Sciatica Treatments???

[+ Axiom2001]

For over two months, I've had a recurrence of sciatica problems.  Prior to that time, I had physical therapy treatments that greatly helped.  About three or so weeks ago, the horrendous pain in my calf area reappeared.  I went to an orthopedic/joint center and relayed my condition to my physician.  He checked the most recent Xray and told me of the options that could be provided to me.  He mentioned additional physical therapy or my being administered an epidural shot.  I requested a prescription for pain, a placard, and one for a walker.  The next day I made appointments for eight sessions of additional physical therapy. 

To date the excruciating pain prevails, and I continue to have difficulty walking.

My question is: have any of you had an epidural shot administered to you, and what were its initial effects?  I don't want to wind up being paralyzed in the end if I choose this as the last resort.  

[+ Lucky]

Epidurals are wonderful. Often immediate and lasting pain relief. I would definitely give it a try, sooner rather than later. I have never had a bad experience.

[samhexum]

4 hours ago, Lucky said:

Epidurals are wonderful. Often immediate and lasting pain relief. I would definitely give it a try, sooner rather than later. I have never had a bad experience.

Not even when you gave birth?  😎😁😇😝

Sciatica has ruined my life.  I sit practically 24/7, and get terrible back and/or leg pain any time I try to do anything outrageous like stand or walk for over a minute.  I've given up and resigned myself to having no quality of life until I die.  And being impotent, I can't even masturbate.  Life is just a bowl of cherries... a big, rotting, fetid bowl of cherries.

[+ sync]

8 hours ago, samhexum said:

Not even when you gave birth?  😎😁😇😝

Sciatica has ruined my life.  I sit practically 24/7, and get terrible back and/or leg pain any time I try to do anything outrageous like stand or walk for over a minute.  I've given up and resigned myself to having no quality of life until I die.  And being impotent, I can't even masturbate.  Life is just a bowl of cherries... a big, rotting, fetid bowl of cherries.

I'm so sorry to know of your sciatica.  The spirit of your postings belie your physical condition.

Only one of my sciatica attacks was severe enough to render me helpless with paralyzing pain and eventual hospitalization.

I know doctors today are so leery of malpractice suits and other legal restrictions regarding pain management medications that many are reluctant to prescribe them.

My doctor of 25 years held out until I told him that, if I couldn't get a pain management prescription from him, I would go into the streets to get something because I was not going to continue writhing on the floor with tears streaming down my face.

My parting shot is don't just give up.  In this day and age there has to be some kind of pain management assistance that can improve your mobility.

 

[samhexum]

18 minutes ago, sync said:

In this day and age there has to be some kind of pain management assistance that can improve your mobility.

Losing 50+ pounds wouldn't hurt, but I also have what my neurologist told me last month was 'not a normal' spine.  Even if I lost weight (easier said than done when you're basically home-bound, any movement hurts, and have used food for comfort and pleasure all your life) I'd have back trouble.  And ED.

Hey, 2021 has brought me a lot of unexpected joy--  the first new ABBA album in 40 years, a Giannis-led NBA title, new TV to watch (my sister and b-i-l got me a ROKU and added me to their [many] streaming services when I only had basic cable before), and them offering me some $ towards my car repair and needed tooth implants. (His dad died in Nov and left them some money).  So it has been my best year in a long time. 

The only sad thing is that I doubt I'll be around in 40 years when ABBA releases their next album.  I'd be 99 by then.  ☹️😟😢

[+ sync]

22 minutes ago, samhexum said:

Losing 50+ pounds wouldn't hurt

 

23 minutes ago, samhexum said:

have used food for comfort and pleasure all your life

I can relate only too well.

For years the physician I go to has harassed me to lose weight.  I kept telling him I've been obese all my life and I feel fine.  He told me it at the time I was able to manage it, but the time would come when my skeleton would be unable to support the weight.

About eight months ago it hit.  Pain in my ankles, knees and lower back.  It was then that I thought maybe that old quack knows what he's talking about and I began to seriously diet.

It has gone pretty well.  After the first five pounds the discomfort in my ankles went away, and after about twelve pounds the knees and back found relief (the back relief may have been assisted by the new mattress).

I'm now thirty pounds underway, but it's a bumpy road, for, as you mentioned, having used food for comfort and pleasure for all of one's life is a powerful pull.

"Keep your hand on the plow."

[+ Pensant]

Losing weight solves a multitude of problems.

[+ Charlie]

The nerves in my foot are tingling as I write this. My problems with sciatica are episodic, and I have been going through a bad patch lately, especially in my lower back and right hip/leg/foot, so I have been getting physical therapy. It is working, but I have found in past episodes that the therapy takes time to produce results: they come slowly rather than dramatically. I use the least drastic pain-killer, which for me is usually ibuprofen, because stronger drugs make me lethargic, and I have found from my experience that movement is more effective than rest to alleviate my pain; the worst time for me is often when I get up in the morning. Because the pain in my foot makes it hard to do very much, the physio for the past two weeks has focused on massage, ultrasound and icing of the foot, and as soon as I was able to start playing tennis again, all the related pain in the calf subsided. Doing exercises regularly at home and not just at the therapy appointment is important, as is conscious control of posture, especially when sitting at the computer. If you are overweight, losing some of it is supposed to help, though I have never been overweight, so I have no personal experience about that. Strangely, no doctor has ever suggested an epidural to me.

 

Edited October 25, 2021 by Charlie
typo

[MiamiLooker]

4 hours ago, sync said:

 

I can relate only too well.

For years the physician I go to has harassed me to lose weight.  I kept telling him I've been obese all my life and I feel fine.  He told me it at the time I was able to manage it, but the time would come when my skeleton would be unable to support the weight.

