Sciatica - is there a concern?

Question

I have been positive for approximately a year and a half. My numbers have been quite good and therefore I am not on a treatment regimen. In the past 6 months or so I have developed sciatica. I have occassional flare ups. In researching sciatica on the web numerous sites indicate to let your doctor know of your sciatica immediately if you are HIV positive, but I have been unable to find an answer as to why. In reviewing this forum, I see there is the potential of drug therapies triggering this. However, since I am not on any drug therapy at this time is this something I need to be concerned about in regards to my HIV status? Is sciatica only a concern for an HIV+ person who is on a drug therapy?

Answer

Sciatica is a pain that travels along the sciatic nerve often down the buttock and the back part of the leg to below the knee. In most patients (including those with HIV) it is due to nerve root compression from a bulging spinal disc or pressure from the overlying muscle. Various forms of arthritis with bone spurs, tumors, metabolic conditions (such as diabetes), or infections can cause pressure on the nerve. If your CD4 count is good (> 350) and you have sciatica then most likely it is due to a non-HIV related problem but a good neurologic evaluation as possible a spinal column scan (often MRI or CT) would help delineate the cause. KH