Swollen foot...what should I do?

Remember sciatica is a symptom not the cause of your pain, swelling and tingling. If the sciatic nerve is irritated the swelling will occur due to vaso-dilation and sympathetic nervous system bring disrupted. It does not necessarily mean nerve damage.

Thanks for your advice Melissa, and for explaining why the swelling is occurring...I think I'll go back to the GP and ask for further tests...I'm just so fed up of going to see the docs only to be fobbed off with more pills or physiotherapy sessions that make little difference, and being treated as though I'm only there to get time off work...I don't relish the idea of having surgery, but if it turns out to be necessary then as you say it makes more sense to treat the underlying problem rather than carry on masking the symptoms. I'm wary of taking Lyrica, after reading the patient info...drowsiness (probably not great for driving or work that requires concentration), having to be slowly weaned off of it should you want/need to stop taking it, oh and suicidal thoughts...those must have been 2 difficult years Melissa! 

Oh yes it was hell. I didn't like the side effects. I had short term memory loss and nightmares mostly. I'm not sure about the drowsiness because I was in a lot of pain and was tired all the time. I initially had my sciatic nerve caught between my pelvis and my femur, so when I had it released the nerve got damaged. I had horrendous nerve pain so was on Lyrica and amitripline. I don't know if it did anything to be honest. Maybe but not much. Narcotics don't work on nerve pain hence these new drugs. I'm not convinced re these medications though but it might help a bit. Plus you are pre being fixed. I suffered terrible hip pain for three years and they kept saying I had CRPS etc and too stay on the medication but it turns out my hips (both) were partially dislocating and I needed urgent surgery. My left foot got the brunt of the muscle spasms as my left hip was worse than my right and again I was told my ankle pain was CRPS and to go back on Lyrica as I had weaned myself off it. Turns out, again I need surgery which I'm having next Monday. I just think ppl should really seriously look for permanent fixes rather than pills and potions. I would advise seeing a spinal surgeon. Someone who will listen compassionately. Don't worry about what others think. They don't know. I think you need nerve conduction studies by a neurologist firstly and a repeat MRI. You clearly have worsening symptoms so keep pushing. I honestly know how exhausting is it but keep pushing.

Some spinal surgeons, if they think you need surgery, may start you on Lyrica pre op to minimise nerve dysfunction. Personally I think this is ok, as long they are not going to ONLY use pills to fix you. That isn't going to work plus you have prolapsed discs. I don't understand why your GP hasn't referred you to spinal? Orthopaedics isn't going to do a lot. Ask for a spinal surgeon referral at least for expert monitoring. Tell them you've done physio and pain management (it's all the rage in the UK) and you want it fixed in whatever way they seem appropriate. (As you can tell I'm very anti pill popping to fix legitimate issues). Good luck!

Sorry I meant 'deem' not 'seem'. Mel

Good luck with the surgery on Monday...sounds like you've had a journey to get to where you are now! I totally agree with your stance on pills and proper fixes...it's so difficult though when so many doctors just want to throw drugs at you...I get that they are obliged to 'do' something when you go to them (I'm also a health worker), but unless they are specialists I don't think they really know what to do! For example, this morning I went to see the GP again. Where I get my healthcare, if you want to see a doctor you have 2 options: either make an 'emergency' appointment at the Health centre or go to Accident and Emergency...under both systems you are likely to see a different doctor every time, and they may not have any notes from previous appointments to refer to...this means explaining what has happened over the last few years again each time, and getting different advice each time...this morning I saw yet another new doctor...he didn't listen to me, told me that my swollen foot was just a coincidence and that I must have a vein in my leg that wasn't working properly...he gave me a prescription for yet another type of anti-inflammatory, told me to start taking the Lyrica, and offered me a note to get time off work...when I declined it, he said 'but everyone comes here for a sick note!' Thoroughly depressing. Tomorrow I am going to try and speak to the Orthopaedic department...I think they refer to spinal surgeons if they see fit. It's so frustrating! I spend my working life helping other people and trying to solve their problems, but the organisation I work for doesn't seem interested in offering the same service to its staff. I really hope they finally put you right on Monday...health is everything...keep fighting the good fight Melissa

Hi Lennie, thanks for your comment...it sounds as though we have similar worries about nerve damage...MRIs aren't that expensive (about 300 euros where I live) and they aren't meant to have consequences for your health, so I don't understand why doctors use them so sparingly...I may end up paying for another one privately if I don't get anywhere with the Orthopaedic guys as I have a deep sore patch in the right lumbar/sacral area, lower than in previous acute episodes, which is telling me that the bones are not happy! I am lucky enough to be able to afford it as currently still working, but I feel for anyone on long term sickness benefit that may not have that luxury.

