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So I had your basic, annoying sciatica for about a week. Then three weeks ago it turned really nasty. I can barely walk, even with a walker. My left leg drags because it hurts too much to lift it in trying to walk. I've been to the chiropractor for 8 sessions so far and so far no relief. I've been trying to get into a spine clinic but a computer shutdown makes them unavailable. I'm supposed to start physical therapy next week and do exercises - really? Hopefully I will be getting an MRI and I can get into a pain management clinic and get epidurals. Or maybe I'll get lucky and they'll just stick a needle in my brain and get it over with.
I've gone through 20 tablets of oxycodone in 10 days with another prescription for 40 more. One pill just mitigates the pain enough so I can get out of bed and do things like wash up, throw something in the microwave, maybe get to the store. I can't clean or cook at this point. Two pills allow me to get to the library and get on the computer to complain here about it.
The pain starts in my butt, goes down the back of my thigh, behind the knee, the back of the calf, and now is hurting me in the ankle and in the arch of my foot.
My life is just basically on hold till this $(*^ goes away.
Everybody I know has had or knows someone who has had sciatica.
So what have your experiences been and how the H E double hockey sticks long does it take to go away?
Ouch. I think you're on the right track getting an MRI. I had sciatica for about two weeks. The PCP gave me something to reduce the swelling and inflammation.
I've written about this before on C-D. I had severe sciatica that manifested a year after a car accident. I suddenly got an idea to try acupuncture (after chiropractic did not work), and it turned out to be the exact right thing to do. I could barely walk, sit, drive, get in and out of bed. It took only 4 sessions to be all better. After the first session I had some relief, and after the 2nd session I could get in and out of the car and drive without pain. I kept going for a few sessions after the 4th one. The amazing this is that this happened at the end of 2014 and the sciatica has never come back. Give it a try. It is worth the money.
The pain starts in my butt, goes down the back of my thigh, behind the knee, the back of the calf, and now is hurting me in the ankle and in the arch of my foot.
There's many things that can cause sciatica, and often it can resolve on its own. In my case, I experienced the pain you are describing above (which generally is referred to as lumbar radiculopathy) about 4 years ago. Mine was similar to yours. Started in the middle of the left buttock and radiated down the left thigh and into my foot (though more often than not the pain stopped around my lower calf). I got an MRI a couple of weeks later and it showed a disc herniation with nerve root compression at level L5-S1. The compression of the nerve root by the displaced disc material is what caused the pain.
You may want to do some research on what dermatomes are and take a look at a map of the dermatomes. Doing so helped me better understand things.
Once I knew what was wrong, I spent 8 months engaging in various non operative interventions, none of which worked, including PT for several months, 2 epidural spinal injections, a couple of chiropractic adjustments (which I honestly didn't feel comfortable doing) and acupuncture (which was the only thing that provided some relief, but usually only for a few hours). Ultimately, I opted for surgery, which had a good outcome and eliminated my pain almost instantly.
Oh, and I wasn't ever having anywhere near the pain you are describing, and my medication was limited to only 1 Celebrex a 2 gabapentin per day. It sounds like you are really having some quality of life issues, so I hope you can quickly figure out what's going on and work towards getting it resolved. Good luck. I feel you...
P.S. There have been several threads on sciatica, you may want to search on those if you haven't already.
Last edited by Texas Ag 93; 10-12-2022 at 06:23 PM..
I've written about this before on C-D. I had severe sciatica that manifested a year after a car accident. I suddenly got an idea to try acupuncture (after chiropractic did not work), and it turned out to be the exact right thing to do. I could barely walk, sit, drive, get in and out of bed. It took only 4 sessions to be all better. After the first session I had some relief, and after the 2nd session I could get in and out of the car and drive without pain. I kept going for a few sessions after the 4th one. The amazing this is that this happened at the end of 2014 and the sciatica has never come back. Give it a try. It is worth the money.
Interesting. I'm not familiar with acu as a remedy for sciatica.
