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BRAIN & NERVOUS SYSTEM
Pain

 

When to seek medical advice

Mild sciatica usually goes away given a little time and patience. Call your doctor if self-care measures fail to ease your symptoms or if your pain lasts longer than six weeks, is severe or becomes progressively worse. Get immediate medical care if:

  • You experience sudden, severe pain, numbness or muscle weakness in your back or leg

  • The pain follows a violent injury, such as a traffic accident

  • You have trouble controlling your bowels or bladder

Screening and diagnosis

To help diagnose sciatica and pinpoint which nerves, if any, are affected, your doctor will ask about your medical history and perform a thorough physical exam, paying special attention to your spine and legs. You're also likely to have some basic tests that check your muscle strength and reflexes. For example, you may be asked to walk on your toes or heels, rise from a squatting position and, while lying on your back, lift your legs one at a time straight in the air. Pain that results from sciatica will usually become worse during these activities.

If your pain lasts longer than six weeks or is very severe, or you have another serious condition such as cancer, you may have one or more imaging tests to help identity why the sciatic nerve is compressed and to rule out other causes for your symptoms.

These tests include:

  • Spinal X-ray. Because ordinary X-rays can't detect herniated disk problems or nerve damage, they're not usually helpful for pinpointing the cause of sciatica. However, a spinal X-ray can show narrowed disks and spondylolisthesis.

  • Magnetic resonance imaging (MRI). This is probably the most sensitive test for assessing sciatic nerve pain. Instead of X-rays, MRI uses a powerful magnet and radio waves to produce cross-sectional images of your back. The test can detect damage to your disks and ligaments as well as the presence of tumors. MRI is noninvasive and has no harmful side effects. During the test, you lie on a movable table inside the MRI machine, which is essentially a large magnet. If you have a hard time lying still for the required period of time — usually 30 to 90 minutes — or you're anxious about the enclosed space, you may be given a sedative. Some MRI units may be wider, shorter or open on all sides, which may be more comfortable for you, although the quality of images taken with these systems may vary.

  • Computerized tomography (CT) scan. This test uses a narrow beam of radiation to produce detailed, cross-sectional images of your body. When CT is used to image the spine, a contrast dye may be into your spinal canal before the X-rays are taken — a procedure called a CT myelogram. The dye then circulates around your spinal cord and spinal nerves, which appear white on the scan. The test can show herniated disks and tumors, but it poses some risks, including infection and damage to the spinal cord. In addition, CT exposes you to more ionizing radiation than do regular X-rays.

Complications

In some cases, sciatica can result in permanent nerve damage, although this is uncommon. Depending on what's causing the nerve to be compressed, other complications may occur, including loss of feeling or movement in the affected leg and loss of bowel or bladder function.

 

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
In no event will The DrEddyClinic.com be liable for any decision made or action taken in reliance upon the information provided through this web site.

 


 



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Last Modified : 03/15/08 02:11 AM