Siatic nerve pain

[alan gage]

Tried the inversion table last night and will keep trying. So far can't tell any benefit today.

Did as Raider Bill stated and didn't go the full 180. More comfortable and less ankle strain but feels much different than laying flat. I could feel some nerve pain while on the table (which I usually don't feel when laying flat) and when I stood the table back up had a good bit of temporary hip pain (which doesn't normally hurt then). But when I walked across the room it felt a little more comfortable to stride than normal. By the end of the evening everything felt like it has for the last year.

Will keep trying it and see how it goes.

Alan

[Greyman]

When I do my feet-up-the-wall method I also stretch my arms out over my head and consciously push my lower back down against the floor and just generally move my lower back around to stretch it out.  They may help on the inversion table as well.  Also, one thing the table doesn't do is stretch the hamstrings so you might try some of that as well - toe touches while sitting on the floor for example.

[alan gage]

I think I'm done with the inversion table. In addition to my sciatic pain I've got some sharp pain in my right hip and the inversion table is making that much worse. Doesn't hurt much when I'm on the table but when I get off, and for the rest of the night, it's very bad. Even today (the day after using the table) that pain is a good deal worse than it normally is.

Also, one thing the table doesn't do is stretch the hamstrings so you might try some of that as well - toe touches while sitting on the floor for example.

My hamstrings, particularly the right side, are extremely tight and I can't get them to stay loose. It's very frustrating. Tried myself as well as the chiropractors, physical therapist, and massage therapist. We can all get them to loosen up and then 10 minutes later they're just as tight as they were before. I've tried religiously stretching every day and they never seem to loosen up. Each day it's like starting from scratch with no lasting results. After a while it starts to feel like the stretching might be making things worse so I'll quit stretching for a while and can't tell any difference. I'm about ready to start it up again but it's hard to find any way to stretch the hamstrings that doesn't cause a lot of pain (not just tight muscle pain).

Alan

[Raider Bill]

Do you take statins?

They made my hamstrings ache so bad I couldn't sleep or get comfortable. I stopped taking them and the pain pretty much went away.

[alan gage]

Do you take statins?

They made my hamstrings ache so bad I couldn't sleep or get comfortable. I stopped taking them and the pain pretty much went away.

That's interesting. But no. I'm only taking ibuprofen as of the last couple months. Before that wasn't taking anything.
Alan

[BradMarks]

Alan:  I have had a micro discectomy(?) to relieve pressure on the sciatic (right side) and my wife has had fusion. For those that may be reading, fusion is the implant of an titanium apparatus in your spine, and not a small one!. Think of 4 ratcheting screws to open the spine up, click, click.  I assisted my wife for nearly a month in day to day activities until her strength regained. Getting in and out of bed for her was a chore. You get good at the "roll" technique. For me, it was trimming the ruptured disc to fit inside the vertebrate area and relieve pressure on the nerve.  I am not to disagree with your surgeon about "no further damage", your situation could be different. My surgeon told me he had not seen a sciatic nerve compressed as severely as mine, and said "it was time" for the procedure. MRI does not show the severity. Your nerve can only recover if the damage is not permanent. No matter what kind of surgery (if you go ahead) do not ever expect to be 100% again.  Of course you are not 100% now, so 90-95 should sound pretty good.  I am 8 yrs removed from surgery and my wife is coming up on 4.

[Southside]

My hamstrings, particularly the right side, are extremely tight and I can't get them to stay loose.

I have the same issue, and at times for no reason will get massive charlie horses in them, the type that will drop you to the ground right there.  I have never asked but suspect it's related to L5-S1 issues since those will cause pain to travel down my hamstring.  

[Southside]

What was the mixed part? Did it help something else?

Bill,

It helped when I didn't have the fragment floating around.  It does relieve compression as a maintenance process, but for me, after that episode I only consider it safe as long as I am not having significant issues.  Mind you I broke my L5 and my L4 along with damaging discs so I have a lot going on there and not in a good way.  The ER doc told me he was shocked I was walking and during the healing process I was told that if I take another significant hit there I won't be walking, that diagnosis forced me out of my career medially.  I think it's the physical work I do now that keeps me from having more deterioration.  

[alan gage]

Had a lot of pain last afternoon/evening. Didn't do anything strenuous to bring it on. Made me rethink my plans of waiting until next fall for surgery. It's back to "normal" today but it made me realize waiting is a gamble. Getting surgery done in February would leave me (hopefully) mostly recovered by June so I could still get a lot done.  If i decided to wait and the pain got worse I either don't get anything done in the summer because of the pain or because I get surgery done early, which also kills the summer/fall. Plus I'm taking 1600-2000mg of Ibuprofen/day to keep the pain in check and maybe I shouldn't be doing that for another 8 months.

