Sciatica

 

 

  Hi, was wondering if anyone could tell me what worked for your sciatica.  I had a epidural steroid injection on April 21st, I fealt a little better on day 2 and was able to move around a little better. On day 3 I thought it was all a waste of time, I could hardly move to get out of bed.  I am still in so much pain early in the mornings, barely able to walk.  I pray I don't have to get up in the middle of the night to go to the bathroom, because the pain starts all over when I move or get up.

 

  I have a dengenerative disc. and a protruding disc at L4/L5. So we know where the pain is coming from. Just don't know what to do about it.  I don't honestly think I would have another injection, just hasn't been enough of relief from it.  It's been almost one week since the injection so I'm sure it would have already done it's job by now, right?

 

  After I am able to get out of bed and able to move around for a while the pain lightens up, so I can handle it for the most part. But the pain never goes completely away.  I'm trying to be posiitve and just do what I can and be thankful.  Never thought I was say I like cleaning the house, but when you are in a place where you can't even move, then you realize just how lucky you really are.  I don't take my health for granted by no means.  I went through brain surgery six years ago, it makes you thank the Lord for each breath you take.  

 

  Wishing you all the very best,

 

  Mercyme

Oh my Lakeside, you've really be through the ringer. So you've had several back surgeries. I don't know if I could go through that many procedures, but until your in that place you don't know what you would do. I went to the emergency room last weekend, the pain was so unbearable I couldn't hardly put one foot in front of the other. They gave me a pain shot, and a muscle relaxer shot. I just received the insurance statement and those two little shots cost $526.00! amazing isn't it?!

I've been in some pain today, but it was manageable. My hubby ask me what I'm going to do if it get's any worse, I said I don't know. But no back surgery! of course after I talk to the neuro surgeon again I may change my mind. there's not of relief with sciatica, so I feel for anyone dealing with it the way I have.

God Bless you and thank you for taking the time to reply Lakeside,

Mercyme :)

Mercyme,

Truly sorry you have to deal with this.  I'm on 4 years, and it has been truly horrible.  I've had 2 minimally invasive discectomies, and 1 surgery for Spinal Cord Stimulator implant, all unsuccessful.  All surgeries were done after 2 years of physical therapists, epidurals, osteopaths, etc.  It was recently discovered that my L4-5 disc that exhibited a small bulge on MRI is actually badly torn.  I'm having fusion surgery Tuesday and will hope for the best.

The usual accepted protocol is 6 months of conservative therapy (P/T, NSAIDS, shots, rest, etc.) before you consider surgery.  I'm assuming you've had an MRI since you've been diagnosed with specific degenerative disc problems.  L4-5 is usually the culprit, but occassionallly L5-S1 or, even more rarely, L3-4.  I would HIGHLY encourage you to have all diagnostic tests possible to define exactly what your pain generator is, and definitely would ask for an EMG, which not only can help locate the problem, but determine if you have any nerve damage or compression.  If so, then in my non-professional opinion, you would likely need surgery to relieve the compression, which could entail disc removal and fusion, or maybe just an out-patient micro-discectomy to trim the bulging disc.  I wouldn't do the epidural again since you didn't get any real relief, but you might request a Nerve Root block, which is a similar procedure but directed at a specific nerve root space.  This can provide some lasting relief, and would help diagnose the problem.  Some surgeons/doctors don't like it, but a Provocative Discography can provide pretty definitive diagnosis.  This involves injecting the discs with dye/fluid in an effort to reproduce your pain.  If it does, it obviously will not be pleasant.  The dye aids in visualization when they do a CT scan afterwards.  It took this to finally diagnose my torn disc.  Pain was not reproduced, however, as it was so badly torn it wouldn't hold fluid and "inflate", which causes the nerve compression and associated pain. 

As to your original question, pretty much nothing has ever given me relief.  I do take OxyContin, which helps, but many days are still miserable.  Pain killers just don't seem to work very well on this type of nerve-related pain.  They help, but they can't kill it, at least not for me.  So, I take only what I must to make it bearable and still stay coherent.  I wish I could tell you something that might help more, but I haven't found it. 

My last advice is to seek out the very best spine specialists you can find.  Travel if you must, and if it's possible for you.  I'm fortunate that my insurance covers pretty much nationwide, so there's a lot of preferred providers.  However, it has taken me 4 years to find the right doctors, and they're a 3 hour drive away.  I live in a major metro area loaded with supposedly highly-competent doctors, and was referred to supposedly the best available, but have been unsuccessful in getting the correct care for my problem.  I truly wish you the best.  Sciatica is a terrible, burning pain, and difficult for others to understand because you don't really see the affliction.  Hang in there.  Good luck and God Bless.

Anon 

Hi Mercyme! Thank you for your post & empathetic comments...yes, 3 back surgeries in about 1 year are enough for me, right now anyway..

