J Anesth Perioper Med. 2018;5(6):325-332. https://doi.org/10.24015/ebcmed.japm.2018.0113

Chronic Sciatica Induced by Endometriosis

Sisi Chen

From the Pain Research Center, Department of Anesthesiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Correspondence to Dr. Sisi Chen at sisi.chen@uc.edu.

EBCMED ID: ebcmed.japm.2018.0113 DOI: 10.24015/ebcmed.japm.2018.0113


Abstract

Aim of review
Endometriosis is known as a chronic disease in which endometrial stromal and glandular cells appear outside the uterus cavity, causing mainly infertility and chronic pain. Endometriosis of sciatic nerve is uncommon and can cause severe sciatica, with the mechanisms not clearly recognized. Along with the physical symptoms, there might be psychological issues in women who have endometriosis. Understanding the interaction between the endometriotic lesions and the nervous system will help to improve the current diagnosis and the effective management of sciatic endometriosis.

Methods
As we know that the pathogenesis of endometriosis mainly refers to inflammation and neuropathy, which brings out some study bases of endometriosis-induced sciatica. First, this review focused on the development of sciatic endometriosis as well as reporting related clinical cases of patients who had sciatic endometriosis; second, we narrated the main symptom of sciatic endometriosis, which is chronic sciatica, and its potential mechanisms; finally, we discussed the existing diagnosing theory and management with the hope of exploring better strategies for future references.

Recent findings
Diagnosis always can be made by magnetic resonance imaging (MRI) and surgical gross findings with histopathological examinations. The findings that endometriallike tissue can develop at the sciatic nerve, offer new insights for better understanding and treating sciatic endometriosis. Many studies have reported that the symptoms could be alleviated by surgically removing the endometriotic lesions. New evidence showed that in a rat model, sciatic endometriosis could cause neuropathic pain and local inflammation.

Summary
This article is aimed to review reports about chronic sciatica induced by endometriosis, explore the possible mechanisms and come up with effective treatments.(Funded by the National Institutes of Health.)

Article Type
Review Article

Declaration of Interests
The authors declare no conflicts of interest.

Acknowledgements
This study was supported in part by grants (NS045594, NS055860, and AR068989) from the National Institutes of Health.

This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.