Sciatica: Effective Solutions for Chronic Leg Pain

Suspected sciatica?

Hello Doctor: My mother is about 52 years old.
Eight years ago, she underwent surgery for a herniated disc that was compressing the nerve on the right side.
Since then, she has been experiencing intermittent pain and numbness in her right leg.
In June of this year, she suddenly experienced severe pain and numbness from her right thigh to her calf, which lasted for eight days, making it impossible for her to walk or sleep.
The surgeon who performed the previous operation said it was nerve inflammation, but medications and injections did not improve her condition.
After eight days, the pain suddenly began to subside.
Recently, for the past five days, her left leg has started to hurt, especially the calf, but there is no numbness.
We consulted a different doctor who suspected sciatica, but again, medications and lumbar traction have not shown any improvement.
My mother is in a lot of pain, and I would like to know what we should do next.
Which type of doctor would be best for diagnosis? Additionally, what can we do to help alleviate her pain? Thank you! ----------------------- Anxious Ms.
Kai

Miss Kai, 20~29 year old female. Ask Date: 2006/10/31

Dr. Zhou Lizhi reply Orthopedics

Sciatic nerve pain is caused by compression of the nerve within the spinal canal, which can result from factors such as bone spurs, soft tissue, or herniated discs.
Based on the description provided by the internet user, it appears that there may still be an issue.
It is recommended that the individual return to the hospital for a thorough examination to identify the source of the compression.
If the nerve is compressed for an extended period, it can lead to irreversible nerve damage and issues such as weakness in the thigh.

Reply Date: 2006/10/31

More Info

Sciatica, or sciatic nerve pain, is a common condition that can cause significant discomfort and disability. It typically arises from irritation or compression of the sciatic nerve, which runs from the lower back down through the legs. Given your mother's history of a herniated disc and previous surgery, it is understandable that her current symptoms are concerning.

Understanding Sciatica
Sciatica can manifest as pain, numbness, or weakness in the leg, often radiating from the lower back or buttocks down to the foot. The pain can vary in intensity and can be exacerbated by certain movements, such as sitting or standing for prolonged periods. In your mother's case, the fact that her symptoms have shifted from one leg to the other suggests that there may be ongoing issues with nerve irritation or inflammation.

Diagnosis and Treatment Options
To effectively manage your mother's sciatica, a thorough evaluation is essential. Here are some steps you can take:
1. Consult a Specialist: Given the complexity of her case, it may be beneficial to consult a neurologist or an orthopedic spine specialist. These professionals can conduct a detailed assessment, including a physical examination and possibly imaging studies (like MRI or CT scans) to evaluate the spine and surrounding structures for any abnormalities.

2. Physical Therapy: Engaging in physical therapy can be highly beneficial. A physical therapist can design a personalized exercise program that focuses on strengthening the muscles supporting the spine, improving flexibility, and reducing nerve compression. Techniques such as stretching, strengthening exercises, and manual therapy may help alleviate symptoms.

3. Pain Management: If your mother is experiencing severe pain, a pain management specialist may be able to provide targeted treatments. Options may include:
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and pain. In some cases, corticosteroids may be prescribed to decrease inflammation around the nerve.

- Epidural Steroid Injections: These injections can provide temporary relief by delivering anti-inflammatory medication directly to the area around the affected nerve roots.

- Alternative Therapies: Acupuncture, chiropractic care, or massage therapy may also provide relief for some individuals.

4. Lifestyle Modifications: Encourage your mother to engage in low-impact activities, such as walking or swimming, which can help maintain mobility without exacerbating her symptoms. Additionally, maintaining a healthy weight can reduce stress on the spine.

5. Surgical Options: If conservative treatments fail and your mother’s quality of life is significantly affected, surgical options may be considered. Procedures such as microdiscectomy or laminectomy can relieve pressure on the sciatic nerve by removing the source of compression.

Conclusion
Managing sciatica can be a multifaceted approach that requires patience and persistence. It is crucial to work closely with healthcare professionals who can guide you through the diagnosis and treatment process. Encourage your mother to communicate openly about her symptoms and any changes she experiences. With the right combination of therapies and support, it is possible to alleviate her pain and improve her quality of life.
If you have further questions or need assistance in finding the right specialist, do not hesitate to reach out. Your proactive approach in seeking help for your mother is commendable, and with the right care, she can find relief from her symptoms.

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