28 years
I usually experience pain on left side of my body which starts on my waist and spreads to my foot. Is this a cause of UTI or what?
Oct 13, 2014
All along the entire length of the spine, at each spinal level nerves exit through holes in the bone of the spine (foramen) on the right side and left side of the spinal column. These nerves are called nerve roots,or radicular nerves. They branch out at each level of the spine and innervate different parts of the body.
Low back problems that affect a lumbar nerve root can radiate down along the leg and into the foot (radiculopathy, or sciatica), thus prompting leg pain and/or foot pain.
The spinal cord’s length is not the sae as that of the spine, so there is no spinal cord in the lumbar spine. Due to this fact, and since the spinal canal is usually fairly spacious in the low back, problems in the lumbosacral region (the lumbar spine and sacral region of the spine) usually cause nerve root problems.
Radicular pain is often the result of compression or inflammation of a spinal nerve. When the pain radiates down the back of the leg to the calf or foot, t is commonly known as sciatica. This type of pain is often deep and continuous, and can usually be reproduced with certain activities and positions, such as sitting or walking.
The pain usually follows the affected dermatome in the leg - the area of distribution of the leg innervated by the specific nerve. It radiates into the lower extremity (thigh, calf, and occasionally the foot) directly along the course of a specific spinal nerve root. The most common symptom of radicular pain is sciatica (pain that radiates along the sciatic nerve - down the back of the thigh and calf into the foot). Sciatica is one of the most common forms of pain caused by compression of a spinal nerve in the low back. It often will be caused by compression of the lower spinal nerve roots (L5 and S1).
Numbness and tingling, muscle weakness and loss of specific reflexes may also accompany radicular pain. When actual nerve dysfunction is noted, this is termed “radiculopathy”.
Causes of this type of pain, in the order of prevalence, include:
• Herniated disc with nerve compression - by far the most common cause of radiculopathy
• Foraminal stenosis (narrowing of the hole through which the spinal nerve exits due to bone spurs or arthritis) – more common in elderly adults
• Diabetes
• Nerve root injuries
• Scar tissue from previous spinal surgery that is affecting the nerve root
Sciatica is a mere description of radicular pain along the sciatic nerve and where the pain is felt but is not an actual diagnosis. The clinical diagnosis is usually arrived at through a combination of the patient’s history (including a description of the pain) and a physical exam. Imaging studies (MRI, CT scan) are used to confirm the diagnosis and will typically show the impingement on the nerve root.
The first line of treatment is conservative and includes physical therapy, medications, and selective spinal injections, and should be conducted for six to eight weeks. If nonsurgical treatment does not alleviate the pain, decompressive surgery, such as laminectomy and/or discectomy/microdiscectomy, may be recommended. The decision to proceed with surgery is based on severity of leg pain and/or the presence of significant muscle weakness. It is important to note that if definitive nerve compression cannot be documented on an MRI or CT-myelogram, then back surgery is ill advised and unlikely to be successful.
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