Sciatica or AneurysmAn example is a patient who visited an emergency clinic after a few weeks for a non-painful pulsing mass on the buttock. There was no:
- Back pain
- Leg pain
- Prior presentations of pain or sciatica issues
Persistent Sciatic ArteryThis is a very rare congenital vascular condition. The sciatic artery runs along the sciatic nerve and functions as the major blood supply to the lower extremities. During human embryo development, the femoral artery begins to form while the sciatic arteries start to return to a less developed state. The process continues until the femoral artery takes over as the major blood supply, with only bits of the sciatic artery left. Persistent sciatic artery can happen either from the sciatic artery not returning to its original size or during normal development the femoral artery developing properly. Most cases of persistent sciatic artery go unknown and are usually detected from another examination for another ailment. Aneurysms often develop based on the arteries/vessel’s tendency for minor trauma/injury when sitting or some form of pressure is applied on the site. Complications include:
- Surgical exclusion of the aneurysm
- Surgical excision of the aneurysm
- Endovascular stenting
- Endovascular coiling
Vascular Conditions In The Leg/s That Can Present As SciaticaThe legs’ blood vessels can get infected, bulged, ruptured, or blocked. This can cause sciatica symptoms, like leg pain, weakness, tingling, and numbness. Severe cases could require medical emergency surgery to save the affected limb.
Acute Limb IschemiaThis condition occurs from a decrease or loss of blood supply to the legs. If there is leg pain, it could feel similar to sciatica pain. However, symptoms can progress rapidly and become severe. That’s when it is not sciatica. Acute limb ischemia present one or more of the following symptoms:
- Pain and/or numbness in the leg while walking and when resting
- Severe pain at night
- Sleep problems
- Pain relief when sitting on a chair with the feet hanging down
- Feet and ankles become swollen
- A pale color and lowered skin temperature over the toes and feet when compared to the legs
Acute Compartment SyndromeThis places increased pressure in the muscle tissues of the leg. It can lead to loss of blood supply in and around the affected area. The sciatic nerve can also get compressed from the increased pressure in the buttock, thigh, or leg. The condition can cause pain, numbness, and weakness in the buttock, thigh, and leg. Individuals have also reported an unusual/altered sensation in the web of the great toe. This is similar to sciatica, as well as one or both legs can be affected. Differentiating symptoms include:
- Leg becomes swollen
- Pain and tenderness present when touching the leg
- A pale color and lowered skin temperature over the leg
- Heart conditions
- High cholesterol
- History of having the condition can also cause a recurrence. This can be from an injury or poor health.
Therapy For Sciatic Nerve Pain
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- Javdanfar A, Celentano C. Sciatic artery aneurysm. West J Emerg Med. 2010;11(5):516-517.
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