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Author Topic: Siatic nerve pain  (Read 7551 times)

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Offline doctorb

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Re: Siatic nerve pain
« Reply #20 on: June 01, 2018, 07:04:32 PM »
There's been a lot of posts about MRI's.  I'd like to throw in a few thoughts....

MRI is a wonderful modality to demonstrate hard and soft tissue findings within the spine, but is not some sort of full-proof perfect vision into your back that will 100% tell you:  1) What exactly is the reason for your pain and 2) What you have to do, including surgery, to relieve that pain.  When MRI first came out, it became almost like a religion.  We started operating on the MRI and not the patient.  Any detected abnormality seemed to become an indication for surgery.  There are all kinds of abnormalities within our aging spines, and the MRI will probably overstate many of them.  MRI's are often over-read, meaning the radiologist can over interprets what he/she sees.  The radiologist's reading is then sent to your doctor, who, unless he/she is a spine specialist, does not have the expertise to interpret the images themselves, and therefore accepts the radiologist's interpretation without question.

Look, MRI has demonstrated many exact problems within many patient's spines.  But those of us who are aging have abnormalities at multiple levels of our spines, and have multiple locations where nerves can appear compressed.  What is THE MOST IMPORTANT FACTOR is having a physician who takes the time to do a detailed physical/neurological examination to determine where in your back, which nerve root or roots, your irritation arises.  If, after an adequate trial of rest, PT, and maybe injections, your symptoms continue to be unbearable, you may be a candidate for surgery.  But that surgery should only occur when the MRI demonstrates an abnormality that accurately coincides with the findings on your physical exam.  If the MRI does not correlate with those findings, despite continuation of the patient's pain, surgery is very unlikely to help and should probably be avoided.

So the MRI is not a miracle truth detector.  It's a diagnostic tool that is part of the assessment of spine pain.  It does not always provide all the answers.  It is not an instant roadmap of your problem and your next step.  And it can be over interpreted leading to unnecessary and or unsuccessful surgery.  But when used wisely by good physicians, it is an invaluable test for better understanding of a complex problem.

As always, if you have been told that you are a candidate for spine surgery, I strongly suggest that you receive an unbiased second opinion before undergoing the knife.
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Offline Runningalucas

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Re: Siatic nerve pain
« Reply #21 on: June 01, 2018, 09:53:34 PM »
I just made the MRI rounds for my lower spine, and hips; also had a leg length test.  My overall opinion, I've always done holistic type stuff instead of the MD, and so far, I'm kinda glad.  Due to scoliosis, degenerated L4, and L5, they sent me into a consult I wasn't ready for; spinal fusion.  

Having L4, and L5 fused, fine, but oh, with scoliosis, at least according to the surgeon, it would mean a complete fusion all the way up into the thoracic region.  It really sounded like rods, or even any fusion should be used as a means of last resort, simply to be able to walk.  I skirted around it, and for the most part got the answer that after surgery, my spine would be perma-light duty. 

For now, and I've not seen it listed in this thread, and maybe someone will tell me it's horrible, but I'm thinking that I'm going to go with the Regenexx stem cell therapy for those 2 discs.  From what I saw online, it works fairly good, and is long lasting.  I asked the surgeon about the stem cells, and they simply had no comment; it's just another form of treatment in their eyes I guess, and separate from their discipline. 

Everything in the AMA seems very compartmentalized, and somewhat like an sales model using a lot of upseliing. 

Offline Southside

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Re: Siatic nerve pain
« Reply #22 on: June 01, 2018, 10:22:32 PM »
I would be in interested to hear more about this stem cell technique you mention.  I do believe the MRI is a good tool to help in determining what is wrong.  I destroyed my L4,L5, and the discs in addition to some issues in the neck region, have done the PT, Chrio, injections, surgery, holistic, you name it.  The back is pretty decent these days, compared to when I could not walk that is, but I do have numbness in my feet and arms / hands, and have lost a lot of strength in certain muscle groups.  It's pretty embarrassing when the therapist tells you to resist the force of her hand against your leg, which she is barely touching and you tell her you are resisting it. 

