the Connection Between Sciatica and Bone Microfractures

Is there a correlation between microfractures of the sacral nerve roots and the condition?

I have sciatica and went to an orthopedic doctor for an X-ray.
The doctor said that my bone is slightly fractured and I need to buy a brace to stabilize my lower back.
However, I have a few questions: once the bone heals, will the sciatica pain go away? In this case of a bone fracture, can I still continue with rehabilitation (since I am doing rehabilitation for sciatica)? Isn't sciatica usually caused by a herniated disc in the back? If there is no herniation, can it still cause sciatica symptoms? Also, how much does a lumbar brace typically cost? I checked with a supplier, and they quoted me 4500 TWD; is that expensive? Before this X-ray, I had X-rays done at two other hospitals, but the doctors said there were no issues with the bones.
Could the fracture be related to the rehabilitation I was doing? Please, Dr.
Zhou, help clarify my doubts.
Thank you.
PS: Since the consulting doctors on the platform are highly professional, a user suggested I come here to ask my questions.
I hope Dr.
Zhou can provide me with the correct treatment direction.
I sincerely appreciate it.

Xiao Pan, 20~29 year old female. Ask Date: 2009/04/11

Dr. Zhou Lizhi reply Orthopedics

Firstly, the user did not mention the age or the cause of the onset.
If it is a young person who sustained an injury due to improper lifting, it is often a herniated disc causing inflammation and compression of the sciatic nerve.
In this case, the focus of treatment would be on medication, rest, and rehabilitation.
If there is a fracture (which would cause back pain), conservative treatment would indeed require the use of a back brace, with prices varying based on the length of the brace.

Reply Date: 2009/04/11

More Info

Sciatica is a condition characterized by pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. It often occurs when a herniated disk, bone spur on the spine, or narrowing of the spine compresses part of the nerve. This can cause inflammation, pain, and often some numbness in the affected leg.
In your case, it seems that you have been diagnosed with a slight fracture in your bone, which could potentially contribute to your sciatica symptoms. While fractures can lead to localized pain and discomfort, they may also indirectly affect the sciatic nerve if they cause changes in posture or mechanics of movement. When a bone is fractured, it can lead to muscle spasms or changes in the way you move, which could exacerbate sciatica symptoms.

Regarding your question about whether the sciatica will resolve once the bone heals, it is possible. If the fracture is contributing to your sciatic pain, then once it heals and you regain normal function and movement, the sciatica may improve. However, it is also important to consider that sciatica can have multiple causes, and if your pain is primarily due to a herniated disk or other spinal issues, the fracture may not be the sole contributor to your symptoms.

As for continuing rehabilitation, it is generally advisable to follow your doctor's recommendations. Physical therapy can be beneficial for sciatica, as it helps strengthen the muscles around the spine and improve flexibility. However, you should consult with your healthcare provider regarding the specific exercises you can safely perform while your fracture is healing. They may recommend modifications or specific rehabilitation exercises that do not put undue stress on the fractured area.

You are correct that sciatica can occur without a herniated disk. Other factors, such as muscle tightness, spinal stenosis, or even lifestyle factors like prolonged sitting, can contribute to sciatica symptoms. Therefore, it is essential to have a comprehensive evaluation to determine the underlying cause of your pain.

Regarding the cost of a back support brace, prices can vary widely based on the type of brace, the materials used, and the manufacturer. A price of 4500 (presumably in your local currency) may seem high, but if it is a custom or high-quality brace designed to provide adequate support and comfort, it may be justified. It's always a good idea to compare prices and consult with your healthcare provider about the best options for your specific needs.

Lastly, concerning whether your rehabilitation could have contributed to the fracture, it is essential to consider the nature of the exercises you were performing. If you were engaging in high-impact activities or exercises that placed excessive strain on your bones without proper technique or guidance, it could potentially lead to stress fractures. However, this is something that should be discussed with your healthcare provider, who can assess your specific situation and provide tailored advice.

In summary, while healing from a bone fracture may alleviate some of your sciatica symptoms, it is crucial to address all potential contributing factors. Continuing rehabilitation under the guidance of a healthcare professional can help ensure a safe and effective recovery. Always consult your doctor for personalized advice and treatment options.

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