Debilitating chronic pain, similar to sciatica. PLEASE HELP
Posted , 7 users are following.
I am praying someone will see this and offer advice for my dear mother. My mother is in a complete debilitated state of physical health. Let me provide details.
In August of 2017, my 66-year-old mother had her left hip replaced. Surgery went well, no complications. Afterwards, she started physical therapy at the hospital. We believe this is what started the heartbreaking issues my mother is now experiencing. My mother suffers from chronic constant pain that starts in her left buttocks and radiates down her leg just before the ankle. She cannot walk without using a walker. She constantly winces and cries out in pain. She has extreme difficulty getting out of bed every single morning. Sleeping is difficult because she is limited to comfortable positions. She cannot stand upright or put any real pressure on her left side. In addition, she has this bulge on the side of her hip where she had her hip surgery. It hurts to touch. No one can explain what this is or what is causing it. She had an MRI done, which revealed:
FINDINGS:
- Multilevel spondylosis.
- Disc bulge with superimposed spondylolisthesis at L4-L5 causing moderate central canal and neural foraminal stenosis.
- Disc bulges at L3-4, and L5-S1 causing a varying degree of neural foraminal stenosis.
- Asymmetry with more pronounced bulging towards the left with foraminal stenosis in this area.
DIAGNOSES:
- Sacroiliac Pain.
- Left posterior high, thigh, buttock pain related to foraminal stenosis on the left and central stenosis.
- Lumbosacral Radiculopathy
The doctor who performed her hip replacement says her current condition is not related to the surgery. Just to note, my mother never had any of these issues in the past prior to the hip replacement. After she saw the hip replacement doctor again (because she gradually started experiencing this butt, thigh, leg pain) he ordered the MRI. After seeing the results, recommended a pain clinic evaluation. We made the appointment there where my mother received 3 injections for pain over the course of 12 or so weeks. None of the injections provided any sort of relief. She received 2 steroid epidural injections in her lower back and then a sacroiliac joint injection. Again, none provided any pain relief for her. The Pain Management Specialist then referred my mother to a Neurological Surgeon for treatment. I prepared all of her documents and sent them to a Neurological surgeon for review. He declined to take my mother because her situation was "too complicated." We got in with another neurological surgeon who honestly did not take my mom's case seriously at all. I did not get a good first impression from him primarily because of his bedside manner. My poor mother was very visibly in pain and distress, not to mention sad. He said my mother was overweight and would need to lose weight before any type of surgery is performed (if that is the route we go). So now she will be walking in the pool at the hospital a few times a week. In the meantime, he ordered an EMG nerve test, which is scheduled for April 26. I (as well as my mother) truly do not think she will last that long. My mom takes Norco every 3-4 hours just to cope with the pain she is having.
Before her hip replacement in Aug of 2017, my mother was an active, able-bodied working woman. She is retired now but was a regular sub at the school district where she was on her feet all day. My mother cannot walk, cannot sleep, cannot do any life activities that she used to do. She is losing hope and her will to continue this route. Please... can anyone provide any suggestions or recommendations for us? We are located in Chicago if anyone can recommend a doctor.
I want to say thank you in advance for anyone who can help. I appreciate you with all my heart.
0 likes, 4 replies
Bosco TSher1987
Posted
I sub for very much sciatica
CHICO_MARX TSher1987
Posted
Well...her pain could be a secondary result of the surgery. I've had a hip AND a knee replaced plus I've had sciatica episodes for decades...
https://patient.info/forums/discuss/sciatic-nerve-pain-from-the-perspective-of-many-decades-629096
When we have pain (like in the hip or knee), out body unconsciously changes the way we walk (our gait) to avoid the pain. All very natural. Sometimes, this can cause misalignment of hips, pelvis, SI joints and lower back... This is for my TKR group but the concept still applies...
https://patient.info/forums/discuss/other-pain-after-a-tkr-641040
The problem here is that she definitely has spine issues as well as possible alignment issues. Which one is causing the sciatia? Both? I would attack this on two fronts:
- Find a local chiropractor who HAS EXPERIENCE with artificial joints. My chiro has years of it so my adjustments take into account the metal in my hip and spine (two fusions). She is VERY careful!!! Take the films to the chiro who may decide that the back issues must come first...I have no idea what that decision will be. However, if some adjustments are called for, that could relieve some pain...maybe.
