Healing Sciatica

Q.Can your sciatic nerve be permanently damaged, or does it just take a long time to heal? I had three discs pressing on the nerve. My back and leg pain seems to have gone, but my foot has not got all the strength back as yet. I am 76 years old and in very good health other than my back.

A.Sciatica is a nonspecific term used in many cases to describe back and leg pain. There are many potential causes for back and leg pain. It is always important when evaluating a patient for back and leg pain to distinguish whether the symptoms are caused from a disorder of the spine or a disorder of the hip. Typically, sciatica is caused from a herniated disc in the spine, compressing one or more nerve roots.

A.In such cases, a thorough neurologic examination is performed on a patient. This includes assessing leg strength, sensation in the legs and reflexes. Furthermore, it is important to inquire about bowel and bladder function and also sexual function. Although unusual, patients with a large herniation of a disc in the lumbar (lower) spine can develop loss of bowel or bladder control.

There are some excellent long-term studies comparing disc herniations that were treated with surgery versus those treated without surgery. It turns out, the prognosis for a disc herniation is good regardless of the treatment. The primary difference between the two groups was that those who underwent surgery had a more rapid improvement in their symptoms. At four to five years from the onset of the symptoms, however, the differences between the two groups was minimal. The neurological recovery in both groups was similar as well.

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