OP, I went to phys therapy for sciatica once. The first therapist I got told me to do the same thing we learned in massage school. Curl up in a ball, pulling your knees to your chest to stretch your piriformis muscle (one of your rear end muscles). I won't explain the theory behind that, because it's usually the wrong thing to do for people above a certain age. A therapist who'd taken a special class specific to sciatica took over after the first session.
If you're 50+, it's probably due to a bulging disc. This is nothing to worry about, except in your case, since it's severe, it wouldn't hurt to get an MRI or whatever type of scan they recommend. But it sounds like your doc has suggested phys therapy first, so give it a try.
Usually, a slightly bulging disc impinging on one of your nerves going through the spinal cord isn't as scary as it might sound. It's just part of getting older. The remedy is to do what in yoga they call the "cobra" posture, with your pelvis on the floor, and your hands pushing you up, so your back arcs upward like a cobra. (Look it up if you need a visual.) Keep your pelvis in contact with the floor as you do this, to get the most curvature of the back that you can. Then let yourself down, then push up again. Do 10 cobras like that. Rest, and do 10 more. Do this 3x/day. Be patient. You should notice improvement by the 2nd week, or end of the 2nd week. If you have the time, you can do it more than 2 sets of 10, 3x daily. You can do 4x daily, or 3 sets x 3, or however many you want, for quicker progress.
Once your symptoms resolve, do a maintenance schedule of 2 sets daily, or 3x/week minimum, as a preventive. Also as a preventive, make sure you have good posture when you're sitting at your desk, or the dinner table, or anywhere. Don't slouch; train yourself to sit with your back straight. Get a good chair with a high, straight back, if you have to.
You shouldn't let a case of sciatica get this bad before getting help. It won't go away on its own, if you wish hard enough.
But now you now what to do. Remember--patience. Do your sets several times daily, keeping in mind that it will take a week or two to notice improvement. Then when it's finally gone, don't quit! Just dial back on the number of sets and frequency, but keep up a maintenance schedule. You don't want to go through this again, do you? My phys therapist said, this is your new normal. Take care of your back.
P.S. The piriformis stretch is actually the opposite of what you should be doing. It will make the bulging disc worse.
A true sciatica is caused by an irritation of the sciatic nerve at its roots, usually due to a herniated disc in the lumbar spine. It does NOT cause back pain, but pain &/or specific muscle weaknesses &/or numbness down the leg & foot just as you've described.
Like any acute injury, there is often a good deal of initial swelling around the herniation that will go down after awhile with proper rest. The herniation itself may or may not shrink....Things like chiropractic manipulations or PT may actually make things worse (you don't wiggle the edges of a cut if you wan it to heal). Acupuncture, if it works at all, works between your ears, not on your leg.
If the herniation is big enough that it continues to cause pain &/or if it's causing muscle weakness that isn't improving much with time, then surgery is called for. An MRI or CT will define the surgical target (L4- S2). Occasionally a true sciatica is caused by spasm of the obturator muscle and not by a herniated disc. PT may help that...A spina tap with injection of lidocaine/cortisone will help temporarily, but your jaw doesn't stay numb forever when the dentist gives you Novocain.
The amount of disability caused by the pain/weakness/paresthesia and the pt's tolerance will determine how aggressive to get with the watchful waiting vs surgical treatment.....If you're really that incapacitated after a week, you probably oughta opt for the surgery.
Last edited by guidoLaMoto; 10-12-2022 at 06:47 PM..
So I had your basic, annoying sciatica for about a week. Then three weeks ago it turned really nasty. I can barely walk, even with a walker. My left leg drags because it hurts too much to lift it in trying to walk. I've been to the chiropractor for 8 sessions so far and so far no relief. I've been trying to get into a spine clinic but a computer shutdown makes them unavailable. I'm supposed to start physical therapy next week and do exercises - really? Hopefully I will be getting an MRI and I can get into a pain management clinic and get epidurals. Or maybe I'll get lucky and they'll just stick a needle in my brain and get it over with.
