Endometriosis is a chronic condition that affects roughly 10% of reproductive-age women and girls globally, according to the World Health Organization (WHO). It is a disease in which tissue similar to the lining of the uterus grows outside the uterus, causing severe pain in the pelvis and making it harder to get pregnant. In rare cases, this phenomenon may also affect the sciatic nerve, which is the largest nerve in the human body, originating in the lower back and extending down the back of each leg. This is also known as sciatic nerve endometriosis.
In an interaction with the OnlyMyHealth team, Dr N Sapna Lulla, Lead Consultant – Obstetrics and Gynaecology, Aster CMI Hospital, Bengaluru, explains the condition in detail and shares effective treatment strategies.
Also Read: Surprising Signs Of Endometriosis In The Leg
What Is Sciatic Nerve Endometriosis?
As is known, endometriosis is a chronic disease. But what's more unfortunate is that it has the tendency of infiltrating almost every organ in the body, greatly impacting the quality of life for women, says Dr Lulla.
"One of the most incapacitating forms of endometriosis is endometriosis sciatic nerve pain. In very rare cases, it may be accompanied by intermittent sciatica pain. Women of reproductive age frequently suffer from deep forms of endometriosis, where some patches of endometrial tissue become active. This type of endometriosis is rare, with about one per cent of women undergoing it," she adds.
What Causes Sciatic Nerve Endometriosis?
Sciatic nerve endometriosis is a rare form of endometriosis that occurs when endometrial tissue grows outside the uterus and affects the sciatic nerve, causing pain and other symptoms.
While the exact cause is unknown, it's said to involve retrograde menstruation, direct infiltration, and possibly hormonal factors.
Retrograde menstruation is when menstrual blood and tissue flow backward through the fallopian tubes and into the pelvic cavity instead of out of the body. On the other hand, direct infiltration refers to the invasion of endometrial tissue directly into surrounding organs or tissues, such as the uterine muscle or nearby structures like the bladder or bowel.
Symptoms Of Sciatic Nerve Endometriosis
“For women with sciatic nerve endometriosis, pain is experienced in the upper ligament of a joint or the hip region, where sharp pain intensifies when they lie down in bed or are sitting in a recumbent position,” says Dr Lulla.
This may mimic sciatica, which refers to pain along the sciatic nerve, the largest nerve in the body, which runs from the lower back down the back of each leg. In active cases, women can experience numbness, tingling or weakness in the affected leg, particularly lacking treatment.
Also Read: Endometriosis & Women's Health: Doctors Answer Most-Asked Questions on Endometriosis
Treatment Options
Sciatic nerve endometriosis diagnosis consists of a medical history review concerning periodic leg pain and a pelvic exam looking for signs of endometriosis, as well as an MRI screening for lesions on the sciatic nerve with 90% sensitivity. If necessary, laparoscopy can confirm the existence of endometrial tissue.
Medical pain management includes pain relievers, hormonal therapies such as contraceptives or GnRH agonists proposed to suppress the growth of lesions, and occasional nerve blocks providing temporary relief. For enduring relief, laparoscopic removal of the endometrial tissue is the most enduring of relief. In tandem, pelvic floor therapy can complement the treatment.
Conclusion
Sciatic nerve endometriosis can deeply affect a woman's life, often going unnoticed or being misdiagnosed due to its unusual symptoms. The pain may come and go, often mistaken for regular sciatica or period-related discomfort, but for those living with it, the experience can be physically and emotionally exhausting. With the right diagnosis and treatment, relief is possible. If you’ve been silently battling recurring leg, hip, or pelvic pain that worsens around your period, don’t dismiss it. Speak to a doctor and take the first step towards feeling better.