A new nerve imaging technology called magnetic resonance neurography does a better job than conventional MRI in diagnosing the cause of sciatica. Sciatica is usually diagnosed through a physical exam and an MRI scan. But of the 1.5 million MRI scans performed each year, only about 20 percent revealed a condition serious enough to be treated surgically.
HOW IT WORKS: Conventional MRI uses radio waves combined with strong magnetic fields to image the soft tissues and organs in the body. Although nerves can sometimes be seen in standard MRI images, the old method has been so unreliable that nerve images have never before played a significant role in diagnosis. MR neurography is capable of generating a detailed image of virtually any nerve in the body. The images are obtained in an MRI scanner, but require special software and hardware upgrades. These images are useful because in most cases, any compression or injury involving a nerve has a distinctive and readily observed appearance.
RESULTS: Following their diagnosis, all patients in the study received treatment to reduce pressure on the nerves and the inflammation: spinal surgery, nerve or muscle surgery, physical therapy and exercise, as well as open MR guided injections. The latter uses a specially designed MRI scanner to guide deep injections of pain medication in the spine, muscles, or near nerves.
WHAT IS SCIATICA: Sciatica is a condition where the sciatic nerve becomes inflamed. The sciatic nerve is the largest nerve in the body, running from the lower spine to down to the back of the knee, where it divides into several branches and continues to the foot. The most common cause of sciatica is a damaged disc in the lower back: the normal cushion between the vertebrae of the spin ruptures, pushing the disc into areas occupied by the nerves. The nerves are pinched or compressed, causing pain.
SCIATICA SYMPTOMS: Common signs of sciatica include:
- A cramping sensation of the thigh
- Shooting pains from the buttock, down the leg
- Tingling, or pins and needles sensations in the legs and thighs
- A burning sensation in the thigh
The American Association of Physicists in Medicine contributed to the information contained in the TV portion of this report.