One of the things I want to do this summer is build a shop. Wanted to do it as soon as spring hit but waiting until fall, if I have surgery this winter, wouldn't be a big deal. Even if my pain doesn't increase I'm not sure if I'm physically able to do that in my current state.

Haven't made a final decision yet. First acupuncture session is this afternoon. Will be interesting to see how it goes. 

Alan

[Southside]

At the advice of my doctors I put my last surgery off for a couple of years of on and off again issues until that fragment made the decision for me as I could not walk.  I remember during recovery commenting that I should not have waited so long, the constant pain takes a toll on so many levels that it was not in my best interest to have waited, but that was my experience.  I will say that from my experience your February / June recovery schedule seems a bit optimistic if you plan on doing much serious physical work.  

[alan gage]

At the advice of my doctors I put my last surgery off for a couple of years of on and off again issues until that fragment made the decision for me as I could not walk.  I remember during recovery commenting that I should not have waited so long, the constant pain takes a toll on so many levels that it was not in my best interest to have waited, but that was my experience.  I will say that from my experience your February / June recovery schedule seems a bit optimistic if you plan on doing much serious physical work.  

The "why did I wait so long" seems to be a common theme when it comes to "elective" surgeries like knees and hips. Probably backs too.
As for the June recovery I'm hoping that by June I'd at least be active and happy enough to enjoy the summer. I'd be hoping for more strenuous activities (like building the shop) in late summer or fall. Then I could spend all winter enjoying that new shop rather than recovering from surgery. I'll be doing some Googling to see how most people seem to fair in terms of fusion recovery.
I'm back from the acupuncturist. No immediate results. Will see how I feel over the next few days. Going back again on Thursday AM.
Alan

[BradMarks]

Addressing the "why did I wait so long" issue, I too had the same thing with me. I would ask people who had surgery "how do you know when it's time?" and the response was generally "you'll know when!".  And you certainly will, because if the need for surgery is there, your condition does not get better but does get worse.  That's the physical part.  Being in constant pain is not easy on those around you, my wife was very relieved when I decided to get the MRI, and surgery was shortly thereafter. I was making life H**L for her. 

[samandothers]

Only regret from my fusion surgeries was waiting too long.  My symptoms prior to my first surgery did not totally go away.  Pain did ease and some numbness went away but not all.  
It may be too early to tell results of the second surgery. The doc did say with brushing that has occurred it will not get worse but may not get better.  I am hoping that it will improve more than it has but I am only 3.5 weeks out.  I still have the pain and unsteadiness on my feet.
I feel if I had gone earlier versus putting off 'surgery' I'd be in a better place.  Both surgeries were easy and out with one over night stay.  No lifting over 8 lbs for at least 6 weeks and at that point we'll see.  I will point out my surgery was at the cervical end and not lumbar.  My entry was through front of neck and therefore probably less tissue and stuff to navigate.
Hope the acupuncture works!

[alan gage]

Gave up on the acupuncture after 6 visits. The same place does chiropractic as well and wanted to give it a shot. Second time for that today and no improvement yet.

Last week went to see another neurosurgeon for a second opinion. He wanted to see another MRI to be sure things hadn't changed (last one was in June or July). Went to Sioux Falls yesterday to have that done and met with him the same day. He pretty much agreed with the first neurosurgeon, that I'm probably looking at a fusion to correct the issue.

Sounds like they're still not positive the bulged discs are causing the issue since the bulges just aren't that big. But the L5/S1 is degenerated pretty bad and that's what they're suspicious of. So in a couple weeks I'm going back for a discogram where they'll inject fluid directly into the L4/L5 and L5/S1 discs and if one (or both) of them is causing my issue the pain I've been experiencing will be replicated at the time. If neither disc replicates the pain then it's back to the drawing board.

Doctor said pain shouldn't be too bad; similar to the pressure I felt from the cortisone injections. He also said they'll have an I.V. in place in case the pain gets too severe and then all I have to do is say (scream) the word and they'll send me to lala land.

When I got home last night I made the mistake of Googling the procedure. Sounds like it can be a bit unpleasant, to put it mildly. Thankfully I also found some people who said they thought it was going to be terrible (after reading online) but it turned out to be no big deal. Wonder which one I'll get?

