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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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