Terrible pain spike today...Need advice about sciatica please

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Mysti
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Date Joined Jul 2011
Total Posts : 101
   Posted 8/3/2011 1:48 PM (GMT -6)   
Hey everybody.  I just wanted to ask some questions for those of you with personal experience with sciatica.  I do know the signs and symptoms etc, and I have dealt with this for a couple of years, but I'm just a bit stumped today as I just cannot believe that pain this intense in my leg is directly coming from my lumbar spine issues.  Yes, I have low back pain but it now seems to be over-shadowed by this leg pain.  So I am wondering if this is common, as it relates with the *severity* of my disc problems per my MRI on July 12.  Even though the report states no foraminal stenosis and doesn't even mention nerve impingement, there is most definitely something going on with my right leg.  I do have 3 3mm protruding discs and I do understand that the extent of damage doesn't always correspond with the pain.  However, my ENTIRE leg (not just the back of it), including buttock, hip, thigh, down to sole of foot feels like *dry socket* wisdom tooth extraction pain...horrible.  It includes cramping, burning, aching, tingling, weakness, numbness, coldness...you name it.  I just cannot get comfortable and was up all night last night.  Is this common with sciatica?  The entire leg, even the front thigh, knee, shin, etc.?  My hip also seems to be hurting, which is new.  I did lift my mother's 50# suitcase yesterday when I picked her up from the Amtrak station....I wonder if that has anything to do with it?  I'm taking my usual hydrocodone (10mg 3xday) and added ibuprofen, also flexeril, lyrica.  (I guess that's a big DUH on the lifting thing).  What are your thoughts and do you know of anything else I can do to help get relief?  Thanks in advance.

straydog
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Date Joined Feb 2003
Total Posts : 16787
   Posted 8/3/2011 2:02 PM (GMT -6)   
Mysti you are correct about the lifting so I won't go there, lol. One of the best things that helped me with the sciatica problems was some injections with steroids. My PCP did mine because I was in such pain he knew I needed relief now not later.

I hope you can get some help.
Moderator Chronic Pain Forum

cogito
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Date Joined Oct 2010
Total Posts : 932
   Posted 8/3/2011 2:02 PM (GMT -6)   
I get sciatica from piriformis syndrome. One thing that helps, at least briefly, is to do a hamstring stretch. I was told at PT that it stretches the sciatic nerve and briefly halts its signal transmission.

If you're unfamiliar with the stretch, google it and try it carefully and gently at first, especially if you're not too limber.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Jim1969
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Date Joined Jul 2009
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   Posted 8/3/2011 2:11 PM (GMT -6)   
Based on what you have mentioned, personal experience, and various Dx's I have received over the years I suspect that you have strained the muscles in your back which in turn is putting a lot of pressure on your bad disc(s) which in turn is causing them to impinge the sciatic nerve and possibly other nerves as well.

As far as home remedies go, beyond what you are doing already, I suggest trying alternating heat and ice. Use one or the other for about 10 minutes every hour, rotating them each hour. If one or the other causes a moderate to severe uptake in your pain levels then discontinue. You can also try some pain relief creams, sports rubs, that kind of thing.

Other than that it is rest and time. It looks like you are already taking the same meds and doing everything else a doctor would have you do.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

spinal soldier
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Date Joined Dec 2009
Total Posts : 687
   Posted 8/3/2011 3:43 PM (GMT -6)   
if the pain is reaching 7-9/10 pain scale, then to me that points to lumbar ridiculopathy of some type. the sciatic nerve is as big around as your thumb or a standard walgreen's pill bottle, that is a lot of nerve that can transmit major pain. you do not have to have bad foraminal stenosis for this to occur. Facet Arthropathy or facet joint arthrosis can cause sciatica by causing a huge inflammatory problem in the general area. when you say you have protruding discs on 3 levels, do you know by the report or the films if they are bulging strait back, "posterior" into the dura which is the sheath that surrounds your spinal cord? if that be the case it does not take much protruding to irritate the cord canal and that can cause sciatica. are your discs healthy and not degenerated or have they lost some of their disc height and equal space between the vertebral bodies. do they appear to blackish? have you had a EMG, Myleogram, or Discogram? none of the 3 is easy but i would say the EMG or nerve conduction study is the least painful and traumatic. a Myleogram at this point since you have a MRI that is not definitive may be the deal because they inject a different contrast than what a MRI would be intrathecally which is the same as a lumbar spinal tap injection, and now interventional radiologist or anesthesiologist are doing the procedure and they put a I.V. in your hand maybe and give you one of about 3 or 4 things: Propofol and Fentanyl or Versed and Fentanyl or they might use dilaudid as the opioid. Demerol was standard for these things but they have disconiued the common use for meds with low adverse effect risk, anyway i'm going on a tangent. i'm curious to see your report and i wish you nothing but the best, "i feel your pain" to quote Pres. Bill Clinton.