But again, as I said b4, if your sciatica is from compression of a nerve or nerve root, as my neuro said, the longer you wait, the less chance of recovering feeling in that affected limb. As PALady says, also. I waited about a year b/c we had to try all the other stuff (hoops for the insurance co) but had I had the fusion sooner, perhaps my leg/foot would be totally normal now. I still don't have complete feeling in it, but the sciatica is gone. Just have the tingling/numbness at times, but like Underthebus, nothing on the previous level, which is such a relief, as you can well imagine.

So see your neruro, do your reseach on what s/he suggests and don't discount surgery, if that is what MAY give you some relief. Fusions are not always successful, but you finally get to the point (I did!) where you contemplate chewing off your leg like those animals caught in traps do!

Keep us posted on your "progress"! We truly care! And Anon, I will be thinking of you on Tuesday also! PALady, me & others here will be rooting for you!

~Lakeside

...geting thru the knee capsule is the hard part, Anon...after that you're home free, LOL!

Sounds like you have great reasons for your fusion...your neuro will do a nice, neat foramenotomy (bilateral probably) and your nerves will leap out of their tethers & sing for joy! Yea! No wonder you are extra-miserable, with co-joined/double nerve roots...ooohhhh, makes me swoon w/ pain just thinking of what you've been enduring. But hopefuly, in a few days, that will be a distant and fading memory. And that lousy disc will be gone too, and your spine will be "immobile" at that level,which feels great once it starts to heal, like mine is---very "solid" and "brick-like"---even improved my walking gait. Oh sure, there's still some pain, on some days a lot yet, but the basic problem is solved (as I hope yours will be too) so I try to think of it as "healing pain" ---sort of re-frame it. Helps---to a point!

Fusion sugery is salvage surgery. We will never be 100% whole or 100% pain-free. But it can (when it works) stop the progression of the decay and "buy time" towards a more normal existance.

Wishing you all the best~! Sounds like you have a great surgeon & that you TRUST him....that's the most important thing. So now rest, relax & let them do their thing & take gentle care of you in the hospital and YOU take gentle care of you, after!

Stop chompin' at the knee, now...you'll need that joint when you start your walking rehab program after you're home ! :)

~Lake

Mercy,
Thing is sad to say we all have been and mostly still are in your shoes! If our pain was resolved most of us would be out living life and not posting to a chronic pain forum! Unfortunately, there are no easy answers, and no 'one size fits all' advice any of us can give. I can suggest you read a lot of other threads on this board to see what others have been through. I certainly would make sure I tried all the "conservative" measures like physical therapy and such before jumping into surgery. But like we've said earlier, you also don't want to wait too long. You can always get a consult from a good neurosurgeon (if you have a major medical center within driving distance that would be a start), and see what they say. And sometimes it can takes weeks or months to get appointments made, so you could be doing physical therapy or more injections (if you decide to have more) while you're waiting for a surgical consult. Because you have a consult doesn't mean you have to have the surgery, but it does give you more info. about options, and how long you should wait.

Anon - since you're posting to this thread I want to add something you're probably not going to like to hear, but I'd plan on longer than 4-6 weeks of recovery if I were you. I have a hunch Lakeside would second this, but I'll leave that to her! I was told 4-6 weeks, too. HA! More like 3 months. I'm almost 7 months out now and I guess if my surgery had been successful (like Lakeside's) I'd probably have to say I'm as recovered as I'm going to be, but my double level fusion (L4-S1) didn't solve my leg & feet pain (although I am told it can take up to 2 years for nerves to heal, and that at that point, it's as good as it's going to get, so maybe I'll still get some relief over the next year or so). Anyway, I'm rambling but I did want to suggest you prepare to be out for longer than 6 weeks. I don't know what kind of work you do, but it was six weeks before I even opened the door and got into my car and drove around the block = very tentatively, I might add. I'm still in physical therapy for the muscles around the surgery site, and I had a minimally invasive procedure. Now if the surgery had been as successful as Lakeside's at removing the radiating symtoms, I'd gladly put up with the muscle discomfort in my lower back. I use an intraferential stimulator at home a lot (similar to a TENS unit but my PT tells me it helps with both pain and blood flow), have a theracane to help with muscle spasms (although could only start using this - very gently - recently), and still use tons of heat and sometimes ice. But I have just this past couple of weeks started some very slow exercises from my PT to help strengthen those lower back muscles. I just want to tell you it's all slower than what they're likely telling you - at least from my experience. And I had prepared my pt. time job for me being out 4-6 weeks and had to extend my leave. They ended up laying me off anyway, after they laid off my supervisor, so now I'm having to pay COBRA for my insurance, but that's another story.