Your observation about the compartmentalization of medicine is spot on.  
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Offline Runningalucas

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Re: Siatic nerve pain
« Reply #23 on: June 01, 2018, 10:33:17 PM »
I would be in interested to hear more about this stem cell technique you mention.  I do believe the MRI is a good tool to help in determining what is wrong.  I destroyed my L4,L5, and the discs in addition to some issues in the neck region, have done the PT, Chrio, injections, surgery, holistic, you name it.  The back is pretty decent these days, compared to when I could not walk that is, but I do have numbness in my feet and arms / hands, and have lost a lot of strength in certain muscle groups.  It's pretty embarrassing when the therapist tells you to resist the force of her hand against your leg, which she is barely touching and you tell her you are resisting it.

Your observation about the compartmentalization of medicine is spot on.  
LOL, been there on the 'I am resisting'...   I'm trying to schedule the stem cells in July.  From what I've read, and been told, you go in, they draw blood for plasma, then they also numb out a hip, and draw the stemcells from the hip.  They process the blood, into a platelet rich formula along with mixing in the stem cells harvested from the hip; then inject.  
https://www.regenexx.com/regenexx-procedures-family/the-regenexx-procedure-explained/

Offline tree-farmer

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Re: Siatic nerve pain
« Reply #24 on: June 02, 2018, 07:14:56 AM »
After half dozen adjustments by chiropractor back is much improved. Seems that sitting aggrivates  it more than anything. My job requires sitting at CAD station, but I have been making a point of getting up every hour or so and walking through shop plus  walking or working outdoors after work to keep pain at bay. 
Wearing a back support  when doing lifting jobs seems to help some too.
A little Irish whisky and Motrin also helps take the edge of the pain as well.

Goal is just to stay functional for as long as possible without more extreme measures.
Old doesn't bother me, its the ugly that's a real bummer.

Offline doctorb

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Re: Siatic nerve pain
« Reply #25 on: June 02, 2018, 08:27:46 PM »
Yes.  Medicine is compartmentalized.  There are those physicians and patients that believe in a treatment, those that want to believe, and those that don't believe.  This is very true for stem cell treatments.

These stem cell therapies have become very widespread throughout many areas of medicine.  The theory is simple...put some non-differentiated cells into an area of inflammation or injury, and they will "regenerate" or modify themselves to solve the problem.  Fix things.  Repair arthritis.  Cure tendonitis.  etc.  Easy peasy Lemon squeezy.  Not so fast, my friends.

As a doc, I am one who is based in science.  I am hopeful that science can demonstrate that these immature cells have the ability, once injected, to sense what is wrong and repair it.  However, real science has yet to back up this hopeful blueprint.  There are studies of improvement in neural function in non-human experiments, but long term clinical studies have yet to show any real improvement.  Yet we inject this stuff everywhere in the body, and do it multiple times (a friend of mine had 6 injections over 15 months for his patellar tendonitis.  He eventually got better, and swears by the treatment.  Would've probably resolved in that amount of time with no treatment.)

Now, the people doing the injections, they are gung ho!  And the risk of a problem from an injection of your own blood products is incredibly low.  So with very low risk, and the alternative treatments being much more costly and invasive, why not give stem cell therapy a try.  Makes sense.  Just doesn't yet have the scientific backing to say it truly works.  

So get in line for your injections, but don't have your head in the clouds.  It's not yet the miracle they want you to believe it is.  Someday.....
My father once said, "This is my son who wanted to grow up and become a doctor.  So far, he's only become a doctor."

Offline alan gage

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Re: Siatic nerve pain
« Reply #26 on: July 20, 2018, 04:50:51 PM »
Thanks for your insights doctorb. Nice to hear it from a doctor's perspective.