Mysti
Regular Member


Date Joined Jul 2011
Total Posts : 101
   Posted 8/3/2011 11:12 PM (GMT -6)   
LOL Spinal Soldier at Pres. Clinton's quote!  Yes, I am told I have arthritis in my spine and the MRI report says 2 of the lumbar discs have *mild* degenerative changes in the facet joints and the other (L5-S1) is *moderate* for degen. changes.  And the radiologist did not indicate "posterior" (or anterior) with the protruding, nor did it even mention anything about annular tearing, so I am assuming those discs are still intact.  I haven't actually seen the films, I just read the report.  Working for years as a nurse, I've seen many an MRI report, but to me it seems this particular radiologist was rather vague in my report.  But I am certainly no expert in radiology by any means.  I haven't had an EMG or any further studies, but you really gave me some good info.  And I would say today my pain level has been around 7/8.  I also had a plain xray of lumbar spine in May, which confirmed the arthrosis and DDD with bone spurs.  One thing I forgot to mention on my MRI report was the existance of *small* hemangioma from T-12/L2....I am unsure if that would cause any problems or not, but it was mentioned.
 
Actually for some reason, my osteoarthritis is really flared up today, with increased neck pain (never had cervial xray or mri except an xray in 1992 after a car accident and I had a bad whiplash injury); and just generally in pain all over.  But I'm not even going to complain about those aches and pains, as this sciatic-type pain blows everything else out of the water.  Plus, I know we are ALL in pain here, and I really do hope y'all aren't spiking today.  Thanks to everyone for the wonderful advice and support.
 
 

BethW
Regular Member


Date Joined Mar 2010
Total Posts : 132
   Posted 8/4/2011 9:59 AM (GMT -6)   
If this is acute (ie caused by lifting the suitcase), and the sciatic pain is only down one leg, try this. Lay on the bed or floor on the opposite side as the painful leg with a pillow (or two) under you at about the same level as the bad disc(s). The pillow will force your back into a curve, which may open up the disc space a little and give the nerve a break.

I hope that made sense. It has helped me in the past, if only while I'm resting.
DDD (4 levels- L2-3 thru L5-S1), Hashimoto's Disease/ thyroid cancer (thyroid removed 6/11),

Mysti
Regular Member


Date Joined Jul 2011
Total Posts : 101
   Posted 8/4/2011 12:47 PM (GMT -6)   
Beth, thank you so much for that idea. Actually, yesterday, my husband was telling me to lay flat on the floor and put my legs with knees bent at a 45* angle on an ottoman or couch or something. I tried that but it killed my sacrum and upper buttocks as it feels really tender in the tissues in that area. I don't know if that's from bone spurs or the DDD or what, but it feels like a bad bruise.

Your idea sounds much better! I think by putting the pillows under the bad disc(s) area, would be way more comfortable....so I am going to try that NOW lol.
DDD, 3 bulging lumbar discs, bone spurs, osteoarthritis

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16787
   Posted 8/4/2011 1:20 PM (GMT -6)   
Mysti my orthopedic says for people with back problems they should never try to lay on their stomach or back, especially when sleeping. Should sleep on our side with a pillow between the knees and it does take the pressure off the back. It takes a little to get use to the pillow but is doable. The only way I will ever lay on my back is in my bed. I too have the topper on my mattress and its mainly how I am able to do stretches.
Moderator Chronic Pain Forum

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 8/4/2011 1:45 PM (GMT -6)   
You should just see the way I sleep Stray!! LOL...With my neck issues...I also cannot lie on my stomach at all...I have the curved tempurpedic pillow (real one...worth the money)..Then when on my side...I have a special leg/knee pillow that is so comfortable..it's the length of my entire leg...so my ankles/feet don't flop down...as well as I have a pefect small pillow that I have between my arms/elbows...

So my spine is in perfect alignment...and it's easy to change sides which I do every hour while I sleep..but it's quite funny looking to get all set up! LOL...

Sorry you are having a tough time Mysti...I hope that the PM will be able to help with some good suggestions..
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

spinal soldier
Veteran Member


Date Joined Dec 2009
Total Posts : 687
   Posted 8/4/2011 4:29 PM (GMT -6)   
i just typed a long reply and the power tripped and pufff gone. i wanted to say the risk of spondylothesis exsist because of multi-level facet joint arthosis. i think you should have a consult with two of the better neurosurgeons in your area. i was similar and having the joints fused helped.