Alan

[red]

In winter of 1998 I had a discogram and I was in major pain . Both my L4-L5 and L5-S1 were Shot . In spring of 1998 I was operated on and fused at both levels.  It was a very slow recovery , until about Christmas time. 

[Southside]

Had one of those done along with a test where they did nerve conduction via electronic signal - not pleasant, but not the worst thing ever, one where they used some hollow needles moving around to listen to the sounds the nerve made - I eventually grabbed the guys wrist and told him not to touch me again or someone else would be listening to the sounds he was making, and the disc-o-gram - they had partially sedated me for that one and even then it was about as bad as when I broke my L5, could not get the pain meds in fast enough.  The problem is if the test is accurately replicating the issue - which in theory is the right result - then you will be replicating the response.  Yea - it's bad, when I accidentally put a 16 penny nail through my finger using a pneumatic framing nailer and pulled it out with a pair of pliers I was told I have a high pain tolerance, but I would never do the disc o gram again.  

[alan gage]

Had one of those done along with a test where they did nerve conduction via electronic signal - not pleasant, but not the worst thing ever, one where they used some hollow needles moving around to listen to the sounds the nerve made - I eventually grabbed the guys wrist and told him not to touch me again or someone else would be listening to the sounds he was making, and the disc-o-gram - they had partially sedated me for that one and even then it was about as bad as when I broke my L5, could not get the pain meds in fast enough.  The problem is if the test is accurately replicating the issue - which in theory is the right result - then you will be replicating the response.  Yea - it's bad, when I accidentally put a 16 penny nail through my finger using a pneumatic framing nailer and pulled it out with a pair of pliers I was told I have a high pain tolerance, but I would never do the disc o gram again.  

I had an EMG test done as well. The needle part didn't really hurt at all. The most unpleasant for me was when they hooked up the electrodes and gave little shocks but even that was bearable since the bursts were so short. 
I've got my fingers crossed on the discogram. I'm going to pretend I didn't see you and Red say it hurts like hell. 
Alan

[alan gage]

I had some interesting talks with my latest chiropractor. He said my SI joint on the right side has little to no movement. My last chiropractor also said things on the right side of the hip weren't moving well at all. New x-rays show my right hip is about 12mm higher than my left. When I had x-rays done a year ago it wasn't nearly so far off. I'm standing more hunched over and crooked than ever before. 

But as to the chicken and egg (are other back issues causing the hip problems or are hip problems causing other back issues?) he says he's not sure. Despite his best efforts to get the hip to loosen up I ended my sessions with him in more pain than when I began, which was the same as the first two chiropractors I'd seen.

After taking 5 days off from chiropractic sessions things were starting to feel a little better but then Saturday I had to quit taking ibuprofen in preparation for my upcoming discogram on Tuesday. Now I can barely sleep or walk. I don't think there's a 90 year old woman in town who couldn't beat me handily in a foot race. Surprisingly enough the nerve pain in my legs hasn't really gotten worse since going off ibuprofen but the hip sure has. 

The last chiropractor I saw was pretty adamant that I should try everything possible to avoid surgery. Said that my MRI and x-ray look better than most of his patients. That surgery shouldn't be required. But he's also at a loss to explain my symptoms and lack of response to treatments. I'm very interested to find out the discogram results on Tuesday and on Thursday I'm going back to see my non-surgical back doctor to get his thoughts. 

I'd love to avoid surgery but mostly I just want to feel human again. 

Alan

[alan gage]

Had my discogram today. When they injected the L4/L5 disc I think my head exploded. But despite the severe pain I didn't think it was so bad overall. I was afraid the pain would last all day (or longer) but in less than a minute after the injection the intense pain had subsided to the same level it was at before. They gave me some of the good drugs via IV after he was done with the injections and the remaining pain just melted away. It probably only took 5 minutes start to finsih for three discs (from the time the doctor started injecting). The L3/L4 gave no pain at all and the L5/S1 wasn't too bad. The L4/L5 leaked some of the fluid out as well. So overall not a pleasant experience but not traumatizing either. 

It's looking more like fusion on two levels (L4/L5 and L5/S1). On Thursday I'll be meeting with my non-surgical back doctor and on Monday will be meeting with a different physical therapist. I want to see if either of them have any ideas on treating the hip pain without going through surgery. In the mean time they're going to try and get approval from the insurance company for surgery. 

Alan

[Roxie]

Please continue to keep us updated on your progress.  Hoping for a good outcome for you.