My 5 weeks of physical therapy are done. Improvement in some areas and backsliding in others. Most of the nerve pain down my legs is gone but still some, especially in the early morning. Still lots of hip pain and SI joint pain. Very stiff trying to bend at waist and poor mobility. Can walk ok but nothing faster. I'd say maybe 30% improvement overall after physical therapy. Don't know how much to contribute to physical therapy and how much just because it's been another 5 weeks. Seems to be making slow but steady progress no matter what I do.

Went back to the doctor and he ordered an MRI. Results were some bulging in the L4/L5 and L5/S1. Doctor is 2 hours away from me so I haven't talked to him directly yet, this was just through some sort of secretary that called to schedule things. We'd talked about a cortisone injection ahead of time and he still thinks that's the next best step so I go back out there Wednesday for that and a little chat.

Sounds like I shouldn't expect the shot to be a cure-all but hoping it will provide some pain relief and that by the time it wears off things will be feeling much better. I'm guessing if nothing else it would make a good diagnostic tool to determine if that's really where my trouble stems from.

Assuming this eventually gets better on its own it sure makes me worry about the future and this happening again. Going on 8 months now. Slowing me down a lot this summer. My idea of fun is taking 30+ day solo canoe trips into remote areas of Canada. Can't imagine having this happen in the middle of one of those. Certainly no trips this year.

Alan
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Offline alan gage

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Re: Siatic nerve pain
« Reply #27 on: July 26, 2018, 12:19:23 PM »
Got my shots yesterday. Left and right side. Not a big deal. Feeling some improvement already but not pain free. They said I could expect the quick acting pain reliever to wear off in a day and up to 5 days for the steroids to really kick in.

Alan
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Offline Ed_K

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Re: Siatic nerve pain
« Reply #28 on: July 27, 2018, 07:47:28 AM »
 The steroids should work. I have had incidents where I've damaged the L4-L5 disk and demanded the steroids  and they work for me each time. they stop the swelling of the disk I think.
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Offline alan gage

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Re: Siatic nerve pain
« Reply #29 on: August 03, 2018, 05:18:37 PM »
A few days after the steroid injections I felt very good. So good that I decided to redo my girlfriend's deck so she could get her house sold. Worked hard on it all weekend. Tried to work smart. Didn't lift anything very heavy and lifted properly. Didn't really feel any pain while doing the work and went to bed Sunday night feeling tired out but otherwise fine. Woke up Monday and could barely walk. Haven't had this much pain since it was at its worst in February/March but it feels a little different. More of a single sharp pain in the buttock rather than multiple hip/back/buttock/leg with radiating nerve pain as well. Been taking it easy and stretching. A little better now on Friday. Mornings are bad news. By the afternoon I feel better, especially if I keep moving. Sitting and then standing is the worst.

It's a wonder we do these things to ourselves.

Alan
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Offline Southside

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Re: Siatic nerve pain
« Reply #30 on: August 03, 2018, 10:31:14 PM »
It's very hard to sit still when you finially have relief after so much time hurting, but you need to. The shots eventually become less and less effective. Let your body heal. 
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Offline Runningalucas

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Re: Siatic nerve pain
« Reply #31 on: August 04, 2018, 12:32:40 PM »
I got my Platelet enriched Plasma last Thursday morning(week and 2 days).  I basically tried to take it easy for a few days, and did okay doing that; as I was trying to let the platelets do whatever they do.  I've read a lot of different things on how it's necessary to take it easy after the platelet injections,  and the doc said no heavy lifting for a couple weeks.  I guess the cells are fragile until healing begins??? Any ways, LOL, forget the fragile...

By Monday, I was fabricating almost all day long.  I noted no fatigue, and was able to stand up, crouch down, stand up, crouch down, stand up, crouch down, most of the day.  Before the procedure, I'd be lucky to get in around an hour of such work before needing to stop.  It was actually a little intimidating, as I ended up waiting for the big blow out to strike, and the longer it went without, the more I thought, 'uh oh' was going to come.... you know, stuck somewhere, and it goes so bad you can't move.

