Sciatica
Q: I spend my days chasing after two toddlers, so occasional muscle pain is
just par for the course. But about a month ago I began experiencing frequent
and painful cramping in the backs of my legs, especially when I'm sitting. It's
getting so bad that I can't even sit down to enjoy dinner with my family! What
could this be, and what can I do about it?
Dr. Donnica: It's unclear exactly what is causing your symptoms, but it
is clear what you need to do about it: you need to consult a physician for a complete
physical exam. You've described a syndrome called nerve root pressure, which probably
has its origins in some sort of back strain, especially if the pain extends below
the knee. It could be "sciatica" if the sciatic nerves are affected,
but there are many other nerve root possibilities. The pain is generally worsened
by sitting, prolonged standing, forward bending, coughing, sneezing, lifting or
straining (as in a bowel movement). The pain may be temporarily relieved by walking,
lying down, and extending (straightening) the spine. If you have numbness, tingling
or weakness in one or both legs or any loss of bladder or bowel control, this
requires immediate medical attention.
There are many other factors that may contribute to leg cramping, although
the exact causes are generally unknown. Conditions your doctor will want to
rule out include spondylolisthesis (a bulging of the disc between the spinal
vertebrae) and spinal stenosis. Inadequate stretching and muscle fatigue (common
for moms!), deconditioning, dehydration, and depletion of electrolytes (e.g.
potassium, magnesium, and calcium) may also be factors. Self-care tips include
stopping the activity that seemed to trigger the cramp; gently stretching and
massaging the affected muscles; and holding the affected muscles in a stretched
position until the cramp stops. Keep well hydrated and be sure to get an adequate
amount of calcium and magnesium in your diet or with supplements. Most importantly,
however, is for you to get a medical evaluation.
Created: 10/29/2004 - Donnica Moore, M.D.
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