- If the main problem is a pinched sciatic nerve root in the spine (mine was that bone spur at L4), then only a NEUROSURGEON (not a neurologist) can fix it. Drugs, pain shots, PT, etc. only mask the problem which must be solved. Find the root cause...fix it. An MRI will show a lot...maybe. A CT/Myelogram with contrast is the "gold standard" test for diagnosing spinal problems. The neuro will have to choose the technique appropriate to her problem. I've had the bone spur, two decompressive laminectomies, a TLIF (rods and screws, pic 1) fusion plus an LLIF (lateral device insertion, pic 2) fusion. All depends on what's wrong and the best surgical choice. See multiple neuros for a few opinions.
Again, could be a combination of both but if there is definitely a spine problem, get that fixed. I'm 70 and just off my last laminectomy. Waaaay better than I was before the op. All my spine surgeries have been very successful. After 45+ years of playing hockey, my neuro told me that my spine was a "junkyard". Glad to have him around to throw out the trash.
Greebo64 TSher1987
Posted
I agree with Chico it is definitely due to the hip surgery, when they do this operation they are quite aggressive in dislocating the hip & the hammer & chisel to fit the new hip joint, so if your mum had the lower back problems before the surgery but not the sciatica then the hip surgery has definitely made things worse...I have the same very similar lower back issues as your mum & last year I lifted something heavy that I should not have lifted [before this no sciatica] whilst lifting I felt a twinge/click in my lower back , since then I have had horrendous sciatica pain in both buttocks & down both legs, this went on for 4/5 months I was at times in tears with pain, [I have put posts on here] I was at my wits end & like your mum the Neurosurgeons did not want to operate & if they did they would have to do quite complex procedures due to the many factions of the lower back issues, if you got a surgeon that did not do the complex procedure needed but tried a quick fix, eg a simple decompression / laminectomy with out fusion then you mum could finish up with even more pain, fusion for your mums condition would be essential it stabilises the spine & prevent further painfull problems..
i myself had to rely on exercise every day also rest periods, now 7 months on the pain is manageable, I sill get some pain in both buttocks when I first get out of bed in the morning, on standing that is, but when I have done some leg stretches & had a cup of tea the pain almost disappears all day, but I have to carful not to do too much in the way of bending / lifting, sometimes if I have to go in a lower kitchen cupboard it will trigger the pain at least in one leg, so I have to sit down for a bit & that seems to get rid of the pain again, but you have to remember that staying in bed too long or sitting too long [although this laying & sitting stops the pain] it will make the pain worse when you get up on your feet.
If the consultants cant do anything for your mum first thing she must try & do is try to lose weight & she must exercise...As Chico says a Chiropractor should be able to help to re-align the problem somewhat.
good Luck
SciaticaWill TSher1987
Posted
So sorry for the pain that your mother is experiencing. It sounds truly horrific. I hope by the time you are reading this that it has eased to some degree.
From my experience, I have known total hip replacements to cause either damage or an entrapment of the sciatic nerve, which might give the symptoms that your mother is experiencing.
With regards to the MRI results, it could be that one of the disc bulges is causing her symptoms, but equally these findings on MRI could be seen in an individual who is suffering from no pain at all (as part of the normal aging process).
Very difficult to give a better recommendation without having assessed your mother in person, but usually the nerve root block injections are very effective at reducing pain when given into the spine, if it is indeed the spine causing the problem. As these did not give your mother any relief, I would hazard a guess as to it being more likely that the new hip is the issue.
I do hope this settles soon for your mother, best wishes to you both.
Will