What type of doctor should I consult for a pain that starts from the back of my waist and spreads to the back of my leg?

For the pain to spread down the leg, the nerve must be irritated. Another name of this type of pain is sciatica. It is important to see a doctor to assess for neurological damage. If left untreated, the neurological deficits may be permanent.

Any doctor (family physician, orthopaedic surgeon or neurosurgeon) can assess and provide recommendation for MRI or treatment.

Treatment options for sciatica include conservative treatment with physiotherapy, exercise, medications and even acupuncture. Spinal injection techniques are also available such as nerve root blocks, nucleoplasty, discoplasty, radiofrequency neurotomy. Minimally invasive methods of treatment would include microdiscectomy or endoscopic discectomy.

The main aim of all these treatments is to reduce inflammation of the nerve root to preserve its function and prevent permanent neurological deficits.

It's also important to note a condition known as acute cauda equina syndrome. It may start off as sciatica, but this time, the nerves supplying the bladder and bowel sphincters are affected (usually due to large central prolapsed disc) and the patient presents with urinary or bowel symptoms as well as leg pain/paraesthesia. This is an acute surgical emergency and should be treated at a hospital and surgery to decompress the spine as soon as possible to prevent permanent urinary/bowel incontinence.

According to Dr Fong Shee Yan, an orthopaedic surgeon, any type of pain and/or neurological symptom that originates from the sciatic nerve is referred to as sciatica. The sciatic nerve is the largest nerve in the human body. It is formed by the union of 5 nerve roots from the lower spine. It passes deep in the buttock and down the back of the thigh all the way to the heel and sole of the foot. The sciatic nerve serves a vital role in connecting the spinal cord with the skin and muscles of the thigh, leg, and foot.

You may read his full answer to a similar question here.

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