The burning sensation is weird, for me it's like having sunburn...but if I try and wear anything (like shoes!) that touches the upper side of my foot it feels as though I've been stung by a jellyfish! I think I have some numbness too...I can still feel stuff, but it feels as though it's a bit further away(?) but I'm not sure if it's the swelling that's causing that.

You're exactly right about the cost of long term sickness and drugs in comparison to sorting problems out. I suppose in part they weigh up the risks of surgery. Also, from the statistics I've found online, it seems as though some long term outcomes are not that different whether you have surgery or not? This makes me suspect that the holders of the purse strings may feel that spending on treatments is not a worthwhile investment, seen as a paper exercise...of course for the folk suffering from the symptoms it is a more pressing matter!

And long term use of painkillers brings its own health risks...I try and have periods off of the drugs to give my liver and kidneys a break...but you can only put up with so much...I birthed 3 children many years ago and I can safely say that this pain, when it gets hold of you, is as fierce as the most intense labour contraction but ultimately worse because of its unrelenting nature.

Well I wish you luck Lennie...I have had temporary relief from sessions with an Osteopath, and you can get an NHS referral for that (if you're in the UK)...but after 10 years I dare say you have tried a few things already! 

 

You're not wrong about the doctors Lennie! I went back to the Orthopaedic dept yesterday and was basically told that when they finally get around to seeing me they would not do any thing more than advise me to walk and swim, and 6 months after that they would refer me for epidural injections (which I already turned down a year ago when the GP offered them)...complete waste of time. I've had to take the day off of work today as I can't keep the pain at bay and am fed up of limping around, so I suppose it's back to the Osteopath and if that doesn't help try the Lyrica. I'm beginning to find it a bit insulting being told by doctors that I need to be more active...I'm on my feet all day at work, do a bit of gardening on days off, and walk and swim when on holiday. It wears you down doesn't it Lennie...if they walked in our shoes for a day they might give it a rest! 

That's awful! What horrid people! Can you insist on seeing a spinal surgeon? I'm not surprised about orthopedics because spinal is not orthopedics. It's very different. Or at least see a neurologist to get nerve conduction studies done. It's crazy how they try to stop ppl being dependent of pain killers yet they lean on pills to get ppl to be mobile rather than fix them. Can I ask why you turned down the epidural injections?

Hi Melissa, I think part of the problem may be that the place I'm currently getting my healthcare is a tiny country affiliated to the UK, and their health system isn't comprehensive...some specialists fly in a couple of times a year to do clinics, and some patients are referred to the UK for specialist treatment, but this latter option is expensive. I do also feel as though I am partly being given the brush off, even though I'm working within the same healthcare system...many things are not fair or fairly distributed in this life, and living as a foreigner in another country is a sure way of learning that!

After my experiences over the last couple of days I have decided to arrange healthcare in a neighbouring country, and see how that differs. This will take a while to arrange (and entail communication problems), but it doesn't seem as though the problem is going to go away any time soon so is probably worth doing.

I turned down the injections after looking at the evidence base and speaking to a couple of doctors. While research shows that they can help with pain more than half of the time, they can also cause iatrogenic problems such as decreasing bone density in menopausal women (me!), and as an invasive procedure obviously carry risk of infection etc. Personally I don't want to undergo any such invasive procedures unless they are going to at least try to fix the problem...and both my parents had osteoporosis in their later years, so I am already likely to have issues with bone density.

I think you're right Melissa, the next step should be more investigations...I have several new symptoms since the last one was done, but am being made to feel as though I am wasting their time. I find it laughable that much of the literature advises surgery to be considered if sciatica doesn't resolve within 6 weeks...4 years down the line I appear to be back at square one...it's like the film Groundhog Day! But I now realise that there are many folk out there (like yourself and Lennie) who have been given the same brush off for a lot longer than I have! It really is good to be in touch with other people who understand what you're going through

 

Oh I see. Sorry I thought you were in the UK. Gosh it's hard isn't it? I had two lots of epidural nerve blocks for my nerve damage post op. I am 33 and have osteoporosis in my spine, entire left leg and foot and right femur, but I was also bed bound for months at a time plus unable to weight bear when walking so they said its dis-use osteoporosis developed over the last years. I also had a lot of muscle wastage and went down to 35kgs (now 39kgs, I'm 4ft 10). I'm slowly gaining muscle. I really hope you find a solution soon. I really feel for you. Mel

I'm sure they're right about the primary reason for your osteoporosis being disuse Mel...it's possible that the injections may have exacerbated loss of bone density, but it's steroids that do the damage so it also depends which cocktail of drugs they used...it sounds as though you've had a tough few years...and if the injections helped you get through it then the benefits probably outweigh any possible negatives. I suppose you're going to be taking it easy for a bit after the op on Monday too? It may be a while before you're able to build yourself back up to your 'normal' weight then. Very humbling to have your sympathy Mel!