Sciatic Nerve Pain From the Perspective of Many Decades
Posted , 19 users are following.
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.
10 likes, 41 replies
elaine29618 CHICO_MARX
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CHICO_MARX elaine29618
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Perky22 CHICO_MARX
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CHICO_MARX Perky22
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Perky22 CHICO_MARX
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jackie56101 Perky22
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Perky22,
Surgery not always the answer alot of the people rush into surgery and feel worse. I had hip surgery revision and I now have sciatic nerve damage from that surgery also have herniated discs L4 and l5 s1 no one will touch me because of the permanent scaitic nerve damage. Hang in there get second and third opinions do your research.
Take care
Let us know how you're doing
Jackie
jackie56101 Perky22
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Perky22,
I was recommended implanted device also. The reviews not so good so I cancelled the trial. I've just had so much pain and disappointment couldn't take the risk.
Jackie
marie89364 CHICO_MARX
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Hi Chico. Had Laminlectomy 16 mnths ago on L3, 4 and 5. Was on Gabapentin at the time. Am off it now. Was in rehab 27 days and am still walking with walker. Do feel body out of alignment. On the side of Sicita am 2cm lower than other side. Have lift in my shoe. Also have nerve pain at S1. At times can be painful. I'm 75 and have only 2 surgies in my life. Rt knee replacement and now back.
Was in PT for 12 mnths. Way too long. They started to really hurt my body so I stopped going and am now with Chiropractor. Went to the Y this morning and signed up for walking in water. I am at my wit's end. Did not know recovery from surgery would be so extensive. Had bad impignment. Any advice you can give me would really be appreciated. I also am dealing with numbness in rt calf and feet. Makes driving difficult.
Marie
CHICO_MARX marie89364
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You've got waaaaay too many things going on simultaneously. One leg being longer is very common when your hips are out of alignment. Show orthotics only make it worse because you're not solving the basic problem...your hips are tilted.
Because you have so many issues. one doc might fixing a problem as they see it but making something else worse. In my mind, you need a holistic approach to your problems...one doc yo manage your entire case and work with all the docs, PTs, chiropractors, etc. to make sure everything is coordinated.
In the US there are many retired docs who go into Patient Advocacy...they're kind of semi-retired and take on complex cases, doing the overall case management and making sure that your needs are handled correctly by getting all the docs to talk to each other so everyone agrees with the master plan. I would seek out such a professional and have him/her oversee your entire case.
marie89364 CHICO_MARX
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Thanks for writing me back and your right. I do have a lot of things going on.
I'll see if I can find those docs your talking about
Finding the right group is sooooo important.
Good luck to you. Sounds like you've had your share.
Marie
marie89364 CHICO_MARX
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CHICO_MARX marie89364
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Uh oh...coccyx. That's a tough one. A decade ago, my daughter, a, ACSM/ACE-certified personal trainer, 5'2", 120# of solid muscle, was squatting 310 pounds when she slipped. Her spotter missed half the bar and as she landed on her butt, the weight came down on her. Compression fracture of L1 (so now she's 5' 1 1/2"
and microfractures of the sacral area. After a body brace and lots of meds, still in pain after 2 years. Went to Mt. Sinai in NYC...the spine capital of the world. Neurosurgeon ordered an MRI of her hips and BELOW...no one had looked there. Turned out that she had completely fractured her coccyx. Instead of coming to a point, there were just scattered fragments.
Very unusual but, as we later learned, not all that uncommon. It seems to be one of the most mis-diagnosed problems ever...a fractured coccyx. Very delicate surgery by the neurosurgeon but she now has 95% of her life back...and no drugs. (The Vicodin was starting to rot her teeth!!!) If you have coccyx issues, you need an MRI of it. When you drill down layer by layer in the MRI from an axial view, your coccyx should come to a point. If it doesn't and the MRI shows fragments, you need corrective surgery to fix it...nothing else will do.
marie89364 CHICO_MARX
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Thank you for sharing. After a fall in 2016 I had X rays down there. According to Ortho he said it was fractured and would heal on its own. It may have because the pain was gone until I had the back surgery and now it's back. The nerves where I had the surgery are not healed yet so don't know if pain coming from there or coccyx. In the meantime I sit on coccyx cushion with another cushion supporting my back. I take 1 mibic per day and sometimes 2 if pain is bad
That's all I take
CHICO_MARX marie89364
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marie89364 CHICO_MARX
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I'm listening to you. I'll follow up and let you know. I know it's not in pieces. Ortho surgeon said x Ray showed small fracture. He also said can't do anything but let it heal by itself. It is so hard to know which dr to trust and who not to. I didn't like or trust this orthosurgeon so never went back to him.
marie89364
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Thank you again for your concern.
CHICO_MARX marie89364
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My different orthopedic docs specialized in the shoulder, hip and knee (two shoulder subacromial inpingements, metal hip, metal knee). When the spine is involved, only a neurosurgeon will do. I've had two decompressive laminectomies and two spinal fusions (TLIF at L3 through S1 and an LLIF at L2/L3). After 45 years of playing hockey, he said my spine was a "junkyard"...his words. I wouldn't trust anyone else. And, yes...with 4.5 pounds of metal in me, I'm the TSA's worst nightmare at the airport.
marie89364 CHICO_MARX
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4.5 pounds of metal. Now that's a lot. I have metal in my knee due to total knee replacement from 12 yrs ago. I hate it at the airport when I have to stand there arms outstretched looking like a criminal. Everyone staring as they walk by. I do hope you enjoy the weekend, at least what's left of it.
Marie
CHICO_MARX marie89364
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I try to go through the arch and...well...that just doesn't work. So I have to go through the scanner and invariably, the agent calls out: "Hey, Frank. You just gotta come over here and see thus guy!!!" It's become a ritual.
marie89364 CHICO_MARX
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How do you feel with all that metal inside you.?
CHICO_MARX marie89364
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I think that I need to stay away from very large magnets...
I played hockey for 45 years...all of those splits, kick saves, checks, etc. took their toll...but I don't regret one second of ice or rink time. Hey, it's a brutal game...followed by equally brutal surgeries. The TLIF was 12 days in the hospital; the knee was a yearlong recovery. Meh...you do the work...you recover.
I really don't "feel" the metal inside and never even think about it. Yes, it's an issue at the airport but other than that, I'm fine. Had some lower back issues after the January laminectomy for the previous LLIF fusion (grew too much bone around it so the nerves got pinched) but a new PT is doing "nerve flossing" (don't even ask...) and about 60% of the residual pain is gone in 3 weeks. Once that is resolved, I'll be OK...just no more hockey...ever. Tough pill to swallow...but ya gotta make good choices.
Perky22 CHICO_MARX
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I’m still waiting to see the results from the recent injection I had done for my left side leg and hip pain. They injected the piriformis muscle thinking this may help and if it does help lessen the pain, we’ll figure out what to do after that. I don’t want to have more injections. I can’t help but think that being put to sleep, even for a “twilight” sleep, it hard on a person and I’m nearing my mid 70’s. Like you, I’ve been athletic all my life and now I’m wondering if all that running and working out backfired on me.