Sciatic Nerve Help Please!

[bendtheski]

The causes of sciatica are many but it most commonly results from either a herniated disk or spinal stenosis. Depending on the cause, the pain of acute sciatica usually goes away on its own in four to eight weeks or so.A thorough diagnostic work-up will reveal the cause.Fortunately, sciatica typically resolves without the need for surgery in about 4-6 weeks. However, if any neurologic deficits develop, such as a foot drop or changes in normal bowel and/or bladder functions, then immediate surgery is usually performed.For acute sciatica without any neurologic deficit, the use of epidural steroid injections can be very beneficial in resolving the discomfort.

This is probably a worst case scenario, or close to it...
In Jan 2003 I herniated my L4-5 disk. Started out with the Chiro who happened to be my roommates brother, and an honest dealer. I had seen him on and off for a few years for occasional muscle spasms and the like. He immediately recognized this as being more serious than anything I had seen him for before.

I was walking with a pronounced limp, had pins and needles, and pain on a 8-9 level after sitting for 15-20 min. The Chiro suggested I go immediately to an orthopedic.

The orthopedic gave me cortizone or similar prescription for a week, and when that didn't provide relief, scheduled an epidural/steroid injection into the affected area. The steroid injection gave me relief for one day, at which time my orthopedic scheduled an MRI.

The MRI revealed a herniated L4-5 disk. By this time it had been approx. 5 weeks since the original injury, caused by a hard, twisting compression while skiing bumps on New Years. The orthopedic referred me to a neourosurgeon and I had surgery the second week in February. Micro-lumbar laminectomy/disectomy.

I experienced immediate relief, and regained a good deal of the strength that was lost due to pressure on the sciatic nerve (S1). Rehab was pretty easy, and I was back to abusing myself on moguls the following December.

I would say that surgery for this type of thing should always be a last option, and there are many other options that may provide significant relief. I had chronic lower back problems leading up to herniating a disk, but herniating a disk is a whole other level of injury/pain/discomfort than simple muscle tears/spasms, and I think I made the right decision opting for surgery.

Ultimately, it was the foot-drop and the MRI that made my mind up for me.

[BigKuba]

Bump again because this shit fucking blows. This is round 3 or 4 for me over the last ~12 years, and this time it's the other leg. Had previously herniated L4-L5 and L5-S1, had a cortisone shot for the L4-L5 in late 2008 that worked -- got me from 100% bedridden to 100% pain free in 72hrs and had been good until now.

Thankfully no pins/needles down the leg/foot (knock on wood), just a stake doused in battery acid being driven into my lower back/butt-cheek.

I've got my PT regimen dialed from last time and my benefits are much worse than last time this happened, so I'm not so keen on running around doctors who are going to tell me what I already know.

Odd thing I noticed this time -- hip flexors + random muscles around the hip/pelvis are sore -- and although I've ridden a bike a few times, it wasn't strenuous enough to warrant this. Almost feels like my lower back got knocked out of alignment and is staying there. I've been working from home and stretching for hours each day, but can't get things to click back into place. Am I just imagining things? Is it worth seeing a chiro (haven't had the best experience in the past), and if so, can y'all recommend one in the Denver area (downtown, but more than willing to drive for a good one)?

Also, what's the best sleep position to let this thing heal or at least not get more aggravated? I've heard on one's back, back with a pillow under the knees, and stomach, but it seems like the extension or flexion debate. It doesn't help that I sleep like a murder scene body outline, but I can try to be more disciplined.

[DeutschBag]

Does anyone have any more information on Ortho Bionomy? For instance, how many sessions would one have to go to? How often? I DO have some practitioners near me, but if I had to go every day or two for treatments, it would be very, very difficult. Especially with our twins due in the next two weeks.

I had an Ozone injection in my L4/L5 a bit over a month ago in lieu of surgery and at my neurosurgeon's advice. It was supposed to fix my disc herniation. It didn't. Things are only getting worse. I've started therapy (again), and after three sessions in four days, can barely walk today. The tingling and burning in my left foot is constant and has been for six months. Today is one of the worst days I've had in a long time. I'm having sciatica down both legs now and tingling in both feet and bad knee pain in my right knee. WTF?? German docs will only give me Voltaren (dicoflenac) and it does absolutely nothing for me. I am seriously at a loss on what to do next and the only answer I'm getting from the Neurosurgeon is, "do more Gymnastiks/Pt". I'll probably end up in the ER tomorrow if this doesn't get better. It would be the third time a PT session has ended up with me in ER. So worn down from all this shit.

[brraaap802]

This is probably a worst case scenario, or close to it...
In Jan 2003 I herniated my L4-5 disk. Started out with the Chiro who happened to be my roommates brother, and an honest dealer. I had seen him on and off for a few years for occasional muscle spasms and the like. He immediately recognized this as being more serious than anything I had seen him for before.

