Sciatica and cramps

Dear Ask The Doctor: Hi, i have had sciatia pain before but the last 2 days the pain in my hip has eased but i have had pins and neddles in my foot for the last 30 hrs and this a.m. woke with cramping in my calf (also a first). should i be concerned? any quick remedies? i am leaving for a cross continent plane flight soon.

Dear Matthew: There are many causes of sciatic nerve inflammation: blunt injury, compression by the surrounding muscles, intervertebral disk degeneration or lumbar disk disease, all of them can produce pain along the sciatic nerve, along with numbness and tingling in the lower limbs.The conventional treatment for Sciatica is aimed to relieve the pain and besides the use of anti-inflammatory medication (as “motrin”, “Aleve”) and vitamin B complex, a physical therapy program can benefit you, with stretching of the hip muscles and local heat or ultrasound application. It is very important also avoid activities that place stress on the lumbar spine. Sometimes the pain and discomfort can persist for several weeks before to improve. The local corticosteroid injection may be considered if you show limited response to oral medication and physical therapy. I also recommend you an evaluation by an orthopedic surgeon to rule out a lumbar nerve problem, maybe a herniated disk that is causing a nerve compression that may produce an inflammatory process affecting nerve roots (neuritis). Regarding the cramps, these are very common in the extremities, especially the legs and feet, and most particularly the calf (the classic "charley horse"). Muscle cramps are felt to be caused by excessively excited nerves that stimulate the muscles. This can occur particularly after injury to nerve and/or muscle; dehydration with low blood levels of calcium, magnesium, or potassium; from certain medications; and even at rest. The pain that is associated with muscle cramps that are caused by poor circulation to the legs that worsens with walking is referred to as claudication. Deficiencies of certain vitamins or minerals, including iron deficiency, thiamine (B1), pantothenic acid (B5), and pyridoxine(B6), can also cause muscle cramps.Muscle cramps usually cause a temporary nuisance and typically resolve on their own without treatment. When muscle cramps continually recur, it is time to seek an evaluation by a physician. The primary treatment of muscle cramps involves methods to relax the affected muscle. This typically is done by stretching, massage, and heat application.