Endometriosis & The Sciatic Region

Endometriosis & The Sciatic Region

OVERVIEW

What is sciatic endometriosis?

Sciatic endometriosis is a condition where the lining of the uterus or the endometrium grows around the sciatic nerve and puts pressure on it.

Can endometriosis affect the sciatic region?

When the endometrium grows around the sciatic nerve, it results in pelvic pain as in the case of regular endometriosis but also a pain in the hip region and leg.

CAUSES

What causes sciatic endometriosis?

The exact cause of endometriosis is not well understood. When the endometrium starts to grow outside the uterus and affect nerves it can cause damage to them. This is known as neuropathy [1]. When the affected nerve is the sciatic nerve, the condition is called sciatic endometriosis. Sciatic endometriosis is caused by inflammation that can be a periodical to start with, but as the disease progresses, this can become chronic and eventually lead to scarring and constant pain.  

SYMPTOMS

Could I have sciatic endometriosis?

The sciatic nerve is the largest nerve in the body connecting the spinal cord with the legs and feet. It runs from each side of the lower spine into the back of the thigh and down to the foot.

sciatic endometriosis

Since sciatic endometriosis puts pressure on the sciatic nerve it can cause pain, numbness, cramping, and a tingling sensation in the lower back, hips, buttocks, thighs, calves, knees, and feet. The pain is usually felt in the back of the leg and radiates towards the heel.

 

What other symptoms can there be?

Other symptoms of sciatic endometriosis are similar to those of regular endometriosis and may include:

  • Pelvic pain

  • Irregular periods

  • Severe period pain

  • Pain during intercourse

  • Fatigue

  • Bloating and nausea

  • Depression and anxiety

Do I have sciatic endometriosis symptoms?

The pain may start just before a woman starts her period and last for several days after the period is over. However, the interval between episodes of pain may shorten with time and the cyclical pain may gradually become constant. Sciatic endometriosis may cause foot drop and negatively affect walking ability. It may also cause loss of sensation, muscle weakness, and reflex alteration. [2]

DIAGNOSIS

How is sciatic endometriosis diagnosed?

Sciatic endometriosis can be very difficult to diagnose as it usually presents like sciatica. But the condition almost always occurs together with regular endometriosis and if a woman is already known to have endometriosis and shows symptoms of sciatica, sciatic endometriosis may be suspected. Imaging techniques such as magnetic electromyography, computed tomography (CT) scan, resonance imaging (MRI), or surgery [3] may be used to diagnose it.

A test called the Lasègue’s test [4] or straight leg raise test can also be indicative of sciatic endometriosis. During the test, the patient is asked to lie down on their back. The doctor then raises the patient’s legs with the knees held in a straight position. If the sciatic nerve is under pressure, for example, due to sciatic endometriosis, the patient experiences sciatic pain when the legs reach an angle of between 30 and 70 degrees compared to the floor.

Early diagnosis is very important as sciatic endometriosis can result in irreversible nerve damage caused by recurrent cycles of bleeding and scarring if left untreated [2].

TREATMENT

What treatment options are there?

Over-the-counter painkillers and anti-inflammatory medications such as ibuprofen may help reduce the pain caused by sciatic endometriosis. Topical painkiller creams applied over the affected areas may reduce the pain caused by sciatic endometriosis.

Gentle exercise such as walking, yoga, and swimming can also help and so can physiotherapy under the supervision of a skilled physiotherapist specializing in endometriosis.

As in the case of regular endometriosis, oral contraceptives may also help reduce the pain caused by sciatic endometriosis.

What if these do not help?

Laparoscopic surgery to remove the endometrial tissue that has grown around the sciatic nerve can be effective in treating severe cases of sciatic endometriosis. It is important that the surgery is performed by an experienced plastic surgeon.

Sometimes endometriosis may have reached the so-called sciatic foramen or the opening in the pelvic bone where the nerves and blood vessels from the pelvis pass through and travel down to the lower legs. Because this area is difficult to reach by laparoscopy, in such cases neurosurgeons may decide to access the area from the back of the pelvis via the buttock.

OUR APPROACH

Endometriosis can affect the sciatic nerve and the so-called S2, S3, and S4 nerves that come out of the spine and supply the skin and muscles of the pelvis and lower limbs. As the disease progresses it can cause permanent damage to the nerves, known as neuropathy.

Patients with sciatic endometriosis have to be evaluated with magnetic resonance imaging (MRI) and surgery, which has to be performed by a very experienced plastic surgeon who knows how to identify the main blood vessel in the pelvic area with its subdivisions. He or she will then need to extend to the area before the sacral bone, or triangular bone at the base of the spine, and reach to the nerves found in this region.

