Foot leg siatic neuropathy
Sciatica is a term that refers to pain along the large sciatic nerve that runs from the lower back down the back of each leg. Neuropathy refers to any condition where nerves are damaged. Any condition that causes irritation or impingement on the sciatic nerve can cause the pain associated with sciatica. The most common cause is lumbar herniated disc ("slipped disc".) The discs (or inter-vertebral 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 isthmic spondylolisthesis.
For some people, the pain from sciatica can be severe and debilitating. For others, the pain from sciatica might be infrequent and irritating, but has the potential to get worse. 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. Depending on where the sciatic nerve is affected, 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 rear or leg that is worse when sitting 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 a piece of taffy. These discs allow for some flexibility between the bones of the spine, and also act as shock absorbers. The pressures within the discs can reach high levels when patients bend or twist, even without carrying a heavy load. If you add to that a heavy load, especially held out at arms' length, the pressures rise even higher. If part of the fibrous outer ring of the disc is weaker than the rest, the softer center (nucleus pulposus) may push its way through, bulging outwards. If this bulge presses against a nerve which is running from the main, central nervous system to one of the legs, it causes symptoms in that leg. Sciatica occurs when the herniated disc presses against the nerves which make up the sciatic nerve. This is more likely to cause problems when the nerve is squashed between the disc and an adjacent bone. Nerves transmit messages around the body, rather like a telephone system. They allow us to feel things they allow our body to do things, eg making your leg muscles contract when you want to walk. Thus, when a nerve is squashed, it may malfunction, and we might feel pain, numbness, pins and needles, and we might find our limbs do not work in the way they should. Other things can cause irritation of or pressure on a nerve in the spine. Sometimes this may be a rough and enlarged part of one of the vertebrae, brought about by aging or other conditions such as infections and tumors. Most times the cause is nothing serious, but one of the reasons for seeing your doctor if the pain persists, is to make sure that serious and treatable causes have been ruled out.
If you still have sciatica after a few weeks, it is likely that your doctor will arrange for you to have a CT (Computerized Tomography) or MRI (Magnetic Resonance Imaging) scan. These show up the soft structures in the spine, as well as the bones, and will show whether a nerve is being squeezed by a disc, or whether something else is causing irritation of the nerve. 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. Here are some steps you can take in the meantime: • Practice good posture. Stand up straight with your ears aligned with your shoulders, your shoulders aligned with your hips and your buttocks tucked in. Your knees should be bent slightly. • Manual treatments for sciatica (including physical therapy and osteopathic or chiropractic treatments) to help relieve the pressure.
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