I was walking with a pronounced limp, had pins and needles, and pain on a 8-9 level after sitting for 15-20 min. The Chiro suggested I go immediately to an orthopedic.

The orthopedic gave me cortizone or similar prescription for a week, and when that didn't provide relief, scheduled an epidural/steroid injection into the affected area. The steroid injection gave me relief for one day, at which time my orthopedic scheduled an MRI.

The MRI revealed a herniated L4-5 disk. By this time it had been approx. 5 weeks since the original injury, caused by a hard, twisting compression while skiing bumps on New Years. The orthopedic referred me to a neourosurgeon and I had surgery the second week in February. Micro-lumbar laminectomy/disectomy.

I experienced immediate relief, and regained a good deal of the strength that was lost due to pressure on the sciatic nerve (S1). Rehab was pretty easy, and I was back to abusing myself on moguls the following December.

I would say that surgery for this type of thing should always be a last option, and there are many other options that may provide significant relief. I had chronic lower back problems leading up to herniating a disk, but herniating a disk is a whole other level of injury/pain/discomfort than simple muscle tears/spasms, and I think I made the right decision opting for surgery.

Ultimately, it was the foot-drop and the MRI that made my mind up for me.

Glad to hear the rehab is ok. My MRI's show herniate L4-L5 with a disc extrusion or disassociation. Disc possible sequestered, or at the least there is a fragment floating around jammed into the nerve. I was told it would be unlikely for it to solve itself without surgery so I suspect that's where I'm headed. Season over.

[bendtheski]

Glad to hear the rehab is ok. My MRI's show herniate L4-L5 with a disc extrusion or disassociation. Disc possible sequestered, or at the least there is a fragment floating around jammed into the nerve. I was told it would be unlikely for it to solve itself without surgery so I suspect that's where I'm headed. Season over.

That sucks man, but there will be other seasons.

I don't know if this is something that all neurosurgeons tell their patients when trying to convince them that surgery is the best option, but mine told me that the nerve (S1) with an impinging disk fragment is like a new carpet with a sofa on it. Move the sofa in a couple of weeks and there will be some impressions from the couches feet in the carpet. A couple of passes with a vacuum and the impressions disappear, but if the couch sits there long enough, those impressions don't go away, no matter how much you vacuum.

I think the moral of the story is, if it's clear that there is physical damage to the disk, and an impingement on the sciatic nerve, the sooner you treat it, the better the chances that the nerve will recover fully. Or as close to fully as is possible.

Just curious, were you snowmobiling when you injured it? I've heard back injuries are pretty common sledding. I also mention it because I had been riding the night before I did my disk, and often wonder if I hadn't actually done it on the sled the night before, and only noticed it the next day because the fragment shifted into a bad position while skiing.

BigKuba,
If I had your symptoms, I wouldn't let a chiro anywhere near me. I was lucky that my chiro was honest enough with me to suggest that my issue might be best addressed with "traditional" medicine.

I'm not knocking chiropractic or any other less conventional methods. They clearly have helped millions and in many cases might actually have a lead on conventional medicine, but if I had all those symptoms you describe, I'd want to have it checked out by an ortho and get a MRI that would hopefully give some insight as to what's actually going on with my spine before letting someone attempt to manually re-align it.

[brraaap802]

That sucks man, but there will be other seasons.

I don't know if this is something that all neurosurgeons tell their patients when trying to convince them that surgery is the best option, but mine told me that the nerve (S1) with an impinging disk fragment is like a new carpet with a sofa on it. Move the sofa in a couple of weeks and there will be some impressions from the couches feet in the carpet. A couple of passes with a vacuum and the impressions disappear, but if the couch sits there long enough, those impressions don't go away, no matter how much you vacuum.

I think the moral of the story is, if it's clear that there is physical damage to the disk, and an impingement on the sciatic nerve, the sooner you treat it, the better the chances that the nerve will recover fully. Or as close to fully as is possible.

Just curious, were you snowmobiling when you injured it? I've heard back injuries are pretty common sledding. I also mention it because I had been riding the night before I did my disk, and often wonder if I hadn't actually done it on the sled the night before, and only noticed it the next day because the fragment shifted into a bad position while skiing.
it.

Thanks. Skiing, not sledding. Plus too many years of doing stupid shit catching up to me.

[Canada Guy]

Thanks. Skiing, not sledding. Plus too many years of doing stupid shit catching up to me.

brraaap802, I just stumbled across this thread and noticed you are also in the Calgary area. What steps did your doc take as far as setting you up with a specialist? I have a bulge in my L5 resulting in moderate to severe central stenosis as well as degenerative disc disease.

