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Suggest Remedy For Persistent Sciatica

Posted on Mon, 26 Oct 2015

Question: Hi , my mother has been experiencing sciatic for the last week or more , pain running down her leg , and lower back pain for the last week . Also at night having to go to the loo every 2 hours . 48 hours ago she thought she had food poisoning , nausea , not wanting to eat , feeling sick . Today she has arrived on hoilday still experiencing nausea , and didn't sleep also due to her leg pain .
When I googled the symptoms came accross Cauda equina syndrome .... I don't want to alarm her , but the food poision symptoms along with the sciatic experience are looking a little similar to the symptoms of CES . Any suggestions please ... Thankyou

Answered by Dr. Ahmad Nazzal (45 minutes later)

Brief Answer:
Neurology consultation, MRI, and treatment accordingly

Detailed Answer:
Dear XXXXXXX,

Thank you for trusting us in HCM with your query. I will make sure to answer your query up to my best.

Regarding the symptoms you mentioned they do fit the differential diagnosis of cauda equina syndrome. Based on this assumption its crucial and key to refer to your nearest hospital do MRI since it is the best way to assess the situation of nerves and level of impaction, get a neurology consult and in the hospital if needed she might be referred to neurosurgery department depending on outcome of the MRI images. Feel free to share the images with me too in case you needed a second opinion.

I do understand you do not want to alarm your mother, but its very important to treat and release pressure on the nerves to prevent permanent damage. The sooner the pressure is relieved once those symptoms appear the better is the outcome, so please do not hesitate in taking her to the hospital.

I wish her full and fast recovery. Please do not hesitate in contacting me with further questions.

Kind regards,
Dr. Nazzal

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Ahmad Nazzal (31 minutes later)

Thankyou , do the symptoms get progressively worse , or can they eliviate . I have just spoken with her again now and her nausea is better tonight after eating . There is a typical siatica pain in the leg , which only effects her walking after a long period if standing up , but no weakness or numness in the buttock area . She still feels the nausea was caused by food poisoning after prawns , as she has diarreoa symptoms which have no subsided . Going to the loo more regulary at night , but only a weak bladder as apposed to leakage etc . She stated in general her symptoms are not getting any worse . Sorry to query again , but its a sunday night in the UK , and this is the NHS ! Which symptoms are worth monitoring the most to indicate an emergency ? As i dont wish to awaken her now if possible . thanks

Answered by Dr. Ahmad Nazzal (17 minutes later)

Brief Answer:
Urine incontentince, inability to move the leg anymore

Detailed Answer:
No problem I am glad to help.

Symptoms tend to progress, but the rate they do is dependent on the situation for proper assessment MRI or CT scan is needed.

Well the nausea and the diarrhea might not be related to her sciatica issue, nevertheless Cauda can lead to bowel changes.

Emergency signs are urine or stool incontinence, numbness in the pelvic region inner pelvic specifically, gait problems and disturbances, and failure to move the leg.

As I mentioned above if you suspect it, you can keep an eye on those signs but I do recommend getting her to the ER as soon as you can. For reassurance in case its not cauda that is good news in case it is then proper treatment is not delayed.

Hope she gets well soon.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Raju A.T