Lower back pain and down leg: Sciatica Vs Lumbar radiculopathy


Q: I have lower back pain when in bed for the last 3years. It only comes for a few days and goes again for a few weeks. Its down my left buttock and leg,sharp darts of pain when i try to get up. Someone said it was my Sciatic nerve? Can an MRI tell me whats wrong as i can get a test for free from my health care. When i get it bad i get up a try walk it off, but i would have slow walk for days,please help!!!!!


A:   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. The conventional treatment for Sciatica is aimed to relieve the pain and besides the use of anti-inflammatory drugs (as Ibuprofen) and vitamin B complex, a physical therapy program 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 for patients who show limited response to oral medication and physical therapy. On the other hand, that “sharp dart” pain might be due to a nerve compression that can produce an inflammatory process affecting the nerve roots (neuritis) in the lumbar region (stenosis, degenerative hypertrophy of facets and disc herniation and bulging) In the younger patients, as yourself, lumbar radiculopathy may be a result of a disc herniation or an acute injury causing impingement of an exiting nerve. In the older patient, lumbar radiculopathy is often a result of spinal canal narrowing from bone (osteophyte) formation, decreased disc height and degenerative changes due to aging process. It can be associated or not to other symptoms as back pain, numbness or hypoactive reflexes. I strongly recommend you to get an appointment with your doctor and get imaging studies done (MRI) to rule out a possible lumbar nerve compression.

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