My doc appears to be a bit clueless and has tried to refer me to a Neurosurgeon, but I am on a wait list for a minimum of 14 months. He doesn't seem to have any idea what my course of treatment should be so he is just taking a stab at it with the referral. In fact, he didn't seem to know if I should see an ortho or neuro surgeon. I would prefer to not have to wait that long if I can help it.

[userA]

z-bo hows the sciatic thing going seven years later?

[brraaap802]

brraaap802, I just stumbled across this thread and noticed you are also in the Calgary area. What steps did your doc take as far as setting you up with a specialist? I have a bulge in my L5 resulting in moderate to severe central stenosis as well as degenerative disc disease.

My doc appears to be a bit clueless and has tried to refer me to a Neurosurgeon, but I am on a wait list for a minimum of 14 months. He doesn't seem to have any idea what my course of treatment should be so he is just taking a stab at it with the referral. In fact, he didn't seem to know if I should see an ortho or neuro surgeon. I would prefer to not have to wait that long if I can help it.

That sucks. Options are go in queue (a long frustrating experience with our "free" public health care, try to find a friend/family member who is a speciliast of some kind to shoehorn you in, or private options (cambie clinic in Vancouver keeps coming up, but it aint cheap). I'm investigating all 3 with no clarity on timing. Seem orthos do spinal stuff as well so it is possible to see either. (I think the Caleo clinic mostly ortho).

You may want to try Chiro, physio,, etc. first. I'll pm you later with some contacts that have worked for me.

[Treycal]

You may want to try Chiro, physio,, etc. first. I'll pm you later with some contacts that have worked for me.

Canada Guy,

I've just gone through a year of dealing with slight herniations/bulging of L4-L5/L5-S1 discs. Initial recovery was pretty good after approx. 6 weeks. Enough to get back to the gym/skiing; however, what my physio at the time thought was just some minor residual nerve "stickiness" on my left side (opposite of my original sciatica symptoms) turned into a full blown crippling pain well beyond what I initial experienced.

After a couple of months of seemingly no progress at my physio, I went to see Dr. Jason Dick @ Riverside Sports Therapy. He's a chiro but focuses on sports related injuries and tends to shy away from the more holistic "I can cure cancer & asthma by adjusting your back" approach. He does a lot of work with the Hitmen & Stampeders. He also uses active release therapy. It took some time, but I'm pretty much back to 90%ish and pain free most of the time. I can't recommend him enough.

That sucks. Options are go in queue (a long frustrating experience with our "free" public health care, try to find a friend/family member who is a speciliast of some kind to shoehorn you in, or private options

Tell me about it. I had no issues getting in to see my family doc and pretty obvious diagnosis, but I'm still waiting for scheduled MRI which will be in mid-May. Total wait time about 8 months and likely well after I've fully recovered. At least I can use the MRI to establish a base line, in terms of disc position, etc., to use if I hurt my back again.

[bmg97]

Man this shit sucks. I just started getting zapped down my right leg a few months ago. I actually had to hangup on a customer because the shooting pains were so bad I couldn't talk. It comes and goes and seems to get worse when my posture gets lazy. Was hoping it would just stop at some point. I actually think it knows I'm talking about it now. I'm hoping the gym and some stretching helps out.

[ghettostyle]

mine is due to an L4 budging disk. though my back did't hurt by i had debilitating nerve pain down my right leg so much so that my ankle actually was slightly swollen. Forward leans KILLED me, and my whole right leg became very inflexible. my dr said that because i was strong before there was a good chance for a full recovery w/out any need for surgery or continuing meds and that it would just take time (he said the durations popular on the med web sites are way off, which in my case they were). It took 6 months to feel "close" to normal, and it continues to get better almost weekly. For me, the best remedy is residing in the fact that i needed initial rest with some light activity to allow the nerve reduce it's own swelling. now i workout 7 days a week on heavy/stressful core, squats, push ups, pull ups, dips etc daily to remain in the best shape i can. Some days are heavier than other, but 7 days a week i find is better than any with inactivity. Even a day or so being a piece on the couch, it feels worse. It could be worse than lifetime prescription of exercise, it could be pain killers...

[DeutschBag]

Just had an emergency surgery to fix my sciatica and horrible lower back pain. Doc said it was my only choice since I could barely walk and no positions were comfortable for me. Couldn't sit, stand, lie down without tremendous pain. Even though my MRI didn't look too bad, when the neurosurgeon got in there, the damage and compression on the L4/L5, L5/S1 nerve roots was quite substantial. Surgeon said the surgery went great and expects a full recovery and a 100% return to action in 8 weeks. Still healing up, but am quite ahead of schedule according to me docs. Gotta thank my diet for that (Paleo). Not saying surgery is the answer for everyone, but I'd been dealing with this for years and no conservative approaches were working. Hope you all can find what works for you.