Sciatic Nerve Pain From the Perspective of Many Decades

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I'm not a doc but was married to a pharmacist for 25 years and now a 30-year psych nurse for the last eight.  As of December 31, 2017, I'm almost 70 and I've had 28 real, "out cold" operations in the past 18 years...not counting tests and work done by chiropractors and acupuncturists.  Lots of minor issues but I do have 2/3's of a stomach, a metal hip, a metal knee and lots of surgical steel in my spine.  Four knee scopes, four kidney stones, gallbladder...get the picture?  It's payback for playing hockey for 45+ years.  I know pain intimately...especially the sciatic type...many occasions over many decades.

First: YOU DON'T HAVE TO LIVE WITH IT!!!!!  Sciatic pain has root causes.  Find the cause, stop the pain.  As a Not-a-Doc, I don't know all of them but in my experience, here are the ones that I have encountered plus their solutions:

1. Trauma: If you've fallen on your hip, severely twisted your back or done something else stressful to your body, there's a good chance that you've knocked something "out of whack".  I did this a number of times falling on my hip while skating without my hockey pads on.  For me, the pain would always start the next morning when I couldn't get out of bed.  Not fun.  The fix?  Chiropractors have this "pretzel twist" technique that snaps everything back into place in less than 10 seconds.  I had this done to me many times...worked like a charm.  A trauma cause is the easiest to identify since the sciatica appears within 24 hours.

2. Misalignment: Lower back, hips and pelvis are all supposed to be aligned and balanced.  Anything out of line can cause pinched nerves...especially the sciatic.  Try carrying a heavy backpack over one shoulder for a week and see how your neck feels...same thing.  My last sciatica episode happened 5 weeks after my knee replacement surgery.  The cause?  I was favoring one side trying to avoid the pain.  This threw my hips out of alignment.  In fact, one leg measured 1/2" shorter than the other because my hips were tilted, pinching the sciatic nerve.  Fix?  Chiropractor 2-3X/week for 3 weeks.  Done.

3. Sacroiliac (SI) Joints:  These are very small spaces between hips and pelvis and can sometimes get "locked" causing sciatic nerve pinching.  For me, this is a chronic condition.  Fix?  I see my chiropractor once or twice a month to keep them loose.

4. Spinal Impingement: This problem occurs when something in your spine in the L4 through S1 region is pressing on your sciatic nerve.  In this case, it could be anything (disc bulge, vertebra narrowing, bone spur, etc.), but whatever it is, no pill, pain shots or chiropractor is going to help.  The other problem is that an MRI may not be conclusive as to the cause.  A CT/Myelogram with contrast is the "gold standard" spine test and will most likely spot the exact cause of your pain.  In my case, the MRI was inconclusive so my neurosugren just went in.  He found a bone spur at L4 literally "crushing" (his term) my sciatic nerve root.  He removed the spur, did a decompressive laminectomy of L4/L5 and shaved back the calcified L5/S1 disc all to make sure it never happened again.  Same day surgery, home that afternoon, no rehab, residual nerve pain gone in a few days.

Moral of the story...  Find the cause.  X-ray plus chiropractor is the first, cheapest no-pills and non-invasive way to address sciatica.  The docs will throw pills at you and tell you to rest.  That path fixes NOTHING!!!

Second, STOP TAKING THE PILLS!!!  All those damn meds are just masking the cause of your pain.  Find the cause, solve the problem.  Those nerve meds (Gabapentin...same as Neurontin, Lyrica, and others) all have HUGE side effects, especially when you're taking other meds.  ALWAYS check for drug interactions before you put anything in your mouth!  The docs are not pharmacists and absolutely do not know all the interactions.  Be your own best health advocate.  Check everything!!!

So...wanna fix your sciatica?  Find the cause and fix the problem.  You'll be pain free and way better off than you are now.  Again...I'm not a doctor.  This is all from personal experience plus the professional medical knowledge of the women I've been married to.  I also ask all my docs lots of questions and do the research into my issues.  Do the same.  Never leave a doc's office without the answers you went there to get.  If the above four causes don't apply to you, find the answer that does.  Just giving up and living with the pain should NEVER be an option...EVER!!!

PS: Some people have mentioned that PT sessions and some exercises can help.  I have no experience with those modalities but they certainly are worth checking out...plus acupuncture...  However I don't think any of those would apply to sciatic pain caused by a structural issue in the spine.  In my opinion, that situation belongs solely in the hands of a neurosurgeon.

