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Sciatica |
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Sciatica
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.
Related Sites:
Treatments Treatments Programs:
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