Lumbar Radiculopathy (Sciatica)
The sciatic nerve is the longest nerve in the body, stretching from the end of the spinal cord to the end of each leg. This nerve is susceptible to pain as a symptom of several different conditions. Pain radiating throughout the path of the sciatic nerve is known as sciatica and may also include numbness, tingling and muscle weakness.
Sciatica can be a symptom of conditions such as:
- Herniated disc
- Spinal stenosis
- Piriformis syndrome
Most cases of sciatica are temporary and go away within 6 to 8 weeks. Pain can be relieved through home care such as ice packs, stretching and over-the-counter medications, as well as physical therapy. More severe cases may benefit from anti-inflammatory steroid injections or surgery to relieve nerve pressure. Sciatica can often be prevented by maintaining proper posture and regular exercise habits.
Spinal stenosis involves a narrowing in one or more areas of the spine as a result of injury or deterioration to the discs, joints or bones within the spinal canal.
Most cases of spinal stenosis develop later in life as a result of degenerative changes that occur in the spine. Osteoarthritis is the main cause of spinal stenosis, as it initiates the deterioration of the cartilage in the area and leads to the bones rubbing against each other and forming bone spurs. Spinal stenosis can also be caused by a herniated disc, ligament changes or spinal tumors.
Patients with spinal stenosis may experience cramping, pain and numbness in the legs, back, neck, shoulders or arms. A loss of sensation, loss of balance and bladder malfunctioning may also occur.
Spinal stenosis is often difficult to diagnose because its symptoms can come and go and may resemble the symptoms of other conditions. A diagnosis of spinal stenosis is usually achieved only after ruling out other conditions. Typically, doctors will perform imaging exams such as a spinal X-ray, MRI, CT scan and bone scan as well as ask questions about your symptoms and overall health to correctly diagnose your condition.
Most cases of spinal stenosis can be effectively treated through conservative methods such as physical therapy, nonsteroidal anti-inflammatory drugs, rest and a back brace. For more severe cases, surgical procedures such as a decompressive laminectomy, laminotomy or fusion may be required to relieve pressure and join the damaged bone back to its normal state.
Complex Regional Pain Syndrome (CRPS)
Complex regional pain syndrome, also known as reflex sympathetic dystrophy (RSD) syndrome, involves long-term, intense pain that occurs after an injury and tends to get worse over time instead of getting better. This condition most often affects the arms, legs, hands or feet and can spread to nearby areas as it progresses. In addition to pain, patients may also experience swelling, sweating, skin sensitivity and more.
The cause of RDS is not specifically known, although it is often linked to the sympathetic nervous system prolonging pain or an abnormal immune system response that prevents proper healing.
While there is no cure for this condition, there are several treatment options to relieve symptoms, including analgesics, antidepressants, corticosteroids and opioids. Alternative treatment methods may include physical therapy, spinal cord stimulation and a sympathetic nerve block. Patients may be prescribed a combination of these treatments in order to achieve effective pain relief.
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