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  • Posted

    Thanks for all the information Chico, I have to admit I haven't tried seeing a Chiropractor as I am unaware of what they actually do.

    I will take your advice and research the benefit of visiting a local practioner, after all what else have I got to lose though I would give anything or try anything to rid myself of this constant pain as like yourself it is a constant unwelcome partner that affects everything I do! 

    Stay strong and have a better 2018.

    Dave 

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    • Posted

      Some people don't believe in them.  I felt that way until I had my first sciatica incident from a skating fall many years ago.  Couldn't get out of bed...had to roll off of it and onto the floor before I could even try to stand.  Worst pain ever...until I had four kidney stones and a TKR!!!  Chiropractors have been very helpful to me for a long time.  One more example...

      About a year ago, I developed a very painful "hip pointer"...the intense pain was literally on the outside tip of my left hip bone.  Went to the doc the next day...handed me a painkiller script and told me to rest.  The next day, I saw my chiropractor.  I was lying face down and she touched a spot on my back near my left kidney.  The pain shot right to the tip of my hip!!!  Told me that it was a tight Quadratus Laborum (QL) muscle.  Just needed some ibuprofen and heat to loosen it up.

      The lesson here is that chiropractors know ALL the trigger points for pain...and also know what to do about them.  If your problem is truly spinal in nature, a good chiro can tell you that too and not waste your time and money.  Give it a shot...

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    • Posted

      Hi Chick Marx

      Thank you for all the information. I've been back to the Drs today and he's lowered my dose of amitriptyline to 35mg instead of 50mg purely because i couldnt function at all. I'm not 100% sure how I have done it or what as caused it all I know is I've had it for 3 months I've gone from been so fit to been in agony and walking around like a zombie. The dr couldn't send me for a scan unless he thought it was cancerous which obviously it isn't so due to nhs cutbacks he's had to refer me to a specialist who will then assess me and then make me an appointment for a scan to which I could be waiting months and still in pain and not been able to train and teach fitness classes. just don't know what else to do I want it to go and train and teach again I'm usually a really for 36 yr old now feel like a 90 yr old

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    • Posted

      X-ray + chiropractor.  See if that helps.  Cheap, non-invasive.  A good chiro will tell you if your problem is beyond their expertise.
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  • Posted

    Thank you for the wealth of information. I have been told I have sciatica but have no lower back, buttock pain.  The symptoms I have are different from sciatica symptoms I suffered in the past.  

    The pain I suffer from is located on the left leg at the back of knee to the right of the tendon.  The pain radiates up and down from the centre fold.  Sitting, lying flat, walking is very difficult. When I wake the knee is stiff I sometimes hold on to furniture to hop due to the pain.   I have tried rest, anti inflammatory drugs (on 10th day),  pain medicine, light exercise (sciatica stretching,  walking), heat & cold therapy, topical medication nothing rids the pain.   The pain is getting worst not better.   I now have a constant ache behind the knee sometimes burning. No Baker's cyst, redness or swelling.  At times it feels like a twang like you get when you hit your funny bone.  The pain is worst going down steps or curb.  Prior to the onset I slipped a few inches and did not suffer pain until several days later.

    I am wondering if anyone suffers from these symptoms.  The doctor's next step is Gabapentin type drug. If this is sciatica where would you put a topical analgesic, on the spine or the knee I tried both.

    Thank you for taking the time to read this replies, tips are much appreciated. 

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    • Posted

      First, I'd see a great sports orthopedic surgeon in your area...a group that works with your local college or pro teams.  This doesn't sound like sciatica but a knee issue...but I'm not a doc  Remember that x-rays and MRIs of the knee are frequently inconclusive.  Your symptoms plus a full exam can point him/her to an underlying problem.  I had four negative MRIs (two on each knee).  All resulted in scopings which revealed (and fixed) menicus tears and femoral condyle rips in each knee.  With me, though, it was 45+ years of playing hockey.  Knees have been bone on bone for 15 years with arthritis helped amazingly by Synvisc injections and then a move to a much warmer climate.  Needed my first TKR at age 68...hoping I don't need another.  See a sports ortho...

      I completely HATE the nerve drugs Neurontin (Gabapentin) and Lyrica.  Too many side effects and interactions with other meds.  Huge weight gains of 20-40 pounds reported.  For nerve pain, I use Aspercream with 4% Lidocaine or a Lidocaine patch...all OTC.  However, you have to find the cause of the pain and solve that, not just calm the symptoms.  I'd start with a knee guy.

