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Chronic Sciatica and back pain

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Posted 11/10/2012 4:33 PM (GMT 0)
Also when my doctor reviewed my X-ray of my lower back, he said my sacrum wasn't formed correctly. It is suppose to be one bone but he said it is two...Anybody have any idea what he is talking about? Is there a name for this?
Posted 11/10/2012 7:51 PM (GMT 0)
Hi Erica, glad to hear from you. So, I take it you did not see the orthopedic surgeon? Since you have what you do showing up on your MRI (nerve involvment) if this were me I would schedule an appt with a board certified neurosurgeon. His education is more extensive dealing with nerve problems of the spine. The orthopedic's is geared more towards the bony structures. But, I would not delay any longer in getting in to see a specialist for a consult.

You asked if 800mg of Neurotin will help you or not, no one can really answer this question as we all metabolize medications differently, so there really is no way of knowing this information. You may or may not get relief, but regardless you have room for increases. I would try this dose for 2 weeks, if no real improvement go back to the pcp and let him know so he can increase the dosage. With what you have showing up on the MRI no wonder you hurt.

Please keep us posted on how you are doing....>Susie
Posted 11/10/2012 7:55 PM (GMT 0)
I just wanted to clarify that when I mentioned the 3600mg dosage of Neurontin (Gabapentin)...that is what a Dr. can go up to. And it sounds like your Dr. is being very good about starting you slowly and then moving up as needed.

So as Stray mentioned, just take it one day/week at a time and work with the Dr. on getting to a good therapeutic level that works for you.

It's great news that you aren't having any major side effects right now...This is why any reputable Dr. always starts on the lowest possible dosage to make sure it is tolerable in the patient..

I also happen to agree about seeing a Board Certified Neurosurgeon. They are the "cream of the crop" when it comes to these types of issues.

Keep us posted!
Posted 11/10/2012 10:16 PM (GMT 0)
Thank y'all for replying. I really appreciate everyone's input. I am only taking 400mg a day. Time will tell if this helps. I have my appt with the orthopedic later this month. I went to a neurosurgeon but she was more worried about the syrinx in my spine then my leg pain. I go back to see her Nov 22 (I think) for a follow up. I will tell her what my lower back MRI revealed and X-ray. I will make her understand that I have been dealing with this for a long time and I am sick and tired of it. Hopefully she will recommend something. I will update everyone when Isee her and if I have noticed any relief with the gabapentin. Again, I really appreciate everyone's input. No one in my family has this problem so at times I feel alone like no one understands and then I get on here and realize there are other people who are going through what I am going through. Thank you everyone for your support and being here for me.

Erica
Posted 1/5/2013 7:22 AM (GMT 0)
Hi everyone,

It's been a little while since I have been on here. Now that the holidays are over with I would like to update everyone. I saw the orthopedic doctor. Told him about my pain and he reviewed my MRI- he doesn't think my leg pain is coming from my herniated and degenerated disc. So he gave me exercises to try and sent me home with prednisone and another NSAID. I have tried the exercises and haven't had much luck with that. He said if the exercises didn't help, we may have to do injections. I haven't had injections before but I am willing to try it. The Gabapentin seems to help as long as I remember to take it. But there are times where I wake up with leg pain in the middle of the night as well as the morning. I feel that if the medicine is working, I shouldn't have leg pain at night right? I go back to the orthopedic this Tuesday. I will update everyone after that appointment. I appreciate everyone's support and input. I just want to get to the bottom of this. WHAT is causing the pain? If it's not my disc, then what? Can they do nerve studies on the sciatic nerve? If so, what would is show?

Erica
Posted 1/5/2013 5:07 PM (GMT 0)
Hi Erica, I think you are correct, if the Gabapentin wasn't working the leg pain would remain the same. So, I think you do have some nerve involvment, however, I am not a dr, just speaking from personal experience only. I would ask my PCP to refer me to a board certified neurosurgeon, as I said before they have more training with nerve problems than a orthopedic does. You can have an EMG done, however, here is something to keep in mind, this test is only about 75% accurate. I saw more normal Emgs on our clients than I ever saw abnormal. They would end up having back surgery and after the dr got in there he saw where the nerve was being pinched or compressed and it did not show up on the Emg. Of course, this is strictly your decision as to whether you want to go this direction or not. I just want you to know it is not a 100% reliable test. I would imagine the ortho is talking about doing Epidural Steroid Injections, these are done in a series of three injections spread out over time. These are not 100% either, it just depends on each individual if they get any relief or not. They are not a cure, kind of like putting a bandaide over the problem.

Keep us posted.......Susie
Posted 1/5/2013 7:27 PM (GMT 0)
Thanks for the update Erica....May I ask what milligram they have you on the Gabapentin daily? Was wondering if they have moved you up in dosage yet as I mentioned in my other posts..it can go all the way up to 3600mg but usually people get good results with the 1200 to 1800mg.

I just want to caution you that this type of medication it really is important to take exactly as prescribed because going off it (missing dosages) can cause some nasty side effects or even a possible seizure. It's also a medication that builds up in your bloodstream so that is why it is taken throughout the day in multiple dosages.

So what I do is set the alarms on my phone to remind me to take my medication (5 times a day for me including my last one before bed)....Most phones should have this feature.

The predinsone and NSAID will help with any inflammation part (as opposed to the Gaba which is for the nerve pain) Just be aware that steroids (Prednisone) can cause insomnia in some people.

I also absolutely agree with Straydog in that a Board Certified Neurosurgeon (Fellowship trained as well) is your best bet to really make sure you have the "best of the best" when it comes to looking over your MRI and dealing with the spine issues.

