From news9live.com
Wallet-induced chronic sciatic nerve constriction causes lower extremity pain, tingling, and burning sensation. Pyriformis muscle stretching may help
- Wallet neuritis is an example of extra-spinal tunnel neuropathy concerning sciatic nerve.
- Pressure increases in sitting position and result in pressure increases the injury to sciatic nerve.
- It is reversible if diagnosed early and corrective measures are taken
The internet is rife with tips and interesting insights on health and unheard concerns that may occur due to everyday habits which may be as small as even carrying a wallet in the back pocket.
Recently, Dr Sudhir Kumar, a neurologist took to Twitter to share an incident of a 30-year-old patient who consulted him for “severe, sharp pain” from the right buttock to the leg and foot for three months continuously. Highlighting the details of the case he wrote, “Pain was more while sitting and lesser while standing or walking. The pain increased on lying down,” he wrote in the thread — ‘How a valuable possession slowly damaged a young man’s nerve’.
Dr Jyoti Bala Sharma, a director of Neurology at Fortis Hospital Noida told News9, “This is a common problem as a result of pressure on the sciatic nerve. Pressure increases in the sitting position and results in pressure increase injury to the sciatic nerve. This is also known as Wallet Sciatica.”
She suggested that the treatment is not to keep the wallet in the back pocket. She further said, “It is reversible if diagnosed early and corrective measures are taken.”
While mentioning the way they ruled out the cause of pain in the patient Dr Kumar went on to write, after being evaluated elsewhere, an MRI spine ruled out slipped disc and nerve compression in the lower back region. Nerve conduction studies had shown severe damage to the right sciatic nerve but no cause for sciatic nerve damage was obvious, he noted.
The other disease-causing similar problem is the lumbar slipped disc or joint problem of the sacroiliac joint. Can be differentiated by an MRI of the Lumbar spine which will be normal in wallet sciatica, said Dr Bala.
According to PubMed, wallet neuritis is an example of extra-spinal tunnel neuropathy concerning the sciatic nerve. Its clinical appearance often gets confused with sciatica of lumbar spine origin. Wallet-induced chronic sciatic nerve constriction produces gluteal and ipsilateral lower extremity pain, tingling, and burning sensation. It was Lutz, who first described credit-card wallet sciatica in an Attorney, and surfaced in the Journal of American Medical
Association, however, the condition has not been well-studied in various other occupations. Long-standing use of a rear pocket wallet may compress and sensitize the ipsilateral sciatic nerve, generating features resembling lumbago sciatica; thereby, remains a source of patients’ misery and diagnostic illusion for pain physicians as well.
Dr Kumar mentioned in his tweet thread that there was no cause for sciatic nerve damage was obvious. Moreover, on detailed enquiry, the patient informed that he always carried a “fat wallet” in his right back pocket, which remained in his pocket while he sat in the office during work (10 hours a day). Now, I could guess the cause. The cause was “fat wallet” syndrome,” he added. The wallet compresses the pyriformis muscle, through which the sciatic nerve passes, thereby compressing the sciatic nerve. The wallet can also cause direct compression of sciatic nerve branches.
As a treatment of this, the expert “did not order any investigations” he said. Rather he advised the patient to remove the wallet from the back pocket while sitting. Pyriformis muscle stretching exercises were also taught to him. One month later, he was much better. Pain score had reduced from 7/10 to 1/10 on the visual analogue scale, explained Dr Kumar.
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