Premenstrual sciatic nerve pain

Image by, courtesy of Jan Tik

Pain radiating from your pelvic region and travelling down your leg before your menstrual period could be premenstrual sciatic nerve pain. It is a painful condition that is caused by the sciatic nerve being aggravated by endometrial tissue growing in your abdomen that is attached to or that is near your sciatic nerve. The hormones during your menstrual cycle trigger the endometrial tissue to swell and press on the sciatic nerve causing pain. While surgery is the most common solution, hormone therapy and pain management may also be options for the treatment of premenstrual sciatic nerve pain.

What Is The Sciatic Nerve?

Your sciatic nerve is a large nerve that runs from the middle of your lower back down both legs. It runs behind the knees and down into the feet. The sciatic nerve controls the feelings in the legs and when it becomes irritated can cause pain in the lower back, hips and legs. The pain may start as tingling and progress to weakness and numbness. The pain may radiate as far down as your toes.

What Is Endometriosis?

Endometriosis occurs when the uterine lining grows outside of the uterus. Its cause is not known, but affects 1% to 5% of women in child bearing years. The tissue can grown on the bladder, ovaries or in the abdomen. Symptoms can include painful periods, heavy periods, pain in the pelvis area and pain in the lower back area. Left untreated, endometriosis can cause infertility because the tissue can block off the Fallopian tubes connecting the ovaries to the uterus.

Endometriosis symptoms are worse before and during your menstrual cycle because each month the body tells the uterine tissue to build up the lining of the uterus. Since there is no place for this build-up of fluid to go because the endometrial tissue has grown outside of the uterus, it is either released into the body causing inflammation or it is contained in a fluid filled sac similar to a cyst. This build up of fluid and tissue causes the nerve to become inflamed. This can cause the endometrial tissue to aggravate the nerves and organs near their location, thus causing pain.

Symptoms of Premenstrual Sciatic Nerve Pain

When the endometrial tissue grows outside of the uterus near the sciatic nerve, it can cause severe pain radiating from your lower back down into your hips and legs. The pain can become severe enough to disrupt normal daily activities. The endometrial tissue can attach itself to the sciatic nerve. Bowel problems such as diarrhoea, constipation, pain and bloating can occur.

Surgical Treatments

Laparoscopy can be used to diagnose and treat endometrial tissue growth. Surgeons use intense heat to destroy the endometrial and scar tissue. Less damage is caused to healthy tissues by this procedure. Recovery time is much faster than with traditional surgery.

Laparotomy, or major abdominal surgery, is sometimes needed if the endometrial tissue area is large. In this method, the surgeon makes a large incision in the abdomen and physically removes the tissue. Recovery time for this surgery can take up to two months.

A hysterectomy is a last resort and only used if the endometrosis has damaged the uterus or ovaries. The surgeon removes the uterus and the ovaries if they are affected. Recovery time for this procedure can be from four to six weeks.

Hormone Therapy

Your doctor may prescribe hormonal therapy if your pain is not severe and surgery is not warranted. This includes birth control pills. Progestins are used for women who can not take oestrogen. Both of these are used to regulate your periods and lessen the symptoms.

Gonadotrophin realeasing hormone agonists (GnRH) work by reducing the amount of oestrogen in your body. This helps to relieve the symptoms and stops your periods. It is not recommended to stay on this therapy for more than six months unless you take oestrogen along with the GnRH.

Pain Medications Used To Alleviate Symptoms

Your doctor may have you treat your symptoms with over-the-counter medications such as naproxyn (Aleve) or ibuprophen (Motrin or Advil). If these do not relieve your pain, she may prescribe stronger pain killers for you.

Living With Prementrual Sciatic Nerve Pain

You can lessen your symptoms by limiting your consumption of caffeine and alcohol. Regular exercise may help to alleviate some pain. Using heat or cold compresses may offer some relief. Getting support online can help you cope with the emotional aspect of this condition. Communication with your doctor and learning all you can about your condition can help you find relief.

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