Not sure what's going on - Sciatica recovery
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Hi. I've had an L5-S1 disk herniation for around 10 weeks, confirmed on MRI and described as a small focal left sided paracentral disc hernia compressing the left S1 nerve root in the lateral recess. I was in and out of A&E a few times with the pain, which included Sciatica shooting pains down the leg for some time. For around 3 weeks or so I lost planter flexion (couldn't stand on my toes) in my left leg. Then it was gradual recovery/improvement over the next few weeks until around a week ago where I was getting by on several paracetamol and the odd 30mg codeine a day. At that point it was mostly back pain not leg pain, and I had been to and been doing Physio/Mckenzie exercises for a while. Something's changed around a week ago, I developed a constant burning pain in the back of my left thigh which has since turned into a kind of soreness down the back of the left leg. Kind of like a lactic acid burn but down the whole leg - it doesn't seem to matter what position the leg is in. I'm now on Gabapentin, naproxen and morphine every few hours; the morphine does seem to get rid of the soreness but the Gabapentin/Naproxen don't really seem to be doing much. I'm on an escalating does of the Gabapentin and have currently only reached around 500mg a day. The problem is I can't really go to work like this (I was back pretty much full time), I can barely walk around the block at the moment! I'm also getting occasional tingling down the leg on standing/moving around. I saw a physio about 6 weeks ago who offered me an epidural; at the time I opted for just more physio as I wasn't that bad. I've now written to the physio to ask to be referred asap for the epidural. I don't know what else I can do at the moment though, my GP says I'm on everything they'd suggest for me, she thinks the epidural is a totally reasonable request (I'm not going for surgery till I've at least tried it once) but doesn't know how to get me referred for it quickly (6-9 month waiting list at a pain clinic - this is the state of the NHS). I have a neurosurgery appointment 3rd Oct to discuss surgery which I will go to but I need to try the more conservative injection first.
Has anyone suffered setbacks like this? I was doing pretty well until a week or so ago, then for no reason that I can see things got worse again. My straight leg raise test hasn't really got any worse and I can still stand on my toes, but the leg pain is crippling me at the moment!
Thanks
0 likes, 5 replies
SLD35 tom51819
Posted
Hi, I haven't ever had a good patch then got worse/different pain. My pain just kept getting worse (two bulging discs l3-4 and l4-5). 500 Gabapentin seems low to me. I don't take morphine, I'm on Gabapentin 600mg 3 x a day and that's not the top dose. It takes about a week to get used to increased doses and builds up in your system.
Hope that helps, not much use am I xx
susan31693 tom51819
Posted
Well snap. Im still in excruciatingly debilitating pain radiating down across left buttock, leg, ankle and foot. Ive tried Gabapentin but like you, it doesn't seem to be very effective. I'm surviving on codeine aand paracetamol but work is difficult and even eating is beyond me at the moment. Pain dulls the appetite I find, the spasms stopped last week and reappeared on Monday and I've become very depressed at the constant struggle. I thought I was getting better and dont understand the setback. Its just the worst pain. Driving is now becoming so difficult too . The pins and needles are like bee stings and I sometimes feel like hot water is running down the back of my leg. Scary stuff. Docs dont seem to offer solutions at all other than differing meds.
tom51819 susan31693
Posted
Codeine and paracetamol is what seems to make the difference for me too. With regards to driving, I've avoided it the past few weeks/months, but I'm lucky enough to live within a 15 minute cycle of where I work. I know how it feels though, every gear change hurts! I do find using an orthopaedic cushion and tilting the seat back helps. How long have you had it, and do you know the cause (have you had an MRI)? I also wondered what your straight leg raise test is (the one where they have you lie on your back and lift your leg). I have improved slightly since my last post (though it might just seem like that as I'm on my week off!). I have found by getting properly warmed up (hard to do I know with the pain, I use a stepper for a few minutes to get the blood flowing and my heart rate up) I can then get a much better leg raise of around 80 degrees using a gym band around my foot and pulling - hurts a lot but I can do it, so I know the flexibility is potentially still there. I've got a neuro appointment on the 3rd Oct, so will see what they say, I may well ask for an epidural or at least a nerve conduction velocity test to rule out permanent nerve damage.
simlor85 tom51819
Posted
Hi Tom.
Sorry to hear about your setback. I have a flare ups myself and the get harder to recover from each Time but I always do the same thing.
Take time off work, 2 weeks or so if possible.
Don't drive at all unless I have too.
Meds if I need them.
Try and get good quality sleep at night.
Eat less and drink more water
No alcohol or smoking.
Slowly but surely I usually bounce back after a month or so. This particular episode is taking much longer though and pain is much worse do I am also seeing a surgeon in two days and going to have a man to man and see if he can help.
Good luck. Not much you can do mate just take it easy, use whatever leave you have and relax. The injections helped.for me both times.
pabbs13040 tom51819
Posted