As mentioned, it's always worth trying the epidural injections as they can be very helpful for some people. I try to go into any procedure or medication with a 100% positive attitude that it WILL work for me...LOL....(Ok..may not always work but even if something helps take the pain down one notch that is success to me). And yes, they do need to be done in a series so it takes patience to get the full effect.

That is the thing about chronic pain....We try to find as many modalities as we can, medicinal and non-medicinal, that all add up to get a decent level of pain relief. I live with a 5-7 depending on my activity level and I do dozens of things to help from exercise to medication.

Thanks again for updating us and hope that you continue to do so...We are always here to offer support and empathy to where you can find that great combination of ways to help our pain.
Posted 1/12/2013 5:15 PM (GMT 0)
Hey Everyone,

Thanks for everyone's input. I am still on 400MG one time a day. I don't think this dose is high enough to be able to feel a difference. I am going to see my Primary Care doctor this week. I am going to tell him it hasn't helped. I also see the orthopedic Tuesday. The orthopedic does not think it is coming from my disc. If he recommends injections I am going to try it.. what do I have to lose? My primary care orthopedic thinks it has something to do with my discs and my sacrum. I don't know what is going on. It is really frustrating. I have to know what the correct problem is in order to receive proper treatment. I have an appointment with a neurosurgeon at the end of this month. I will let everyone know how that goes. For the past 4 days I have had leg pain that hasn't given up at all! I can't hardly stand it anymore. I have leg pain EVERYDAY. I hate it so much!! I don't understand why there isn't a solution to this!! It is the most aggravating relentless pain I have ever felt! Something is going on...if it's not my disc then what? I have a feeling that the nerve is impinged somewhere. It has to be to have leg pain everyday, right?? The only thing that has taken my pain away is narcotics.. that's it. I understand I can't take them forever but my gosh I need something until I can get this pain fixed! Oh also, the past 3 times I have had the CRP checked on my blood tests, it has been DOUBLE the normal range. Normal is 0-20 my reading was 43 for inflammation. I am negative for RA, Lyme disease, or any immune diseases. I just pray that one day we will all be PAIN FREE! I am too young to have chronic pain. I am only 23!! I feel like I can't even enjoy my life! Sorry I am kind of venting to you guys but I need to get this off my chest. It is so frustrating! I wish you all the best!

Thanks everyone and take care,

Erica
Posted 1/12/2013 5:33 PM (GMT 0)
I am wondering.. could this leg pain's cause be from the sacrum/sacroilliac joints? The doctor told me my sacrum wasn't formed right.. if so this could also be causing the problem if it isn't my disc...what are your thoughts on this? Has anyone had sciatica from sacrum/SI pain?
Posted 1/18/2013 7:52 PM (GMT 0)
Hi Everyone,

Hope everyone has been having a great week. I saw the orthopedic doctor and told him the exercises were not helping. He gave me 2 cortisone shots. One in my upper butt ( I would assume around the sacrum/si joint) and one on the outside of my thigh. Man them shots burned like hell! So far I have had some relief. I am not sure how long this will last but I would say at least 30-40% of the pain is gone. He said I had bursitis. I can't sleep on my right side anymore (it's still somewhat sore from the shot) but so far I haven't really had terrible leg pain. This is great news! I just hope it lasts ... :). I see my primary orthopedic soon for a follow up and a neurosurgeon at the end of the month. I will update everyone when I see those Dr's. Let's pray these injections keep me almost pain free...but I know this isn't a solution.

Erica
Posted 1/19/2013 3:40 AM (GMT 0)
Hi Erica,
I also have sciatica along with many disc issues in my low back and neck...my sciatica symptoms are very intermittent...but have been so bad that one time I was stuck sitting in a car outside my house for a couple hours because it hurt to bad to move, and I have had a couple trips to the emergency room because of raging 10 scale pain...and this was all before I turned 24...sonIc know what you are talking about!.

I have had injections in my lower back, about 6 of them, and those have worked for me for several months at a time. I had my last one in June in my low back, and it is just starting to wear off...I am getting one in my neck next week and then next month I am getting the section joint one...

Are you still only taking 400mg gabapentin? I take 1800mg daily...900mg mid day and the rest before bed, and it does help along with the tramadol taken 4x daily, oxycodone 4x daily, and a muscle relaxer skelaxin up to 4 times daily with ibuprofen as needed...and my ice pack and heating pad are close friends of mine...you are young so many docs will hesitate to get you too much meds but a mix of meds to tackle the different symptoms will help control the pain levels but each person will find the mix that works best for them since we all respond to them differently.

I do hope the injections work for you and you get your relief! Keep us in the loop! :-) a
Posted 1/19/2013 3:44 AM (GMT 0)
And about all those funny words in my post...well, my cell phone thinks it knows what I want to say lol I tried to edit but it was scrolling all over the place, so I decided on this little disclaimer instead!
Posted 5/7/2014 11:37 AM (GMT 0)
This may sound silly to some, but drinking lots of water/fluids can sometimes
greatly improve a painful experience.

I had horrid lower back spasms that required direct injection of cortisone and anaelgesics.
This stopped the spasms and made life livable.
But I had painful aching of the upper thigh and calf.
Then I remembered that dehydration causes muscle cramps.
I immediately drank a half liter of water and the thigh and calf pain vanished.

I now think there is a good chance the spasms were dehydration driven too.

For what is is worth
If it helps just one person here, then I will be glad to have posted.
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