FROM OUR EXPERTS
“Sciatica” is an old world term that refers to leg pain felt down the back of the thigh into the calf and foot. What about thigh pain? What about buttock pain? Unfortunately, “sciatica” has been wrongly applied to all types and locations of leg pain. In 1948, the use of the word “sciatica” was declared “unhelpful” by a leading orthopedic specialist because it is limited to a certain location and really does not address the origin of the pain. Over the years, many older medical terms like sciatica have become archaic as the newer research technologies give doctors clearer definitions and a better understanding of the human body. Leg pain that comes from the low back is most accurately categorized as referred pain or neurogenic pain. These terms apply to all locations and address the origin of the pain. With these newer terms, the antiquated word, “sciatica”, has no place in the modern world. Sally has been waking up with right ...
If I had an episode of lower back pain, am I always going to be more likely to have lower back pain in the future?
It is true that once you have an episode of lower back pain or shooting leg pain, you are probably more likely to have it in the future - if you do nothing. But you are not going to "do nothing."
I see a lot of patients with lower back pain and shooting leg pain. Once we work together to resolve the pain, a very common question and concern that is raised is whether the pain is likely to return. A typical example is the following: Mr. X comes in with lower back pain that shoots into the right leg all the way to the foot. MRI reveals a herniated disc at L5-S1 level. After an injection, the pain is 90% better. Next, Mr. X starts physical therapy. Six we...
Last month, the American Pain Society added to its recommendations to health care providers regarding the diagnosis and treatment of low back pain .
In addition, the Society decided to discuss openly procedures that could be risky to sufferers of low back pain, including recommendations on surgery and other invasive therapies.
Unfortunately, there is not a significant body of good evidence to justify unquestioningly embracing these new recommendations. It is difficult to find well-done clinical studies which support the use of a number of the more invasive treatments used for chronic low back pain.
The initial set of guidelines for the management of chronic low back pain were published in "Annals of Internal Medicine" last October. However, these recommendations dealt more with the initial evaluation of a low back pain patient, and included thoughts on what type of x-rays to order in addition to more conservative treatments such as massage/manipulation and exerci...
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