Sciatica then can come from a variety of causes, things that have to do with your arteries, things that have to do with your nerves, but the common thread is pain that generally starts in the back, goes to the buttock, down the leg, and can be either in the thigh or the calf or any parts thereof. The good news is, is you don't have to live with Sciatica, and there are a multitude of treatments that work well to get people better, both medically and if necessary, surgically.
So then we look at patients who have acute back pain, who also have leg pain. And most often this'll be in a demographic that's older than teens starting in the 20s more people in their forties and 50s fair number in their sixties interestingly enough, not so much in their seventies, eighties, and nineties. And the important part of this is that it's the leg pain signals that something's going on in the back that's pinching one of the nerves and is causing the leg pain. Commonly, this is called sciatica and Sciatica, sort of a poor term as it were because it just means leg pain and it doesn't really tell you anything much about the diagnosis for the most part. But if somebody is having pain that radiates down to their front or their thigh back of their calf, then you start thinking of things that are pinching on nerve roots. The most common cause of that in an acute setting is actually a ruptured disc. Americans have been taught that ruptured discs account for everything. Perhaps even the satellites fallen out of the sky or the stock market going down. But the reality is, is that disc ruptures are in and of by themselves things that can cause no problems can cause big time problems, can cause a lot of leg pain and may cause some back pain as well. So the long and short of it is, is that again, we're thinking of things that cause the leg pain. Other things can be cysts. They can be bone that's overgrown, where the bone has gotten too tight and is squeezing things.
Many people ask, "how can I keep from getting Sciatica?" And the answer is stay active. Four to five days, a week of good cardio or aerobic exercise has shown to be preventative. However, some of these changes are just degenerative, they occur with age and you really can't prevent becoming older. If you've had Sciatica, it's gotten better, stay active. Try to keep that Sciatica away.
With Sciatica, there's some definite warning signs that you should seek almost immediate attention. One of those is, is if you have a neurologic deficit. That's sort of a funny term, but what that really means is if you have a weak leg or weak legs. You shouldn't have a weak leg or legs. It needs to be attended to. If you have a blue toe or a toe or a foot that looks like that, it is model that it doesn't look right, doesn't look like it's getting blood flow to it. Also, if you can't get around and you previously weren't on a walker and having troubles, and now you are, you have to use a walker or crutches. You need to be seen and evaluated.
Sciatica is everybody. Just about everybody you talk to has had an episode in their life where they have had leg pain from one cause or another. Strictly speaking, the stuff that has to do with ruptured disc and spine origin, though, is still fairly common in the populous and probably 40% of the population will have had Sciatica at sometime in their life.
So with the diagnosis of Sciatica, the two tests that help us the most are the non-invasive arterial studies and the MRI. If your arterial studies would show arterial blockage are positive, then you'll need to see a vascular surgeon. But don't be worried. Not everybody needs surgery and there are many medical treatments for it. For causes that we see on MRI, such as Lumbar stenosis, the bony overgrowth, which squeezes the nerves, or a ruptured disc, or other things that squeezed the nerves, many times, conservative treatment can help before one has to go to surgery.
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