On the good news side, I really don't find I've lost much, if any, mobility from a double fusion. My surgeon told me before the surgery that I'd likely already lost mobility from the DDD, herniations, etc., and he was right. I almost feel like I maybe have gained a little, because I can do some things now - like fold clothes on the bed, without back pain, and that hurt a lot before the surgery. I have found that there are some movements that are really painful. I shared with Lakeside how I had been ill, needing to vomit (sorry for the graphics folks!) a few weeks ago and found out that bending over a toilet and stressing those muscles is definitely out! But overall I do not feel I've lost flexibility. But I still have the sciatic pain, and numbness and tingling in both feet. It's possible I waited too long (nearly 3 years) for the surgery.

Good luck Tuesday!
PaLady

Mercy,
I left you another post on a different thread, but I really think you're doing too much too soon. I didn't start PT for 3 months after my fusion surgery - and it was minimally invasive surgery. Sitting is one of the worst things you can do, and walking around a mall is probably not great either as it's probably on hard floors. This all is very delicate and some of your pain is already coming back. Mine never went away, but if you're going to be one of the lucky ones to get relief I would be treating my body with TLC big time and err on the side of caution. My hunch is your doc wouldn't want you doing all this activity this soon. Walking around the house is one thing, or maybe taking short walks outside, but you seem to be trying to be back to "normal" too quickly. Do you want to risk paying the price of aggravating that nerve? Nerves are very delicate and it can take them up to two years to heal, IF they do. You had some good signs in that your leg pain went away after surgery.

Too much too soon, IMHO.

PaLady

Mercy -
It's not giving up to take care of yourself after surgery, so as to maximize the positive benefit of surgery. I wonder why you're allowing yourself to have a long day and, again, you're not even a week out from surgery. I would suggest you slow down big time, and tell your doctor all the activity (including sitting) you've been doing, along with your symptoms. I don't know if your doc will do another MRI, but you need to take better care of yourself or from the sounds of it your surgery won't be successful. You keep doing more activity, and you keep having more pains. Connect the dots!

PaLady

Sorry if this sounds a bit harsh, but I'd have given anything to have my leg pain eliminated by surgery. You're risking what sounds like potentially a successful procedure. A few weeks of calmer activity is well worth the trade off, IMHO.

Post Edited (PAlady) : 5/10/2008 8:56:48 PM (GMT-6)

 

  Hello, just a little update since my discectomy L4/L5 on May 5th, it's been four weeks now and I'm doing good. I'm being a good girl and doing all the pt exercises they gave me.  I went for a long walk yesterday, and today my back is stiff and achy. Also have a little leg pain, guess I over did it a little bit, it was walking outside not in a Mall, lol.  I go to the neuro surgeon this Friday June 6th.  I've started having terible migraines, I've always had migraines, but these have been really bad, I also have a bone spur in my neck so that may be causing the migraines. 

  I hope you are all doing well, I will continue to do my walking and try to take care of my back.

  Blessings

  Mercyme 

Hi, Janet,
First, I'd suggest you cut and paste your post and start a new thread. This thread is older and your post and questions might not be seen as much.

Speaking as one who has had failed double lumbar fusion surgery, and still had ongoing SI join problems, sciatic, pain, and feet numbness, I would say please don't count on surgery to relieve all your pain. Unless a doctor can pinpoint one source of pain and access it easily through surgery, it's likely you'll have some pain to manage even after surgery. And fibro pain is not likely going to be relieved by surgery, although I'd suggest posting to the fibro board for help with that.

Definitely - definitey - get a second opinion from a different surgeon (not in the same practice as your doctors) before surgery. I know I and many of us here keep going for the next procedure, treatment, surgery, etc. in hopes of getting free of pain, and getting our lives back. That may happen with some people, and they're not likely to be posting here because maybe they've gone on with their lives. But since at least one doctor has told you that even fusion would not help, I would proceed very cautiously.

A discetomy (I've had one) is a test where a needle is inserted into the disk space which has a flouroscopic (type of X-ray) camera on the end, so they can see right into the disk(s) spaces. But you won't be able to have a lot of sedation because you have to give the doctor feedback so he/she knows if they're hitting the area causing you pain. So it's not fun to have. But it's not surgery.

As far as recovery time, you can read on some other threads here (and I'd really suggest reading a lot of them) to see that doctors most often tell us the shortest time possible for recovery - my guess is to entice us to have surgery. But all my times were doubled; the doctor's nurse was actually more accurate, and I did have a minimally invasive procedure. It took me 6 weeks to even sit in my car, and 3 months to get back to even a few hours of work.

Many of us don't want to use narcotic medications, but find that's the only choice left for us. If done under the guidance of a good pain management doctor, they can be extremely helpful. And there are non-narcotic medications that can help also. Please don't think that surgery will mean you will be free of medications. I suspect that happens in only a small percent of cases, but then that's just my opinion.

Hope this helps some.

PaLady

Modelmaker & others,
This thread was started over a year ago. Janet's post was new, and I hope she starts another thread so she gets more responses for her.

PaLady