I've gone through 20 tablets of oxycodone in 10 days with another prescription for 40 more. One pill just mitigates the pain enough so I can get out of bed and do things like wash up, throw something in the microwave, maybe get to the store. I can't clean or cook at this point. Two pills allow me to get to the library and get on the computer to complain here about it.
The pain starts in my butt, goes down the back of my thigh, behind the knee, the back of the calf, and now is hurting me in the ankle and in the arch of my foot.
My life is just basically on hold till this $(*^ goes away.
Everybody I know has had or knows someone who has had sciatica.
So what have your experiences been and how the H E double hockey sticks long does it take to go away?
I'm leaving you 2 links, please read them. I've shared extensive information on what helped me. I've suffered as bad as you. I used crutches though, couldn't put my leg on the ground. It's just too much information for me to bring over to give you as I've quoted from other threads in one.
See my replies starting here. See this part of my reply to see if it applies to you too. When laying like that, push on your butt to see if there are tender spots like I have. If so, your sciatic is probably from your butt area and not your spine.
Last night I could barely sit. I laid down on my right side with legs bent like I was sitting, could feel how sore I was where the legs meet the pelvis. I'll be surprised if I don't suffer sciatica at some point this week, with it being the cause.
...
I figured out laying down, pushing on myself by accident. I was doing something, moved my left leg a certain way where I was able to notice just exactly where the pain was coming from. I then used google to find photos of various anatomy such as nerves or muscles of body parts. Eventually more information comes online such as showing in the photo I posted.
Here is the dermatomes image mentioned i agree, it's a great image, you could print it and mark where your pain is
Quote:
Originally Posted by guidoLaMoto
A true sciatica is caused by an irritation of the sciatic nerve at its roots, usually due to a herniated disc in the lumbar spine. It does NOT cause back pain, but pain &/or specific muscle weaknesses &/or numbness down the leg & foot just as you've described.
Like any acute injury, there is often a good deal of initial swelling around the herniation that will go down after awhile with proper rest. The herniation itself may or may not shrink....Things like chiropractic manipulations or PT may actually make things worse (you don't wiggle the edges of a cut if you wan it to heal). Acupuncture, if it works at all, works between your ears, not on your leg.
If the herniation is big enough that it continues to cause pain &/or if it's causing muscle weakness that isn't improving much with time, then surgery is called for. An MRI or CT will define the surgical target (L4- S2). Occasionally a true sciatica is caused by spasm of the obturator muscle and not by a herniated disc. PT may help that...A spina tap with injection of lidocaine/cortisone will help temporarily, but your jaw doesn't stay numb forever when the dentist gives you Novocain.
The amount of disability caused by the pain/weakness/paresthesia and the pt's tolerance will determine how aggressive to get with the watchful waiting vs surgical treatment.....If you're really that incapacitated after a week, you probably oughta opt for the surgery.
This is one of the few times I disagree with you. I had disk fusion L5S1, it did not stop my sciatica because mine is due to my butt, not necessarily my disk herniation. Worst mistake I made was fusion, I know others who feel the same too. There are a lot of failures with fusion. It should be a last resort after everything else fails. He should try the deep butt injections like I've had luck with, it can't hurt. It took it away for many years.
If the OP really needs surgery, he should research artificial disk replacement in Germany to see what they've been using for 20+ years now. Spines are not meant to be fused stiff, they need to bend and flex.
OP do not make spinal fusion surgery without thinking because you could end up like me and others I know in worst shape needing a cane, giving up most things in life. Quality of life is poor. If my grandson wasn't so attached to me I'd apply for medical euthanasia in my state. You have to be terminal it says.
I was fused twice, first was with an LT cage in 2001 that did not fuse, I had micro-motion, bone rubbing metal when I walked. In 2006 they added rods and screws which hurt like heck, they feel like they're going to shoot out of my back when spasms get bad.
In my experience, at least half of all lumbar laminectomies are done for the wrong reason-- back pain. Spinal fusion, as you point out, is anti-physiological and should be reserved for severe spondylosis-- the sliding of one vertebrae off the vertebrae it's sitting on. Results are often disappointing and often just substitute one set of symptoms for another.
