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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What does severe pain from the buttocks to the right leg indicate?

I have a shooting pain that starts in my right buttock and extends down my right leg. My pain started just after Thanksgiving and has increasingly grown worse. Originally the pain only went to my knee but now extends to my ankle. I have been taking Aleve to try to lessen the pain but it doesn’t always work. Standing from a seated position is excruciating and reaching the floor is nearly impossible because the pain in my whole leg is so bad. I am usually an active person, going to the gym and walking my dogs daily. Should I make an appointment with a neurologist, an orthopedic surgeon? I’m a 61 year old woman who is in good health. This is really effecting my lifestyle.
Mon, 26 Feb 2018
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Anesthesiologist 's  Response
hi mam, let me thank you first for a detailed description of your problem.yours is a typical pain of sciatic nerve compression.the possible causes are :
1)lumbar disc degeneration disease or disc dislocation.
2)any trauma to lumbar spine
3)any tumour compressing sciatic nerve.
a detailed physical examination by an orthopedician or a neurologist or a spine surgeon is necessary and MRI may also be ordered for a specific diagnosis.the recommended treatment modalities are as follows :
1) complete bed rest for atleast 4 weeks
2) pain relieving medications like NSAIDs
(aceclofenac,ibuprofen),neuropathic analgesics like
pregabalin,gabapentin(to be taken only at night before
going to bed),opioid analgesics like
oxycodone,oxymorphine are useful.
3) muscle spasmolytics can be used if muscle spasm is severe
chlorzoxazone, cyclobenzaprine,metaxalone are some of
them.
4) topical application of analgesic ointments or local
anesthetic like 5% lidocaine patch would provide some
pain relief.
5) even with the above therapy for 2 weeks,pain doesnt
subside,lumbar epidural injection of a local anaesthetic
with or without a long acting steroid is advised.it provides
pain relief for at least 4-6 months.
6) lumbar facet joint block is another advanced and more
promising modality of pain relief.
7) few precautions like avoiding sitting on the floor,avoiding
lifting heavy weight,prevention of abnormal postures are
recommended.
so,you can consult a spine expert or an ortho doctor and discuss the above mentioned modalities of treatment.hope my explanation clarifies your doubts.any further queries,please do write to us.its my pleasure to guide you.thank you.take care.bye.
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