Arthritis Treatment

Arthritis Treatment, Sacroiliitis and Sciatica in Lancaster, PA

Sacroiliitis

Sacroiliitis is one of the most common reasons a patient presents to the pain clinic. Sacroiliitis is inflammation of one or both of the sacroiliac joints, which are situated where your lumbar spine and pelvis connect. Sacroiliitis can cause pain in your buttocks or lower back and sometimes radiates down one or both legs but generally not past the knees. Prolonged standing or stair climbing may worsen the pain. Some causes of sacroiliitis include ankylosing spondylitis, osteoarthritis, pregnancy, infection, and occasionally from trauma. The diagnosis can be made by taking a thorough history and by performing an extensive physical exam. Occasionally an X-ray or MRI may be ordered to help rule out of abnormalities. Physical therapy, steroid injections and potentially radiofrequency ablation may be performed to help alleviate pain and get a patient functioning again.  Over-the-counter pain medications and muscle relaxants are often helpful to relieve the inflammation associated with sacroiliitis. In cases where pain persists, surgery to fuse the joints may be suggested. Electrical stimulation is also a possibility and works to reduce pain.

Sciatica

Sciatica is also known as sciatic neuritis. The sciatic nerve runs down both legs and when a patient has a herniated disc, spinal stenosis, or bone spur this puts pressure on the nerve and causes radiating pain. It usually only involves one side of the body. It is a very common problem and affects more than 3 million people every year. Although the pain can be severe in some cases, the pain usually resolves without surgery, however patients that have either bowel or bladder dysfunction may be surgical candidates. Some risk factors for sciatica are age, obesity, a job that requires you to carry heavy objects, and twists or turns. Prolonged sitting or patients with little activity may have increased risk of sciatica Diabetes also increases a patient’s risk of nerve damage. Potential complications include the loss of feeling in the affected leg, weakness in the affected leg and most seriously, loss of bowel or bladder function. Prevention includes regular exercise, maintaining proper posture while sitting, and using proper lifting and stretching exercises, which can help alleviate the pain. A thorough history and physical exam will be done to establish a diagnosis. Sometimes X-rays, Electromyography (EMG),MRIs, and CT scans are used to help with the diagnosis.  Treatment may include, anti-inflammatory medication, muscle relaxants, tricyclic antidepressants, and anti-seizure medication or narcotics. Physical therapy can be helpful as well as epidural steroid injections and surgery. Surgery is usually limited for when the compressed nerve causes significant weakness, loss of bladder or bowel control, or pain that is unresponsive to other treatments.

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