With advent of CT & MRI, we're finding that an amazing number of people have herniated discs and don't know it.....and that most people with back pain don't have herniated discs.
If a disc is herniated chronically and impinging on the sciatic nerve in such a way as to cause a paresis (weakening) of a muscle (foot drop is most common) that muscle will atrophy (shrink away) and never return to normal if surgery is delayed.
If your sciatic pains were relieved by deep gluteal injections, you probably had the obturator spasm I mentioned and not herniation of a disc as the cause of pain....It's one thing to be blind due to optic nerve damage, and another to be blind because your eyelid droops shut.
I'm not big advocate of disc surgery. They scrape away the disc material that has crept down into the nerve root canal, but any surgery leaves scaring, and that scaring may be as bad or worse than the original disc problem. It's a crap shoot...
As I said, most spinal surgery is not needed...It depends on how badly your life is affected by the problem. Most cases of acute sciatic resolve on their own with adequate rest.
Re: the above post^^ (I was posting at the same time as Dr. Guido, who added some excellent info)
Roselvr, in fairness to the OP, you and I should probably not be discussing surgery right out the gate as we are. OP doesn't even have a diagnosis yet. I think I often mention surgeries with these posts because I had an excellent outcome on a much more minor procedure than you did. You're understandably cautious. In that regard, I think our differing experiences are a good balance to each other. Many spine surgeries are probably not necessary, but there are some spine issues where surgery is quickly indicated, however, including weakness, foot drop or bladder/bowel problems (which is treated a surgical emergency).
My father had a fusion at L5/S1 last month (along with some other work). It was his second spine surgery but first fusion. The technology has come a long way since your procedure. They didn't even use plates or screws. There was no hardware to speak of, just some kind of internal cage like structure. His incision was only about an inch long. He's still in considerable pain, but the surgeon did a lot of work in that small space and the nerve damage was so bad (because my father had waited so long), the recovery will be very long and there's no guarantee his pain will completely resolve.
Like you, I wonder why disc replacements aren't more common here in the US. When I asked my surgeon (who was the same guy my Dad uses), he said he does a lot of cervical replacements, but almost no lumbar replacements. Apparently, the lumbar ones are much more difficult because they usually require an anterior approach, so you also have to have a general surgeon on he case since you are working extensively in the chest or abdominal cavity. My guess is that ultimately the reimbursement for lumbar replacements isn't worth it for the resources, risk and effort involved. But, they do a ton of them in Germany for some reason. I'd be curious to learn more about them.
Last edited by Texas Ag 93; 10-13-2022 at 05:28 AM..
I get a sciatic attack occasionally. I noticed that it occurs when the muscles in my lower back and pelvis start "cramping" up and at these times I really focus on relaxing those muscles. It always works once I figured out the reason for my pain. Stretching helps a lot in my case but making sure to not let my back seize up keeps the lightning bolt from even starting. I usually stretch my butt muscles when sitting up. Pull knee up, then bend in to it. Some people give up on stretching a bit early. It takes time, especially when you get older and everything starts drying up and tightening up. The muscle that seizes up on me seems to be about level with my belly button on the side of the pain.
I think what makes sciatica so hard to cure is the pain is so excruciating it's almost impossible for your back/butt muscles on that side to relax. Although the pain is instantaneous, it took years to get to where you're at.
I've got a couple of compressed disks as well but those pains are completely different. My sciatic pain is exactly as you describe.
I feel for you. Sciatica isn't fun. Maybe you can get your Dr. to give you some muscle relaxers and try those for a few days instead of or in addition to pain killers. Drink plenty of water.
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Remember--patience. Do your sets several times daily, keeping in mind that it will take a week or two to notice improvement. Then when it's finally gone, don't quit! Just dial back on the number of sets and frequency, but keep up a maintenance schedule. You don't want to go through this again, do you? My phys therapist said, this is your new normal. Take care of your back. 
