Is Tendon Release Surgery Effective for Sciatic Pain Relief?

Q: Is Tendon Release Surgery Effective for Sciatic Pain Relief?

Hello： The formation of bone spurs, in simple terms, occurs at the junction where bone meets soft tissue, subjected to prolonged excessive pressure, tension, and injury, which promotes degenerative changes in the bone. <br>These degenerative changes lead to bone hyperplasia. <br>

Is a tendon rupture serious?

Hello, Doctor: I have been experiencing pain in both sides of my buttocks for over a year, primarily at the ischial tuberosity—sitting causes pain, while standing does not.
Various examinations, including spinal MRI and pelvic MRI, have not determined the cause.
I have tried various treatments without success! Recently, an orthopedic surgeon discovered bone spurs at the ischial tuberosity using ultrasound, but he believes my pain is not caused by the bone spurs.
Instead, he thinks it is due to tight tendons at the ischial tuberosity, so he suggested performing a release surgery to cut the tendon halfway with a needle, which he believes would yield good results.
I have a few questions: 1.
What is the effectiveness of this release surgery that involves cutting the tendon halfway with a needle? Am I a suitable candidate for this procedure? What would happen if the tendon were accidentally cut completely? 2.
Can bone spurs at the ischial tuberosity truly not cause pain? What methods can differentiate whether the pain is caused by bone spurs or tight tendons? I am concerned that if the pain is due to bone spurs, I would still experience pain after the surgery, making the procedure unnecessary! Thank you for your response, Doctor!

Kunao de ren, 30~39 year old female. Ask Date: 2007/09/07

Dr. Su Hongci reply Rehabilitation

Hello: The formation of bone spurs, in simple terms, occurs at the junction where bone meets soft tissue, subjected to prolonged excessive pressure, tension, and injury, which promotes degenerative changes in the bone.
These degenerative changes lead to bone hyperplasia.
Therefore, bone spurs are directly related to excessive physical activity, exercise, and age.
Research has shown that activity or inappropriate exercise often leads to excessive wear of the bones and soft tissues around the joints, causing an imbalance in joint stress that results in the formation of bone spurs.
Clinically, many patients may have bone spurs but do not experience pain.
This is related to the location of the bone spur.
For example, if a bone spur on the spine develops at the anterior edge of the vertebral body, it may grow large but does not stimulate the nerves, resulting in minimal pain.
However, if a bone spur happens to grow in the nerve canal, even if it is small, it can cause numbness and tingling in the hands or feet.
Typically, tendon release surgery can be used to reduce spasms and excessive muscle tension, improve muscle strength balance, enhance body function, correct existing deformities, alleviate contractures, and stabilize joints.
However, the efficacy and contraindications of surgery should still be discussed with an orthopedic surgeon.
Wishing you good health!

Reply Date: 2007/09/07

More Info

Tendon release surgery, particularly in the context of sciatic pain relief, can be a complex decision that requires careful consideration of various factors. Based on your description, it seems that you have been experiencing persistent pain in the gluteal region, specifically around the ischial tuberosity, for over a year. You have undergone multiple imaging studies, including MRI scans of the spine and pelvis, which have not provided a definitive diagnosis. The recent ultrasound examination revealed a bone spur, but your orthopedic physician believes that the pain may be attributed to tightness in the tendons around the ischial tuberosity rather than the spur itself.

1. Effectiveness of Tendon Release Surgery: The proposed procedure involves using a needle to partially cut the tendon, which is referred to as a tendon release. This technique aims to relieve tension in the tendon, potentially alleviating pain associated with tightness. The effectiveness of such a procedure can vary significantly among individuals. In some cases, patients report substantial relief from pain and improved mobility, while others may experience minimal benefits. It is essential to have a thorough discussion with your orthopedic surgeon regarding the expected outcomes, potential risks, and the specific reasons they believe this surgery may help your condition.

Regarding your suitability for the procedure, it is crucial to consider the underlying cause of your pain. If the tightness in the tendon is indeed contributing to your symptoms, the release may provide relief. However, if the pain is primarily due to the bone spur or another underlying issue, the surgery may not address the root cause.
As for the risks, if the tendon is accidentally cut completely, it could lead to weakness or instability in the affected area, potentially exacerbating your symptoms rather than alleviating them. Therefore, it is vital to ensure that the surgeon has a clear understanding of your anatomy and the specific structures involved before proceeding.

2. Bone Spur and Pain Correlation: The relationship between bone spurs and pain is not always straightforward. While bone spurs can contribute to discomfort, they do not always cause pain. The presence of a bone spur does not guarantee that it is the source of your pain. To differentiate whether your pain is due to the bone spur or tight tendons, a comprehensive evaluation is necessary. This may include physical examinations, assessments of your range of motion, and possibly additional imaging studies or diagnostic injections to see if targeting the spur alleviates your symptoms.

In some cases, a diagnostic injection of a local anesthetic around the area of the bone spur can help determine if it is the source of pain. If the injection provides significant relief, it may indicate that the spur is indeed contributing to your discomfort. Conversely, if the pain persists, it may suggest that the issue lies elsewhere, such as in the tendons or muscles.

In conclusion, tendon release surgery may offer potential benefits for your condition, but it is essential to weigh the risks and ensure that it is the appropriate course of action based on a thorough understanding of your specific situation. Engaging in an open dialogue with your orthopedic surgeon about your concerns, the rationale for the proposed surgery, and alternative treatment options will be crucial in making an informed decision. Additionally, exploring non-surgical interventions, such as physical therapy or targeted injections, may provide valuable insights into the nature of your pain and help guide your treatment plan.

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