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1235
   Posted 8/4/2011 10:40 PM (GMT -6)   
A 3 mm protrusion is just that , a tiny protrusion of the disc, which may be caused by position of the person during the MRI....if there were nerve impingement in the lumbar area, it surely would have been on the report- foraminal stenosis is what it would be called. The sciatic nerves run through the back of the legs, hips and get smaller as they travel down the legs....lifting a 50# suitcase could certainly have caused the sciatica flare....and most probably did. Not lifting things properly is one of the biggest causes of flares of sciatica in all of us. Ice , alternating with heat may help, anti inflammatories may help, and injections of steroids may help to reduce the inflammation as well. The biggest relief comes from resting and avoiding any further lifting or twisting until the sciatica pain subsides. Sciatica can cause pain in the hips as well, since the nerve travels down through the hip area....or the hip pain may be caused by bursitis. An injection of lidocaine and steroids in the bursa really helps with that pain, almost instantly.
I had decades of severe sciatica flares before my first back surgery so have some idea what she is talking about.I'm sorry that you are going through this, it's terrible pain....A spondylolysthesis most probably have shown on the MRI unless it is a brand new one, but she would be complaining of different symptoms.
Motorcycle accident 1992, Back problems from 92 to 2005. August 2005- early 2006- Chiropractor care
March 2006- consult with surgeon -PLIF/TLIF L4-5, spondylolysthesis, canal and foraminal stenosis, multiple herniations
Post Op Cauda Equina Syndrome
Revision August 2007- salvage op
March 2011- 2nd onset of Cauda Equina Syndrome
Needs surgery to prevent paralysis

CRPSpatient
Veteran Member


Date Joined Mar 2011
Total Posts : 1276
   Posted 8/6/2011 6:55 PM (GMT -6)   
Hi Mysti, just wanted to offer my sympathies on your pain levels. I hope that you can get them down very soon *hugs*

Laura
CRPS since 1999, diagnosed in 2005 and since spread to full body, spasms, dystonia & contractures, gastroparesis, orthostatic hypotension,bradycardia/tachycardia, bone spurs, bursitis, carpal tunnel syndrome.

On Oxycontin/Endone, Topamax, Mobic, Magnesium, Florinef, Somac, Cipramil. Have a spinal cord stimulator, intrathecal pump with baclofen & bupivacaine and doing physio.

mtgman
Veteran Member


Date Joined Mar 2005
Total Posts : 1289
   Posted 8/7/2011 1:16 AM (GMT -6)   
i used to have sciatica so bad i could not even roll over in bed...it was horrible! i refused the shots and was put on muscle relaxers and went for physical therapy- got a massage each time- not sure that did anything but it was sure nice...they did decompression which was awesome and what i think resolved the issue- strappd me down on the table and pulled- very cool machine. i have issues still every once in a while but nowhere near as pronounced or prolonged as it used to be. hope you feel better soon.
37 year old male living in AZ. Diagnosed with Crohns at age of 15.
Currently on 20 mg prednisone. still taking Asacol. Done with Remicade- antibody level was over 8! Waiting for scope results to see about Humira or Cimzia.
In the middle of a bad flare now for 2 years...it's been one heck of a ride!

Mysti
Regular Member


Date Joined Jul 2011
Total Posts : 101
   Posted 8/7/2011 1:22 AM (GMT -6)   
Thank you Laura and everyone else replying to my post. It sounds like you all have way more reasons to have pain than I do...so I feel somewhat of a hypochondriac now. But I do have some pretty significant pain going on that is driving me nuts.

While I am in no way trying to diagnose myself (my GP has been telling me for 5 yrs that it is sciatica from my DDD...and the pain has grown worse since the past couple weeks (even since my MRI last month)....but my first PM appt is not til the 29th of the month, so I've been doing my research and I think I have come to a conclusion as to what I THINK may be going on. It is starting to make sense now. Sacroiliac Joint Disease/Dysfuntion. I've also learned that it can be very difficult to diagnose on MRI and is usually dx with hand manipulation tests by the doctor. I'd like to hear from anyone that might have some experience with this condition. My pain is in my low back (around L4/5) and to the right, then it *feels* like my hip, but only to the *inside* of my hip, to the groin/ pelvis/ front & back of thigh/ outer calf to bottom of foot. It's like a gnawing, aching, sharp, crampy pain that also includes prickly feelings in my feet, but especially right one.

Anyhow, geez I'm so sorry I seem to get long-winded and gabby so I apologize for the length of my posts here. Maybe I will start another thread on this. Hugs to all of you...I hope you're having a peaceful night.
DDD, 3 bulging lumbar discs, bone spurs, facet joint arthrosis/sclerosis, osteoarthritis
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