Since then, the last few days have been spent on the backhoe clearing brush, and stumps.... I didn't think of it as being hard on my back, till I saw the gopro footage that I was taking of doing the work; I was getting thrown around fairly good, I guess you just don't notice all that much....  Anyhow though, the back is still doing fairly good; by now, I would've needed around a week off to let the glass in my back settle down, but so far, I'm just 'this side' of the 'glass'.

I guess time will tell, supposedly it just keeps getting better, but with as hard on my back as I am, we'll see...  If it does, WOW.

Offline alan gage

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Re: Siatic nerve pain
« Reply #32 on: January 15, 2019, 03:27:16 PM »
This isn't my thread but figure I've posted enough of my progress (or lack of) so I might as well keep going.

My last update looks to have been August. Things settled down after the deck installation induced pain and were better than before the cortisone shot. After a few weeks things started getting more painful again. Talked to doctor again and we decided to try another shot in October (I think). I had relief the day of the shot and then nothing.

Pain began to get worse end of November so I went to see a different chiropractor who did a lot of painful elbow massage and stretching in addition to adjustments. After 4 or 5 visits I was a little worse than when I started (things felt aggravated) and he threw in the towel.

Had to wait until early January to get back into see my back doctor. He wasn't convinced surgery would be required but wanted to consult with a surgeon anyway. Before doing that he ordered a nerve test saying the surgeon would want to see it before giving an opinion. It showed the S1 nerve has some signs of aggravation, helping confirm the original diagnosis. Got a call a few days later saying they recommend I go see a Neurosurgeon. They're supposed to be calling to schedule me in the next couple days. Will be interesting to see what he has to say.

My day-to-day now consists of high levels of sharp hip pain during the night if I try to sleep on my side. Sharp pain in my lower back (right side SI joint?) at times, often when I raise my right arm, nerve pain in the back of both thighs, both outer calves, and outer ankles. Often worse when standing and sitting in my office chair. This comes and goes. The right side is worse but the left side will hurt too, sometimes both at the same time. I now regularly get pins and needles from my outer calf to top of foot. Mostly right side, sometimes left. I also get passing waves of intense throbbing pain in my rear thighs/buttocks/and what feels like a little below the SI joint. These usually occur when I stand from a sitting position or stretch/move wrong when seated. It mercifully passes after 5 seconds or so. I have extremely limited flexibility, especially in my right hamstring. If I work on that area I can get it to loosen up but 5 minutes later it will be as tight as ever.

Sometime in September I started taking ibuprofen at night so I could sleep. Sometime in November I started taking it during the day too. Even with the ibuprofen things feel far from good but without it I'm very not happy.

Nothing seems to make it better. I'll be diligent about doing the PT exercises and after a couple weeks with little to no progress I'll start to think maybe I'm actually making things worse. So then I'll stop doing my exercises. Either way it feels pretty much the same.  I'll try taking it really easy for a couple weeks and no change. At the end of the year I took 3 weeks off work thinking being on my feet and moving around all day might make a difference. Nope again.

Alan
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Offline Old Greenhorn

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Re: Siatic nerve pain
« Reply #33 on: January 15, 2019, 04:21:26 PM »
Did you ever try the acupuncture? We have some practitioners around here that work wonders. Also, if you have not tried it yet, the inversion table should at least give you temporary relief. Every one is different, every body and injury are different. Keep your chin yup and don't give up looking for the CORRECT solution. It IS out there. Mine happened to be the RIGHT chiropractor. he is now fixing what the neurosurgeon could not 12 years ago. Keep the faith.
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Offline Ed_K