[alan gage]

Went to see my regular (non-surgical) back doctor today. Just wanted to go over everything with him again to be sure he couldn't think of something we'd missed or if he had any other recommendations or misgivings. He listened to everything I had to say, asked some questions, and gave my hip a going over. He's of the opinion there isn't a problem with my hip (despite having lots of hip pain). He said they often see complaints of hip pain but the source is elsewhere (like my bad discs). He reiterated that fusion is a last resort but seems to be out of other ideas. He said we could try more injections or physical therapy but he wasn't real confident in them doing me much good based on my treatment history.

He didn't come out and say I should have surgery but reading between the lines I think that's what he's leaning towards. I suppose unless they see something really bad then it's a decision that is supposed to be left up to me.

I'll be seeing a physical therapist on Monday to see if they have any bright ideas and hope to see my other neurosurgeon soon to get his thoughts. He's the one that I'd like to do the actual surgery if it comes to that but I'm not sure how soon they can get me in. He's going to review my discogram results and I should be hearing from his office early next week. I have confidence in both surgeons doing a fine job but he's the one I started with and we got along well (not that I don't get along with the other).

At my discogram earlier this week they prescribed me hydrocordone and tramadol. This is the first prescribed pain medication I've ever used. I took a tramadol last night a few hours before bed and I had my best sleep in months. Took another when I woke up this morning and so far feel better today then I have in quite a while. I don't really want to make a habit of using this stuff but it sure is nice to get a little relief.

Alan

[mitchstockdale]

Went to see my regular (non-surgical) back doctor today. Just wanted to go over everything with him again to be sure he couldn't think of something we'd missed or if he had any other recommendations or misgivings. He listened to everything I had to say, asked some questions, and gave my hip a going over. He's of the opinion there isn't a problem with my hip (despite having lots of hip pain). He said they often see complaints of hip pain but the source is elsewhere (like my bad discs). He reiterated that fusion is a last resort but seems to be out of other ideas. He said we could try more injections or physical therapy but he wasn't real confident in them doing me much good based on my treatment history.

He didn't come out and say I should have surgery but reading between the lines I think that's what he's leaning towards. I suppose unless they see something really bad then it's a decision that is supposed to be left up to me.

I'll be seeing a physical therapist on Monday to see if they have any bright ideas and hope to see my other neurosurgeon soon to get his thoughts. He's the one that I'd like to do the actual surgery if it comes to that but I'm not sure how soon they can get me in. He's going to review my discogram results and I should be hearing from his office early next week. I have confidence in both surgeons doing a fine job but he's the one I started with and we got along well (not that I don't get along with the other).

At my discogram earlier this week they prescribed me hydrocordone and tramadol. This is the first prescribed pain medication I've ever used. I took a tramadol last night a few hours before bed and I had my best sleep in months. Took another when I woke up this morning and so far feel better today then I have in quite a while. I don't really want to make a habit of using this stuff but it sure is nice to get a little relief.

Alan

Alan,
Not sure of your whole history or your physical condition / habits but just from quickly reading a couple of your posts it reminds me of a couple things I have heard of before... have you heard of, or considered, spinal decompression.  From what i gather this allows the spine to lengthen and alleviate stress on the discs. I have heard its very helpful on bulging discs.

Another story I remember was on the Joe Rogan podcast with a former wrestler called Diamond Dallas Page. He runs an intensive exercise program that has a yoga base and remember the story of a veteran that could not walk without the help of two canes from an injury while in service, he was able to rehabilitate his injury through the program.  Weak muscles and poor posture put alot of undue stress on your skeletal system especially your spine.   Anyhow here is the link Joe Rogan - Wheelchair'd Vet Walks and RUNS after Yoga Program | "Never Give Up" - YouTube.

I suffer from chronic backpain and acute sciatica...all my problems stem from sitting in a chair 8 hrs a day.  Hitting the gym regularly and focusing on back and core muscles helps keep the pain at bay for me.  Although it difficult to maintain with little kids and ton of other stuff to do.

Hope you can find a solution.

Mitch

[alan gage]

Saw the physical therapist today. He spent about 30-45 minutes with me doing an evaluation asking me questions and figuring out what hurt when. He had me on my stomach doing a combination of things repetitively trying to gain some range of motion before feeling pain in my buttock and my leg tingling. We didn't gain any ground.

My posture is very crooked so he also tried a couple methods of hip repositioning but neither of them worked either. By the time we were done I was just as crooked and in slightly more pain. He said he didn't think he would be able to do anything for me.

