PAIN IN LOWER BACK WITH NUMBNESS IN BUTTOCK AND LEG: DESCRIPTION AND POSSIBLE MEDICAL PROBLEMS
I remember one patient recalling her battle with sciatica. Margo was healthy, active, and in her mid-40s. A few years earlier, she had told me that she sometimes felt a slight tingling run down her hamstring, but she had always just shrugged it off.
Three years after the tingling first started, Margo and her husband were on vacation 1000 miles away from home when she suddenly felt excruciating pain begin to shoot through her back and down her left leg. “I’d had back pain before,” she told me later, “but it was never anything like this. It was so bad that sitting was all but impossible for me. The only thing that helped was walking.”
She finally went to the emergency room several hours after the pain first appeared. By that time, her foot and ankle were totally numb. The neurologist told her it looked as though she had sciatica and thought it was caused by a herniated disk in her back. Sciatica is a condition in which the sciatic nerve, which runs the length of the hamstring and through to the foot, becomes swollen and leads to pain and numbness in the leg.
A slipped disc occurs when one of the discs in your back that serve as a cushion between vertebrae either ruptures or bulges out and presses on one of the nerves that originates in the spine. This can occur due to age, overexertion, or a sudden twist of your body.
A prolapsed disc is also known as a slipped disc, though the disc doesn’t actually slip but instead protrudes. When sciatica occurs, the disc that is the most likely culprit is the fourth or fifth disc in the lumbar region, or the lower back. With sciatica, the disc presses on the sciatic nerve, the longest nerve in the body. The pain will run down your back into your buttock and down your leg. As Margo discovered, it may be difficult to walk on either your heels or your toes, and your range of motion will be severely limited.
To confirm the diagnosis, Margo underwent an MRI. An MRI, like a CAT scan, is a specialized radiological procedure. The patient is placed on a platform and wheeled into a huge cylinder.The machine causes claustrophobia in some people; you might need some mild sedation if you expect that you will feel artxious, even though the entire procedure takes less than an hour and, in some cases, only 20 minutes. Some MRI machines actually have music piped into them.
Margo’s diagnosis for sciatica was positive, and since it was caused by a herniated disc in her back, surgery was scheduled for the next day. When she had fully recovered, Margo was able to enjoy all her old activities, with one important difference: she had no more back pain.
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