by Tamer Seckin, MD | Posted on June 23, 2020
Sciatic endometriosis is a condition where the lining of the uterus or the endometrium grows around the sciatic nerve and puts pressure on it.
Yes. When the endometrium grows around the sciatic nerve, it results in pelvic, hip, and leg pain.
While the exact cause of endometriosis is not well understood, the cause of sciatic endometriosis is. When the endometrium starts to grow outside the uterus and around the nerves, it can cause damage to those nerves. This is known as neuropathy . When the affected nerve is the sciatic nerve, the condition is called sciatic endometriosis. Sciatic endometriosis is caused by inflammation that can begin as a periodical. However, as the disease progresses, it can become chronic and eventually lead to scarring and constant pain.
The sciatic nerve is the body's largest nerve, 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.
Because 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.
Other symptoms of sciatic endometriosis are similar to those of regular endometriosis and may include:
Severe period of pain
Pain during intercourse
Bloating and nausea
Depression and anxiety
The pain may start just before the start of your period and last for several days after. 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" or the inability to lift the front of one's foot, and negatively affect walking ability. It may also cause loss of sensation, muscle weakness, and reflex alteration. 
Sciatic endometriosis can be very difficult to diagnose as it usually presents like sciatica. But the condition almost always occurs together with regular endometriosis. If a woman is already diagnosed with endometriosis and shows symptoms of sciatica, sciatic endometriosis may be suspected. Imaging techniques such as magnetic electromyography, computed tomography (CT) scan, magnetic resonance imaging (MRI), or surgery  may be used to diagnose it.
A test called the Lasègue’s test , or straight leg raise test, can also indicate 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 due to sciatic endometriosis, the patient experiences sciatic pain when the legs reach an angle between 30 and 70 degrees in relation to the exam table.
Early diagnosis is key as sciatic endometriosis can result in irreversible nerve damage caused by recurrent cycles of bleeding and scarring if left untreated .
As in the case of regular endometriosis, oral contraceptives may also help reduce the pain caused by sciatic endometriosis.
Over-the-counter painkillers and anti-inflammatory medications such as ibuprofen, as well as topical painkiller creams, may help reduce the pain caused by sciatic endometriosis.
Gentle exercise such as walking, yoga, swimming, and physiotherapy under the supervision of a skilled physiotherapist who specializes in endometriosis, can also 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 an experienced endometriosis excision surgeon perform the surgery.
Sometimes endometriosis can reach 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 surgeons may decide to access the area from the back of the pelvis via the buttock.
Endometriosis can affect the sciatic nerve and the so-called S2, S3, and S4 nerves that come out of the spine and travel to the skin and muscles of the pelvis and lower limbs.
We make sure that patients with sciatic endometriosis are evaluated with magnetic resonance imaging (MRI) and surgery, which has to be performed by a very experienced endometriosis excision 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 the nerves found in this region.
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I’ve seen many obgyns over the years explaining my monthly symptoms during my period...but eventually it became a daily struggle with these pain. It feels like a poke here and there near my right pelvic region. I was given birth control pills for the past ten years but honestly, it didn’t help at all. I was in bed whenever I had my period. I was previously sent to GI doctors for possible appendicitis but it was ruled out from imagings…
Dr.Seckin is so much more than a surgeon. His passion for helping endometriosis sufferers and determination to improve the quality of life in all of his patients is undeniable. I remember when my gynecologist first told me I needed a laparoscopy. Her exact words were "I can do the surgery, but if you were MY daughter- I'd send you to him." From the first day I met him he took the time to explain endometriosis to me since I knew…
I was there for hysterectomy but then I found out that I also had endometriosis.My both surgeries went excellent and I feel great!.I am so thankful to Dr.Seckin and all his team for making my journey smooth!
I am a physician who suffered from deep infiltrative endometriosis. I needed laparoscopic surgery, so I went to see my former gynaecologist and he performed the procedure (a surgery which he supposedly does hundreds of times a year) last November. I had severe pain again when I had my period in January and was advised to go on taking a low hormone dose anticoncipient pill. My symptoms came back quickly and got worse in a few months’ time. I went…
After years of excessively painful periods, a serious loss of quality of life, and a series of uninformed and uninterested doctors, Dr. Seckin and Dr. Goldstein turned my life around. I was told I woke up from my surgery almost a year ago with a smile on my face, and I haven't stopped since. Before I heard of Dr. Seckin, I was experiencing almost daily terrible pain to the point where I had difficulty walking, inability to eat, inexplicable weight…
Dr Seckin and his team gave me back my life! Tomorrow will be 1 month since my surgery and I feel great. Dr. Seckin, Dr Liu, and Dr Goldstein are not only beyond words talented and amazing Doctors, but they are also genuinely wonderful and caring people. I cannot say enough great things about Holly, Asiye and Kim as well. They were all caring, kind, patient, and took the time to listen to me and explain anything I needed to…