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Re: Siatic nerve pain
« Reply #34 on: January 16, 2019, 10:17:34 AM »
 This makes me MAD. I can't believe that you're not getting better. Did they allow you to get an MRI?
  I went back thru this whole thread, I spoke about my problems with my L4-L5 disk and what they did to repair me.
  At reply 28 I miss spoke of more injuries to L4-L5 which is wrong it was the disk above there.
 Now back to the present, I wish I had tried the inverted table thing but I didn't. It wasn't something offered to me. I did finally get the MRI and operation but only after I was at the point of laying on the the floor crying from the pain or dead asleep from pain killer's. I couldn't walk and when they operated they said another week and I would of never walked again.
 It's been almost 3yrs since I lost my youngest son at 36 yrs old from doctors miss-diagnose of his pain in the upper disks in his back and neck. Kept doing shots into the sciatic never. They never took the pain away. And they kept giving him more pain meds even to the extent of pain patches. Some a hole told him that if he sucked on the patch it would work better.That over worked his heart an killed him.
 DON'T GIVE UP, keep telling them to do something. Like Doc said maybe even stem cell treatment. There is a whole lot more to stem cells. So you would need to ask lots of questions to know how and why they would work for you. I had a stem cell transplant of my own cells to get me to remission from cancer, where I am now. Rita just had an operation on her foot and they used stem cells to grow new skin in the incision.
 Do something don't end up on the floor crying!
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Offline alan gage

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Re: Siatic nerve pain
« Reply #35 on: January 16, 2019, 10:44:04 AM »
Did you ever try the acupuncture? We have some practitioners around here that work wonders. Also, if you have not tried it yet, the inversion table should at least give you temporary relief. Every one is different, every body and injury are different. Keep your chin yup and don't give up looking for the CORRECT solution. It IS out there. Mine happened to be the RIGHT chiropractor. he is now fixing what the neurosurgeon could not 12 years ago. Keep the faith.
Haven't tried acupuncture yet but am not ruling it out.

Thanks,

Alan
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Offline alan gage

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Re: Siatic nerve pain
« Reply #36 on: January 16, 2019, 11:06:18 AM »
This makes me MAD. I can't believe that you're not getting better. Did they allow you to get an MRI?


Yes, MRI was done sometime this last summer. Bulged discs at L4/L5 and L5/S1 that appear to be pinching the nerves.

I'm frustrated at not getting better but so far I've been happy with the medical care and advice I've received. I do diagnostics for a living (auto repair) and can see that the doctor is going through the same process. Start with the simple and work up based on the problem. He suspected the bulged discs even before the MRI and prescribed physical therapy. When that didn't work he ordered the MRI which confirmed the bulged discs and then he ordered cortisone shot. After the shots had limited success I decided to wait a couple more months to see what happened. Then I went to see a different chiropractor and when that still didn't help I went back to the doctor last week.

When I talk to other people who have had bulged discs and search on the internet it appears most people get better after a few weeks of rest and stretching or physical therapy. My doctor told me that's how it normally goes too. But apparently I'm special and now I'm meeting with the surgeon next Tuesday to see just how special he thinks my case is. We've been climbing the diagnostic ladder and hopefully we're now near the top. I'm very curious to see what he has to say.

I really appreciate your concern and thank you for relating your story. Very sorry about the loss of your son. Can't imagine how difficult that would be, especially under those circumstances.

Alan
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Offline samandothers

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Re: Siatic nerve pain
« Reply #37 on: January 16, 2019, 12:59:54 PM »
I set here reading this 2 weeks out from having a fusion surgery.  Mine was on the other end of the spine C7-T1 and my second fusion surgery and fourth for my issues.  It has been a process.

My initial symptoms were wrist/lower arm pain and finger tingling.  Job was a lot of sitting and typing.  Off to the hand doc.  Diagnosis of carpal tunnel and tried cortisone, carpal tunnel surgery, physical therapy.  Not much if any help.  Hand doc then suggested neck xray and results sent me to neck doc.  
Then MRI of neck and found disc issues.  First surgery was discectomy and fusion of C5-C6-C7 5 years ago.  Did not go to the next level of T1 though there were signs of some issues there.  With nerve damage I was told it can take 6 months or more for them to heal.  There were some improvements but was having pain in elbow that was not improving. Off to the elbow doc.
Test results and thoughts are issues with the funny bone nerve, ulnar nerve.  A year after the first fusion had cubital tunnel surgery (elbow).  Things were better.
In last year I have had return elbow and forearm pain.  In addition I had numbness tingling in my lower back and feet.  Started to also have issues with being unsteady on my feet, just did not feel right.  Back to the neck doc another MRI and results were this last fusion.