It's not really the answer I wanted to hear but I'm glad that he was upfront with me and I wish I'd at least started my physical therapy from 1 year ago in Sioux Falls (where I was today) rather than back home at our small hospital. He appeared to be very conmpetent and seemed to realize the reason why we hit a wall with some exercises when trying PT before. Of course he also has the benefit of MRI and a year's worth of my medical history on this problem.

Anyway, that pretty much clinches it. I'll be having surgery. Can't wait to get it done and start recovering. I'm about ready to leave work now and then I'll go home to lay down and read in bed for 3 hours before going to sleep. Pretty exciting life.

Thanks for the info and links, Mitch. I really do appreciate it.  I've done some reading on the spinal decompression and decided against it since I couldn't come up with any definitive evidence of it working as claimed and at this point I don't want to invest 1.5-2 months into something I'm not confident will work. As for the yoga thing it looks great but I'm not convinced it will work for me (isn't that what everyone says?). I've tried stretching and PT but we've never been able to gain any ground. Before I get to the point where I'm stretching any muscles the nerve pinches and I get a lot of pain in my hip/buttock and my lower leg starts to tingle. This has gotten progressively worse over the last year and it hasn't mattered if I've been up on my feet doing everything I'm capable of (running sawmill, cutting/splitting/stacking firewood, building lean-to addition, putting flooring in my hose, going for walks) or if I've taken it easy for a week or two. Nothing seems to help and I keep going downhill.

Alan

[doc henderson]

alan, I have sciatica as well from an injury trying to move an overweight combative pt.  with mri, you should know if the prob. is a  nerve outlet (surgery may help 50/50) vs periformis muscle spasm/injury/swelling ( injection may help).  Just like you, I avoid surgery if at all poss.  I have a buddy who is a chiropractor, and he did a drop table maneuver to move my SI joint, that seemed to help temp., but not for long.  i had an injection from my buddy a pain doc, and I had foot f\drop for  a day and less pain, then all returned. i got my L knee scoped and my maniscus trimmed, and now my intermittent sciatica is improved.  i was favoring my L knee and flaring up my chronic intermittent sciatica.

[alan gage]

alan, I have sciatica as well from an injury trying to move an overweight combative pt.  with mri, you should know if the prob. is a  nerve outlet (surgery may help 50/50) vs periformis muscle spasm/injury/swelling ( injection may help).  Just like you, I avoid surgery if at all poss.  I have a buddy who is a chiropractor, and he did a drop table maneuver to move my SI joint, that seemed to help temp., but not for long.  i had an injection from my buddy a pain doc, and I had foot f\drop for  a day and less pain, then all returned. i got my L knee scoped and my maniscus trimmed, and now my intermittent sciatica is improved.  i was favoring my L knee and flaring up my chronic intermittent sciatica.

That's interesting about your sciatica improving after some knee repair.
The chiropractors have been using a drop table maneuver on my SI joint as well as other more and less aggressive methods to try and get it moving better; all of which have resulted in more pain and no improved mobility. The last chiropractor, who really seemed to care and know his stuff, just shook his head and said, "that doesn't even make sense" when I recounted my injury and treatment history and he reviewed my MRI and xrays. He was confident something could be done but after 5 visits I was in worse pain than when we started, which has been the case for all the chiropractors (3).
So at this point I've just got to hope the neurosurgeons know what they're talking about. I'd like to think they do since the majority of their patients are the not-so-common problems that couldn't be resolved by more conservative treatment. I'm really hoping to wake up from surgery and have them tell me that once they got in there things looked much worse than the MRI indicated and that I must really be a fine upstanding American to have withstood the pain and discomfort in such an upstanding way and that everyone is sorry they doubted me and that here's a big bowl of your favorite ice cream and that you'll be back to running that sawmill by July. Maybe I'll write it down for them to be sure they get it right.

All joking aside, and this might be premature to write, but being a healthy guy my whole life this is the first time I've ever delved into our medical field. I've got to say that I've been very impressed with everyone I've dealt with; from the people at check-in to the surgeons and anesthesiologists and everyone in between. They've all been friendly, professional, and competent. They all seem to genuinely care about their career and patients. Same goes for the chiropractors.

Now that I hobble around I get asked a lot about what's wrong and also get to hear a lot of other peoples' experiences and I hear a lot of bad stories about incompetent doctors. I'm sure some of those complaints are well deserved but I'm relieved to find it out isn't the norm.

Alan