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    • Posted

      The nerve drugs didn't work for you?  My husband has had pain in the leg while driving.. just had a second shot today and was given Gabapentin.   He also has anxiety so I'm hoping that nerve drugs calms his mind too for relaxation.   He did visit a chiro but he is one to not stick with anything and has to deal with it 'his own way'.

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    • Posted

      I have found chiropractic to be extremely helpful my whole adult life.  However, there are limits to what they can accomplish.  Getting a shot and taking a drug just masks the underlying cause of his problem.  You need to see an ortho and get a definitive diagnosis...the root cause of the pain.  Sometimes, it's generated from a place you least suspect.  One time, I had severe sciatica in my right leg.  The cause was a bone spur crushing my sciatic nerve root at L4/L5 in my spine.  That took a neurosurgeon to fix.  Gotta find the cause...

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  • Posted

    thank you for the reply I will insist on seeing a specialist.  I may go to emergency over the weekend to fast track as my doctor thinks sciatica.  I have had sciatica pains from the knee wrapping down to ankle in the past but this does not feel like those symptoms.  This is why I sought online support from sciatica sufferers.  Usually when I get sciatica it lasts 3 weeks at most. Had it from flying in November so very familiar with the symptoms. 

    Tonight I will go see if I can find Aspercream with 4% Lidocaine or a Lidocaine patch.  I am in Canada hope they have it.  A few days ago I looked for a new product that was advertised on TV which contained Lidocaine it was not on the shelf.  I will go to the pharmacy sometimes they keep some over the counter meds behind the counter.   I want the cause found before I take strong meds or do exercises that could make it worst.  For many years I did weight lifting using heavy weighs especially with the leg press this may have caught up to me.

    Thank you so much for the reply I will continue to check out this forum as I do suffer from sciatica a few times a year.  I wish you the very best for your health. 

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  • Posted

    Thank you just saw spine doctor my s1 is gone. I have horrible nerve pain pills don't work . He suggested injection and if that doesn't work surgery I have had injections but really scared to have surgery. I had hip revision in 2013 which I got unfortunately got sciatic nerve damage from the surgery

    Going back to my doctor on 4 wks wish me luck and thank you for sharing your story

    Jackie

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  • Posted

    Hi Chico, I have re read your posting as you have sent it me twice now, when I posted before about my sciatica, and I am thinking of paying to see a chiropractic although can ill afford at the moment so it will have to go on my credit card if they are able to take a card payment, I am waiting for one to get back in touch with me right now.  It seems they can identify and put right a lot of what may be wrong.  Thanks once again.
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    • Posted

      Sorry for the double hit.  I've read over 4,000 posts in the last two years...sometimes it's all a blur.  I wrote all those discussions (29 now?) because I got tired of typing the same stuff over and over again...  Sorry.

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    • Posted

      No problem Chico, I was grateful for the chance of a second read through as have now come to conclusion that chiropractic best bet for me and am making call to one local to me with great reviews i n about hour and half when their phone lines open. Thanks once again.
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    • Posted

      Hi Fiona. Have you had a scan before you see a chiropractor? A chiropractor may or may not be able to help and if the manipulate you without knowing the underlying cause, they could do more harm than good. 

      Remember, pain, any pain, always has a cause. No chiropractor should ever consider treating a patient unless the cause is found. And an X-ray is far from having the ability to diagnose a spinal or any other issue unless it is something like a crush fracture etc. 

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    • Posted

      I’m sorry to say I 100% disagree with your advice other than the last sentence. I used to be a spinal nurse and unless a chiropractor had the root cause diagnosis in front of him/her, the damage they can cause can be permanent and serious. And ppl just don’t get better and keep having to go back. 

      Just an X-ray is so far from adequate investigation it’s beyond a joke. Any serious sciatic pain should be thoroughly investigated before any allied health person considers treatment. Thousands of things can go wrong in the spine and pelvis to cause nerve pain, some serious, some not as serious. Some ppl may find a chiropractor helpful but to say an X-ray and chiropractor is the quickest and easiest treatment is just plain negligent advice. And to say that sciatic pain can be caused through impingement through L4 to S1 is again wrong. It can occur higher up, even to L1. Sorry, I find your advice too simplistic. Particularly when you are so sure. Tell your story by all means but to advise ppl the way you are, I’m sorry, it’s not on. 

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