots to the glutes or legs, which could indicate a nerve compression condition.
3. Sudden weakness in the legs: Limb weakness can be caused by compressed nerves in the spine due to conditions like sciatica or spinal stenosis. However, sudden leg weakness could also indicate a stroke.4. Incontinence: Back pain paired with inability to control the bowels or bladder might be a sign of serious nerve compression or a spine infection, such as discitis or meningitis.5. Numbness or pins and needles in the groin or glutes: This is known as saddle anesthesia and is also a sign of a serious nerve or spine condition.
If you have leg weakness, incontinence, and numbness together, you might have cauda equina syndrome, a serious illness characterized by spinal cord nerve damage. This is a medical emergency, and patients usually need surgery immediately to decompress the nerves and reduce permanent damage.
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Who To See For Sciatica
Family doctors and general practitioners can diagnose and treat simple cases of sciatica. Chiropractors and physical therapists also treat people with sciatica.
A , or physician who specializes in the nervous system, is the best person to manage severe sciatica. Your primary doctor may refer you to a specialist in such cases.
Approximately 40% of people will experience sciatica in their lifetimes. Report any episodes, even ones that resolve with self-care, to your primary healthcare provider. If youre unsure if your symptoms are related to sciatica, or if your symptoms get worse despite home therapy, consult a physician.
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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.
Other Conditions That Cause Back Pain In Older Adults
We often see a range of less serious but still painful spine conditions in seniors. Most patients with these conditions will not require surgery. Physical therapy, medication, injectable anesthetics, or a combination of treatments usually can control symptoms.
- Degenerative disc disease, which can cause whole spine pain, and lumbar arthritis, which usually causes low-back pain, commonly develop with age and are considered wear-and-tear conditions.
- Sacroiliitis is an inflammation of the joints that connect your spine and pelvis. This condition can cause pain in the low back, glutes, and upper legs.
- Ankylosing spondylitis is an inflammatory arthritis that causes patients spines to become inflexible, resulting in a continual hunched forward position and spine pain.
- We also check for adult degenerative scoliosis and kyphosis, spine-curving conditions that can result in back pain and weakness in the lower extremities.
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Do Pinched Nerves Go Away On Their Own
Have you ever been seated with your legs crossed for too long and noticed your foot has fallen asleep? That tingling, numb sensation is a classic example of a pinched nerve. It is rather common to experience a mild example of a pinched nerve like this and usually repositioning your body is all it takes for the pressure on the nerve to ease and for normal feeling to return. However, there are other types of pinched nerves that do not resolve as quickly and may require you to seek medical treatment from an orthopedic surgeon. Orthopedic doctors and surgeons specialize in the spine and joints, which affect the whole body, so they are highly skilled in addressing pinched nerves and their effects on various parts of the body.
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What If I Dont Want Surgery For My Back Pain
Fortunately, most people with back pain dont need surgery. We usually take a conservative approach first, using a wide variety of nonsurgical spine treatments, said Dr. Guo. For example, I might send you to physical therapy or chiropractic therapy. I might recommend medications such as anti-inflammatories, muscle relaxants, or some nerve-pain medications. We offer injection therapy, including epidural injections, joint injections, and nerve blocks and ablation if your back pain fails to improve with the conservative treatments. Chances are, one of these approaches will help reduce your back pain and improve your function and quality of life.
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Slump Test For Sciatica
A relatively simple tests for a pinched sciatic nerve can be done at home, if you are experiencing lower back and leg pain. Interpretation of the results of the Slump Test for sciatica can be a lot more difficult though it’s work for the experienced clinician.
Test the muscles in your leg
In just two minutes with the aid of a kitchen chair only, you will know if you have paresis in the leg.
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What Is Sciatica
The condition is caused when the sciatic nerve, which spans the lower back down the back of the legs and the feet, becomes injured or inflamed. In rare cases, this can be the result of serious conditions like spinal stenosis, in which the spinal canal narrows and compresses the nerve. Benign and cancerous tumors in the spine and nerve damage as a result of other conditions are also occasional causes. Most often, there is a less serious catalyst for sciatic pain.
