Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Kaye received a Bachelor of Arts degree with honors from the University of California, San Diego in Applied Mechanics and Engineering Sciences. After graduating from New York Medical College, he completed his internship and residency training in pathology at Harbor - UCLA Medical Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
A majority of patients with sciatica from disc herniation
have resolution of their pain with various conservative measures,
including antiinflammatory and muscle-relaxant medications, exercises,
physical therapy, and time. However, some 10%-15% of affected
patients require surgical procedures to relieve the pain.
In recent decades, cortisone medications have been
injected into the space around the spinal cord (epidural space)
to reduce the inflammation and swelling of the disc herniation,
thereby relieving irritation of the adjacent nerves. It has never
been certain as to whether this procedure (epidural injection)
can actually reduce the need for surgery.
Sciatica is nerve pain from irritation of the
sciatic nerve.
The sciatic nerve is the largest nerve in the body.
Sciatica pain is typically felt from the low back to
behind the thigh and radiating down below the knee.
Treatments for sciatica depend on the underlying cause and the severity of
the pain.
What is sciatica?
Sciatica is pain in the lower extremity resulting from irritation of the sciatic nerve.
The pain of sciatica is typically felt from the low back (lumbar area) to behind the thigh and radiating down below the knee. The sciatic nerve is the largest nerve in the body and begins from nerve roots in the lumbar spinal cord in the low back and extends through the buttock area to send nerve endings down the lower limb. The pain of sciatica is sometimes referred to as sciatic nerve pain.
What are causes of sciatica?
While sciatica is most commonly a result of a lumbar disc herniation directly pressing on the
nerve, any cause of irritation or inflammation of the sciatic
nerve can reproduce the symptoms of sciatica. This irritation of nerves as a result of an abnormal intervertebral disc is referred to as radiculopathy. Aside from a pinched nerve from a disc, other causes of sciatica include irritation of the nerve from adjacent bone, tumors, muscle, internal bleeding, infections, injury, and other causes. Sometimes sciatica can occur because of irritation of the sciatic nerve during pregnancy.
Picture of a herniated disc, a common cause of sciatica
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
A pinched nerve can be caused of a variety of conditions, for example, carpal tunnel syndrome, herniated disc, sciatica, arthritis, spinal stenosis, trauma, and more. Common symptoms of a pinched nerve include pain, numbness, tingling, and weakness. Treatment of a pinched nerve depends on the cause of the pinched nerve.
There are many symptoms involved in the 1st, 2nd and 3rd trimesters of pregnancy. The first early pregnancy symptom is typically a missed period, but others include breast swelling and tenderness, nausea and sometimes vomiting, fatigue and bloating. Second trimester symptoms include backache, weight gain, itching, and possible stretch marks. Third trimester symptoms are additional weight gain, heartburn, hemorrhoids, swelling of the ankles, fingers, and face, breast tenderness, and trouble sleeping. Read more to learn about recommended procedures and tests for each stage of a healthy pregnancy.
A herniated disc may be caused by injury or degeneration from age. Symptoms depend on the location of the herniation and whether nerve tissue is being irritated. An MRI or CT scan is performed to diagnose a herniated disc. Treatment may involve physical therapy, cortisone injection, pain medications, antiinflammatory medications, muscle relaxants, and surgery.
Degenerative disc disease makes the disc more susceptible to herniation (rupture) which can lead to localized or radiating pain. The pain from degenerative disc or joint disease of the spine is usually treated conservatively with intermittent heat, rest, rehabilitative exercises and medications to relieve pain, muscle spasm and inflammation.
Radiculopathy, a condition in which a nerve or nerves along the spine are compressed causing pain, numbness, weakenss, and tingling along the nerve(s). Some causes of radiculopathy include bone spurs, disc hernation, osteoarthritis, tumors, infection, and neuropathy. Treatment depends on the are of nerve compression. Surgery is generally not required.
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain includes: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
Cauda equina syndrome is a medical emergency condition that is caused by the uncommon compression of the nerves at the end of the spinal cord. Symptoms of cauda equina syndrome include lower back pain, tingling and/or numbness in the buttocks and lower extremities, bowel or bladder incontinence, and weakness in the legs. Causes of cauda equina syndrome include herniated discs, hematomas, or infection. Treatment is generally prompt surgery.
Radiculopathy is a condition due to a compressed nerve in the spine that can
cause pain, numbness,
tingling, or weakness along the course of the nerve. Radiculopathy can occur in
any part of the spine, but it is most common in the lower back (lumbar
radiculopathy) and in the neck (cervical radiculopathy). It is less commonly
found in the middle portion of the spine (thoracic
radiculopathy).
What are the risk factors for radiculopathy?
Risk factors for radiculopathy are activities that place
an excessive or repetitive load on the spine. Patients involved in heavy labor
or contact sports
are more prone to develop radiculopathy than those with a more sedentary
lifestyle. A family history of radiculopathy or other spine disorders also
increase the risk of developing radiculopathy.
What are the causes of radiculopathy?
Radiculopathy is caused by compression or
irrit...