Foot leg siatic neuropathy
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Sciatica is a term that refers to pain that runs from the lower back down the back of each leg along the large sciatic nerve . Neuropathy refers to any condition where nerves are damaged.
Any condition that causes irritation or pressure on the sciatic nerve can cause sciatica. The most common cause is lumbar herniated disc ("slipped disc".) The discs are the cushions which separate the bones of the spine (vertebrae).
Other common causes of sciatica include lumbar spinal stenosis, degenerative disc disease, or spondylolisthesis.
The pain from sciatica can be severe and debilitating. Usually, sciatica only affects one side, and the pain often radiates from the lower back all the way through the back of the thigh and down through the leg. The pain may also radiate to the foot or toes.
One or more of the following sensations may occur as a result of sciatica:
• Pain in the buttock or leg that is worse with sitting
• Burning or tingling down the leg
• Weakness, numbness or difficulty moving the leg or foot
• A constant pain on one side of the rear
• A shooting pain that makes it difficult to stand up
Symptoms that constitute a medical emergency include progressive weakness in the legs or bladder/bowel incontinence. Patients with these symptoms should seek immediate medical attention.
The intervertebral disc looks a bit like a doughnut. The ring around the outside is tough and fibrous, and the center is more like jelly. These discs act as shock absorbers.
If part of the fibrous outer ring of the disc is weak, the softer center (nucleus pulposus) may push its way through. If this bulge presses against a nerve it causes symptoms in that leg.
Once the pain of sciatica passes, there are exercises, stretches and other measures that may prevent it from returning. A physical therapist can develop a complete, personalized program.
Other sciatica treatments include:
•Manual treatments for sciatica (including physical therapy and osteopathic or chiropractic treatments) to help relieve the pressure.
•Medical treatments for sciatica (such as non-steroidal anti-inflammatory drugs ( NSAIDs), oral steroids, or epidural steroid injections) to help relieve the inflammation.
•Surgery for sciatica (such as microdiscectomy or lumbar laminectomy) to help relieve both the pressure and inflammation may be warranted if the sciatic nerve pain is severe and has not been relieved with appropriate manual or medical treatments.
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