Long winded way of saying it is a process that may be a bit different for all.  With help from the medical folk, others input and our research we find a course.  We hope and pray it is the right course.  Time will tell if this was my right course but I felt I had to do something, not ready to settle.  

Press on until you find your right course!


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Offline charles mann

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Re: Siatic nerve pain
« Reply #38 on: January 16, 2019, 09:35:11 PM »
broke my back in iraq, l5 and s1 were busted from my body armor making contact with the bones and the ramp flooring. we came in to an lz, i dropped the ramp, went to run off the ramp to provide security and slipped on some oil form our aft xmsn. i couldnt move my legs, so a pilot raised the ramp from the cockpit and flew me to bagdad from the vibration during the 1hr flight or just luck, or whatever it was, when we landed, i could move, but couldn't walk 3 days later, i was able to walk, but not well, but well enough to go back my unit. several wks later, i was cleared back for flt duty. i ate pain meds like it was candy for 2 yrs, even had injections of a steroid and lidocaine cocktail, plus prescribed morphine pills, delaudid and percoset. i finally was able to sleep by doubling the dosage and chasing with a 6 pack of bud light. i could at least get more than 2hrs of sleep a night. 
i also messed some nerves up in my upper back, that caused my left arm to go numb while crewing. i couldn't even tell i was holding the 240 (new version of the pig (m-60) for you old timers) or feel my flight suit flapping against my arm. the nerve damage made it to where long drives, or if i was doing the flying, long flight, sitting idle in 1 position holding the controls (fixed wing was better, i could set the eng power, and fly with my right hand. heli, not so much, gotta be johnny on the spot with he collective (up and down lever) in case the eng crapped out, or whatever mother nature decided to throw at me), my arm would be numb, and i had a spot on my left should blade area, about the size of a coke can, that would feel like it was on fire inside, but the surface skin was numb, as numb could be. 10 yrs later, after yrs of listening to the va say there is nothing wrong, i had a civi neurologist test me, and wow, the va was wrong, i had an electrical disconnect between my back, down my arm and into my hand. a bit of nerve relocation, I'm sorta fixed. 
now my sciatica, nope, ill live with the everyday pain and numbness in my legs and feet. i can walk and run, climb up and down the aircraft, do my job, put food I'm belly, and I'm not letting anyone mess with it. i know a few other soldiers who wrecked their backs in acft crashes/hard landings, and they either have to have a walker or cane to move around, or now have a new profession, bc they can't bend over to pick a piece of air off the ground.   
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Offline Greyman

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Re: Siatic nerve pain
« Reply #39 on: January 17, 2019, 03:29:39 AM »
I don't have much faith in MD's when it comes to back pain, they just treat the symptoms and don't step back and take into consideration the entire 'system'.  Then when it's too bad they go to surgery.  I had bad sciatica for years and finally went to a chiropractor.  The first one was ok but didn't help a whole lot, then I found another who helped a lot but was pretty erratic in his treatment and I kind of lost confidence.  I finally went to an MD and got steroid injections - the first 2 did nothing then the 3rd one helped.  Keep in mind it just kills the pain, it doesn't fix the problem.  I can still tell when my back is tight and limits movement.
The best things I've found is to stretch the hamstrings.  I found a technique where you lay on your back on the floor with the legs up the wall that really helped.  I would go from crippling pain to jumping around after 20 minutes of that - focusing on relaxing and stretching the lower back and hamstrings while in that position.
A doctor told me that the percentage of people with bulging disks is roughly the same as your age - 50% for 50 year olds for example.  If you are 6' tall or over the percentage goes up.  An MRI will show that, but it really doesn't mean much.  


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