At times, the inflammation caused by endometriosis can affect the sciatic foramen or the opening in the back of the pelvis into the sciatic canal. It may be difficult to reach this area by laparoscopy, meaning neurosurgeons dealing with this issue, may prefer to approach from the back of the pelvis with a rather ample incision in the buttock muscle.

PATIENT STORY

A Happy Ending for this Adenomyosis and Endometriosis Patient

A Happy Ending for this Adenomyosis and Endometriosis Patient

I wish my doctors pointed me in Seckin's direction a lot sooner, says Christine Eboli. I would’ve had more years to spend with my kids.

Read More >>

 

 

 

 

 

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You may call us at 212-988-1444 or have your case reviewed by clicking here.

References

  1. https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061
  2. https://pdfs.semanticscholar.org/44ce/e7e5b71d6238851e473732c23dd0e69a6002.pdf
  3. https://www.ncbi.nlm.nih.gov/pubmed/12394671
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483767/

 

 

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Patient Reviews

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  • Megan Rafael Moreno

    I was in pain for 2 years. I was getting no answers, and because dr Goldstein and dr seckins were willing to see and treat me I'm finally feeling almost back to normal. They were very down to earth and helpful in my time of need. Dr Goldstein was easy to talk to and caring, she took care of me…

  • Nancy Costa

    Dr. Seckin is one of the best endometriosis surgeon. Every time I go to the office, he really listens to me and is always concerned about my issues. Dr Seckin's office staff are a delight and they always work with me. I feel I can leave everything to them and they will take care of it. Thank you to the…

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    Fast forward 5 years to find out incidentally I had a failing kidney. My left kidney was only functioning at 18%. During this time, I was preparing all my documents to send to Dr. Seckin to review. However, with this new information I put everything on hold and went to a urologist. After a few months, no one could figure…

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    I had a wonderful experience working with Dr. Seckin and his team before, during and after my surgery. I came to Dr. Seckin having already had laparoscopic surgery for endometriosis 5 years prior, with a different surgeon. My symptoms and pain had returned, making my life truly challenging and my menstrual cycle unbearable. Dr. Seckin was quick to validate my…

  • Anita Schillhorn

    I came to Dr. Seckin after years of dealing with endometriosis and doctors who didn't fully understand the disease. He quickly ascertained what needed to be done, laid out the options along with his recommendation and gave me the time to make the right decision for me. My surgery went without a hitch and I'm healing very well. He and…

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    Dr. Seckin brought me back to life! I am now 3 weeks into my recovery after my laparoscopy surgery, and I feel like a new and improved woman! Being diagnosed with Endometriosis, then 25yrs old in 2015, and discovering the severity of my case being stage 4, made me devastated. Dr. Seckin's vast knowledge of the disease, sincere empathy, and…

  • Jason Curry

    My wife had her laparoscopic excision surgery to remove endometriosis with Dr. Seckin on Jan 30, 2014. She doesn't write online reviews so I'm writing this on her behalf. I accompanied her with each office visit she had. The staff--Lucy and Kim, are very friendly, warm and professional. Dr. Seckin was excellent in every capacity. He spent a lot of…

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    He is an awesome doctor who saved my daughters life from debilitating endometriosis..she knew instantly upon awaking from surgery that she was better..that wad May and no complaints only praises for Dr. Wonderful Seckin!!

  • Karen N

    I was diagnosed with Endometriosis at 19. I saw several Endometriosis "Specialists" since then, had a few laproscopic surgeries to "remove" the endometriosis and continued to be in pain. I had a hysterectomy in 2012 and was told this would stop the pain once and for all. No such luck! Tired of spending days in bed with a heating pad,…

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    I researched and found Dr. Seckin after dealing with years of doctors who couldn't help me or refused to go the extra mile for their patients. I have to say I am truly blessed to have found such a compassionate and talented doctor. He is exquisite with everything he does, and both his team at the office and surgical team…

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    Dr. Seckin is a very skilled surgeon. There are not many doctors like him that truly understand the effects of endometriosis. I am lucky to have found him. The staff is wonderful too.

  • Meg Connolly

    Dr. Seckin truly LOVES what he does and cares about his patients from the bottom of his heart. My life has already changed in 3 weeks and I couldn’t be more grateful. Should I ever need another operation for endometriosis, Dr. Seckin will be the one to do it. I recommend him to anyone I come across with similar problems…

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