Available treatment eases painful, almost crippling condition

Sciatica, a painful, sometimes almost crippling condition, can affect patients of any age, says pain management specialist Dr. Pam Cunningham.
  In younger patients, the pain may come on after heavy exertion.
  "You might move a heavy object or pick up your child and feel a sudden, severe pain in your lower back that radiates downward through your legs," Dr. Cunningham says.
  The term "sciatica" comes from the sciatic nerve, a long nerve that originates in the back and runs down the back of each thigh, branching to the heel. However, Dr. Cunningham says, the term "sciatica" is often used to describe any pain that runs down a patient's leg.
  "It may be caused by torn or herniated disk in the lower back," she says. "Similarly, pain from damage to the neck can radiate through the arms."
  Because the pain is very severe, the first step in treating sciatica is to get the pain under control. Patients may receive cortisone by mouth for about a week. At this point, if the pain is more tolerable, physical therapy is the next step.
  "Physical therapy mobilizes and retrains the muscles so that they can better support the back," Dr. Cunningham says.
  If oral medication does not relieve the pain sufficiently, another option is cortisone injected directly into the site of the pain.
  "The medication is injected while the patient is under sedation in order to make him or her as comfortable as possible," Dr. Cunningham says. "The doctor injects the medication under X-ray guidance so that the medication goes directly to the site of the pain."
  If the patient gets no relief, Dr. Cunningham says, surgical options are available.
  In older patients, sciatica may take longer to develop and may be the result of a chronic condition, such as degeneration of discs or facet joints (back joints).
   "There are several causes for sciatica in older patients, and it's important that we screen for these conditions using X-ray, an MRI or sometimes a CT scan. Over time, there may be calcification of the joints, or a narrowing of the nerve outlets that causes pain in the legs," Dr. Cunningham says.
  In older adults, the condition is treated in much the same way that it is in younger patients, but is usually considered more of a chronic condition that needs to be monitored and treated over the course of time.
  "In younger patients, the good news is that they usually make a full recovery from sciatica," Dr. Cunningham says. "In older patients, the good news is that sciatica pain can be greatly relieved."
  Dr. Pam Cunningham, a board-certified and fellowship-trained medical doctor specializing in interventional pain management, is located in the Professional Building at 318 N. Alleghaney, Ste. 303. She sees both self-referred and physician-referred patients. For more information, call (432) 331-1234.