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Highlights From the Marc Darrow,
M.D.,J.D. Radio Show
Is It
Sciatica?
Caller: I have had
back pain
for some time, the pain radiates down my legs, I have had three
epidurals and cortisone shots but without any relief, where do I go
from here?
Dr. Darrow:
The fact that you had three epidurals is a good sign
because that means that the pain is not from an inflamed nerve. It
is probably a ligament in the low back, most likely the
iliolumbar
or
sacroiliac ligaments. These
ligaments can refer pain down the
legs and look a lot like a sciatica problem but is really not
sciatica.
We get over a 100 new patients a month and I would say that 25% of
them come in and say that they have been diagnosed with sciatica,
most of the time it is not, but sciatica is such a common term for
back pain that radiates down the leg that it gets used.
On examination we find the “sciatica” problem to be those ligaments
mentioned or a
bursitis or it’s the iliotibular band, the
connective tissue side of the leg from the hip to the knee that gets irritated.
What Is Radicular
Pain?
Radicular pain is described as deep and usually constant. It follows
the nerve down the leg and is often accompanied by numbness or
tingling and muscle weakness.
The most common example of this type of problem is the sciatic pain
that radiates along that sciatic nerve - down the back of the thigh
and calf into the foot. This type of pain is caused by injury to a
spinal nerve. Some of the possible causes of this are a disc
protrusion or bulge, arthritic changes or a narrowing of the opening
through which the nerve exits.
While a few of these cases will require
surgery, most respond to
conservative care. Here the care will consist of multiple therapies,
all designed to reduce
Inflammation,
balance your posture, strengthen supporting structures, attain
normal motion and improve the health of the nerve that is involved.
In all types of back pain, your health habits play an important
role. For example, there are certain foods that are high in the fats
that cause more inflammation. Limiting intake of these animal fats
and increasing your intake of the good fats that reduce inflammation
may play an important role in your healing. Smoking is another
health concern. Statistically, smokers are slow healers with respect
to back pain.
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