May 05, 2011

Q. I am six months pregnant and have developed shooting pain down my leg, which I think is sciatica. What are the causes, and what course of treatment should I consider during my pregnancy?

It’s not unusual for pregnant women to have multiple maladies that temporarily manifest themselves then disappear after pregnancy. Some pregnant women may suffer from sciatica, which is caused by irritation of the sciatic nerve.

The sciatic nerve is actually a cluster of nerves that exits the lumbar spine, enters the buttocks, and then travels down the leg into the foot. for this reason, a major symptom of sciatica is shooting pain from the buttock down the back of the leg into the foot. The pain can vary from moderate severity to completely disabling.

The pain is usually caused by compression of the sciatic nerve and is commonly the result of a degenerative or herniated disk. While most cases clear up in time, patients suffering from extreme pain or loss of bowel and bladder function may require urgent surgical intervention to address the source of the issue.

If a herniated disk is indeed the cause of a patient’s sciatica, rest, pain management and physical therapy interventions such as core strengthening exercises are the first steps toward recovery. Normally the pain and symptoms will go away after pregnancy, but in a small percentage of patients these symptoms could persist or recur at a later time.

If the patient’s pain and quality of life has not improved after the pregnancy, the patient should consult her physician or a spine surgeon for an accurate diagnosis and a review of surgical and non-surgical treatment options.

They may elect a minimally invasive procedure called a microdiscectomy or microdecompression surgery to remove the protruding part of the disk. A slightly more invasive procedure, referred to as a lumbar laminectomy, entails a bigger incision and involves manipulating more tissue around the disc. an additional cutting-edge surgery for patients with severely damaged discs is the artificial disc replacement where the entire disc is replaced with a prosthesis.

Patients should consult their physician and/or a spine surgeon to determine the best treatment options.

Allister Williams, MD, is board-certified by the Board of Orthopedic Surgery. He practices orthopedic surgery at the Mountain Valley Orthopedic Group, East Stroudsburg.

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