A herniated or bulging disc, in which the discs that usually provide cushion between vertebrae slip out of place, can put pressure on the sciatic nerve and cause this pain. Degenerative disc disease can lead to the same results, as well as osteoarthritis. Sciatica can also become an issue due to one-off injuries, or as a result of pregnancy. In pregnancy, your center of gravity shifts and joints become more elastic, leading to sciatic pain until the baby is born or changes positions.
Sciatica is often characterized by weakness or numbness in the lower back, legs, or feet. Some people will experience dull pain while others will experience sharp pains that radiate down the nerve. Symptoms are often exacerbated by movement.
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Who Should I See
For many people, sciatica can be instigated by knots in the muscles or spinal misalignments as a result of too much sitting, or too much stimulation. In these cases, chiropractors are often the first line of defense as they can evaluate the spine and perform adjustments to improve its condition. With regular adjustments and physical therapy, many people are able to reduce pain with chiropractic care.
A family care or primary care physician will often be able to recognize sciatic pain and make the proper referral, though who they send you to may differ. Because it is a nerve causing the pain, many people will seek help from a neurologist to relieve their sciatica. A neurologist will likely perform diagnostic testing using x-rays or MRIs to identify the root of the issue and develop a plan for treatment. In cases of severe or chronic sciatica, a neurologist is likely to end up managing a case due to their expertise in the nervous system.
While neurologists can manage the nerves, sciatica is sometimes caused by a more aggressive issue in the spine, like a herniated disc or degenerative disc disease. In these cases, an orthopedic doctor will be able to step in and examine the spine. These doctors often determine if surgery is needed in serious cases, and if so what kind of surgery. Orthopedic doctors will seek non-invasive options first and create a treatment plan that matches the severity of your condition.
V Inflammatory Lower Back Pain
Although comparatively few patients have low back pain due to inflammation, the problem can be life long and can impair function significantly. The good news is that treatments can help essentially all patients, and can lead to major improvements.
Seronegative spondyloarthropathies are a group of inflammatory diseases that begin at a young age, with gradual onset. Like other inflammatory joint diseases, they are associated with morning stiffness that gets better with exercise. Sometimes fusion of vertebrae in the cervical or lumbar regions of the spine occurs. Drugs called TNF-alpha blocking agents, which are used for rheumatoid arthritis, are also used to treat the stiffness, pain, and swelling of spondyloarthropathy, when the cases are severe and not responsive to traditional medications.
People who have spondyloarthropathy have stiffness that is generally worst in the morning, and have decreased motion of the spine. They also can have decreased ability to take a deep breath due to loss of motion of the chest wall. Its important for the physician to look for problems with chest wall expansion in patients with spondyloarthropathy.
Reactive arthritis syndrome is one of the forms of spondyloarthropathy. It is a form of arthritis that occurs in reaction to an infection somewhere in the body, and it carries its own set of signs and symptoms. The doctor will look for:
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Risk Factors You Can Change With Lifestyle Changes
- Not getting regular exercise
- Doing a job or other activity that requires long periods of sitting, heavy lifting, bending or twisting, repetitive motions, or constant vibration, such as using a jackhammer or driving certain types of heavy equipment
- Smoking. People who smoke are more likely than people who don’t smoke to have low back pain.
- Being overweight. Excess body weight, especially around the waist, may put strain on your back, although this has not been proved. But being overweight often also means being in poor physical condition, with weaker muscles and less flexibility. These can lead to low back pain.
- Having poor posture. Slumping or slouching on its own may not cause low back pain. But after the back has been strained or injured, bad posture can make pain worse. “Good posture” generally means your ears, shoulders, and hips are in a straight line. If this posture causes pain, you may have another condition such as a problem with a disc or bones in your back.
- Being under stress. Stress and other emotional factors are believed to play a major role in low back pain, particularly chronic low back pain. Many people unconsciously tighten their back muscles when they are under stress.