In the United States, a pinched nerve with sciatica affects about 1% of the population in a given point in time. Sciatica involves a burning type of sensation going down in the right or the left leg resulting from a herniated disc pushing on the nerve root. The question is, can that lead to permanent damage of the nerve? What can pain management doctors in Arizona do to help?
The answer is yes it can. Here’s a little bit of a basic understanding. When a nerve root is compressed that in and of itself does not cause pain. It does however, spark up inflammation which can lead to sciatica pain which may be incapacitating. so a large part of treatment for herniated discs revolves around trying to decrease this inflammation.
When a nerve root becomes inflamed and sciatica occurs, the pain travels typically along the sensory distribution of that nerve root. So for an L3 nerve root compression that is on the front of the thigh. L4 actually travels below the knee on the front of the shin, and L5 travels below the knee typically on the outside of the calf. When you get into the sacral nerve roots, S1 involves the back of the calf and the side of the foot and maybe a little bit of the bottom of the foot. Not everybody walks out of a textbook, so this can vary from individual to individual.
The result of nerve root compression and inflammation can be pain, numbness, pins or needles. Symptoms involving these do not mean surgery is absolutely necessary. It remains a quality of life decision, and if conservative treatment does not help after about 6 to 8 weeks, then surgery is definitely an option.
Surgery for a herniated disc is over 90 to 95% good to excellent results. The pain typically goes away, and the patient is able to get back to doing the types of things they want to do. At times the numbness involved never goes away. So from that regard it can be permanent damage to the nerve root and by and large most patients don’t care. As long as the pain is gone, a little numbness is tolerable with the exception of if it’s on the bottom of the foot it may be especially annoying because patients are not able to walk as effectively with that issue.
Another issue when it comes to permanent nerve damage is a potential problem with muscular weakness such as a foot drop. If a patient has muscular weakness, surgery should be considered much sooner than otherwise. The reason is if it is delayed more than 3 to 6 months, the chances of the muscular weakness becoming permanent are much higher. This is even if the surgery performed is technically perfect.
Conservative treatment including epidural steroid injections at an Arizona pain management clinic may alleviate the pain and also maybe help with muscle weakness. These should be attempted prior to surgery if at all possible to see if there gone to work. There are some risks associated with lumbar discectomy surgery. Even though those risks are fairly minor, they should not be ignored.
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