[36F] Experiencing sciatica and bilateral leg pain post-hysterectomy

Patient Description

A 36-year-old female presents with sciatica and pain radiating to the front thighs, which worsens after sitting for more than 30 minutes or towards the end of the day. The pain is described as dull, tight, and tingling, beginning in the pelvis and affecting the lower back and calves, particularly in the evening. There is a slight loss of leg control in the evenings, but no changes in bladder or bowel control. The patient had a supracervical hysterectomy 6 weeks prior. No other pre-existing conditions, chronic illnesses, medication use, or family history of spinal problems or neurological conditions were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible causes for your symptoms include:

  • Sciatica: This condition occurs when the sciatic nerve, which runs from your lower back down to your legs, is irritated or compressed. It can cause pain, numbness, and weakness in the lower back and legs. The pain can be worsened by sitting for long periods.

    • Treatment typically involves physical therapy, pain relievers, and in some cases, surgery.

  • Lumbar radiculopathy: This condition occurs when a nerve in the lower back is compressed or irritated. It can cause similar symptoms to sciatica, including pain, numbness, and weakness in the lower back and legs.

    • Treatment typically involves physical therapy, pain relievers, and in some cases, surgery.

  • Post-operative complications: Given that you had a supracervical hysterectomy six weeks ago, it's possible that your symptoms could be related to this procedure. Post-operative complications can include nerve damage, which could potentially cause the symptoms you're experiencing.

    • Treatment would depend on the specific complication and could range from conservative management to additional surgical intervention.

What you can do

While waiting for your appointment with your doctor, here are some things you can do to help manage your symptoms:

  1. Avoid sitting for long periods. If you need to sit, try to take regular breaks to stand up and move around.
  2. Over-the-counter pain relievers, such as ibuprofen, can help manage your pain. However, they should be used sparingly and only as directed.
  3. Gentle stretching and strengthening exercises can help relieve pressure on your sciatic nerve. However, it's important to consult with a healthcare professional before starting any new exercise regimen.
  4. Applying heat or cold to your lower back can help relieve pain. Try using a heating pad or a cold pack for 15 minutes at a time.

What you should look out for

You should seek immediate medical attention if:

  • Your pain becomes severe or unbearable
  • You experience sudden, severe weakness in your legs
  • You lose control of your bladder or bowel movements
  • You experience numbness or tingling in your groin or inner thighs

Remember, this advice is intended to be general in nature, and specific causes may not apply to your personal circumstances. Always consult with a healthcare professional for accurate information.

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9 mo ago

People Also Ask

What is sciatica and what causes it?

Sciatica is a condition where the sciatic nerve, which runs from the lower back down to the legs, becomes irritated or compressed. This can cause pain, numbness, and weakness in the lower back and legs. Common causes include a herniated disc, bone spur, or spinal stenosis.

How can a supracervical hysterectomy lead to nerve-related symptoms?

A supracervical hysterectomy involves the removal of the uterus while leaving the cervix intact. Post-operative complications can include nerve damage, which might occur due to surgical manipulation or positioning during the procedure, potentially leading to symptoms like pain or tingling.

What are the common treatments for lumbar radiculopathy?

Common treatments for lumbar radiculopathy include physical therapy to strengthen and stretch the back muscles, pain relievers to manage discomfort, and in some cases, surgical intervention to relieve nerve compression.

When should I seek immediate medical attention for my symptoms?

You should seek immediate medical attention if you experience severe or unbearable pain, sudden severe weakness in your legs, loss of bladder or bowel control, or numbness or tingling in your groin or inner thighs, as these could indicate serious complications.

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