About eight months ago it hit.  Pain in my ankles, knees and lower back.  It was then that I thought maybe that old quack knows what he's talking about and I began to seriously diet.

It has gone pretty well.  After the first five pounds the discomfort in my ankles went away, and after about twelve pounds the knees and back found relief (the back relief may have been assisted by the new mattress).

I'm now thirty pounds underway, but it's a bumpy road, for, as you mentioned, having used food for comfort and pleasure for all of one's life is a powerful pull.

"Keep your hand on the plow."

Relying on my terrible cooking during the pandemic has helped me lose over 40 lbs.

[+ Axiom2001]

I just read the preceding posts and want to thank the individuals who've already responded.  I truly appreciate your advice and will definitely take it wisely.

 

Others may continue to respond, for, as the old adage goes,"  ...the more the merrier!"

Edited October 27, 2021 by Axiom2001

[gallahadesquire]

The main differential diagnosis for sciatica is piriformis syndrome.

 

Piriformis syndrome

Completely different malady with different treatment. 
Epidural steroids should be given as a planned pair, with the second one given two weeks after the first, even if no efficacy from the first shot. Some people will get relief on #2. If so, a third shot should be considered. Of course, this is along with home excercise and physical therapy to make sure you’re doing the exercises correctly. 
 

long retired anesthesiologist here with a fellowship in pain management. 

[+ FreshFluff]

11 hours ago, Charlie said:

The nerves in my foot are tingling as I write this. My problems with sciatica are episodic, and I have been going through a bad patch lately, especially in my lower back and right hip/leg/foot, so I have been getting physical therapy. It is working, but I have found in past episodes that the therapy takes time to produce results: they come slowly rather than dramatically. I use the least drastic pain-killer, which for me is usually ibuprofen, because stronger drugs make me lethargic, and I have found from my experience that movement is more effective than rest to alleviate my pain; the worst time for me is often when I get up in the morning. Because the pain in my foot makes it hard to do very much, the physio for the past two weeks has focused on massage, ultrasound and icing of the foot, and as soon as I was able to start playing tennis again, all the related pain in the calf subsided. Doing exercises regularly at home and not just at the therapy appointment is important, as is conscious control of posture, especially when sitting at the computer. If you are overweight, losing some of it is supposed to help, though I have never been overweight, so I have no personal experience about that. Strangely, no doctor has ever suggested an epidural to me.

 

I’m sorry you’re going through this, Charlie. A few years ago, I had raducular pain from the neck, amd it was just awful. I wrote about it here, of course.  I recommend the epidural. It’s safer in the lower back than it is for the neck. Technique matters when driving a needle, so if you go this route, find someone with significant volume. 

[Danny-Darko]

I also suffer from Sciatica. Doing "Williams Flexes" taught to me by a physical therapist decades ago and a good chiropractor keep me out of pain and drug free too. I passed on the epidural since I'm diabetic and it messes with the blood sugar. 

Williams Flexion Exercises - Wikipedia

Edited October 27, 2021 by Danny-Darko

[josh282282]

17 hours ago, sync said:

I know doctors today are so leery of malpractice suits and other legal restrictions regarding pain management medications that many are reluctant to prescribe them.

Board certified primary care physician here.

I treat sciatica all the time. Back pain is a (very) common complaint in primary care. 

But, NO, syncs comment above is inaccurate.  Opiates, such as Vicodin,  are NOT indicated for long term LBP chronic pain. It has nothing to do with fear of lawsuits or legal restrictions (btw, what legal restrictions were being referred to? As a licensed physician with a DEA license its perfectly legal for me to prescribe opiates, although I very rarely do). Opiates rarely improve functioning and create a host of other issues that can be quite detrimental to the patient.  First do no harm, after all. So any Pain Treatment plan typically declines opiates as an option.   

My deep empathy to you, Axiom. Sciatica is horrible. 

 

LBP SUGGESTIONS FOR ALL (not in any particular order of importance,  and each patient needs a tailored treatment plan- please see your primary care physician) 

1) Weight loss

2l Physical therapy 

3) Epidurals 

4) a TENS unit

5) ibuprofen 

6) lidocaine patches 

7) yoga 

8 neurosurgery 

9) gabapentin/lyrica 

10) Cymbalta 

11) exercise 

12) probably more but I'm too tired to think any further,  it's been a long day, and I'm exhausted but riddled with insomnia 

Warmest regards to all

Josh

 

 

[Guest]

Sciatica is a real pain in the ass!  

Chiropractics to straighten a clearly pivoted hip was my solution decades ago.  I treat minor recurrence with chiropractics and acupuncture. I also have a Tens unit that I love 

[+ sync]

4 hours ago, josh282282 said:

Board certified primary care physician here.

I treat sciatica all the time. Back pain is a (very) common complaint in primary care. 

But, NO, syncs comment above is inaccurate.  Opiates, such as Vicodin,  are NOT indicated for long term LBP chronic pain. It has nothing to do with fear of lawsuits or legal restrictions (btw, what legal restrictions were being referred to? As a licensed physician with a DEA license its perfectly legal for me to prescribe opiates, although I very rarely do). Opiates rarely improve functioning and create a host of other issues that can be quite detrimental to the patient.  First do no harm, after all. So any Pain Treatment plan typically declines opiates as an option.   

My deep empathy to you, Axiom. Sciatica is horrible. 

 

LBP SUGGESTIONS FOR ALL (not in any particular order of importance,  and each patient needs a tailored treatment plan- please see your primary care physician) 

1) Weight loss

2l Physical therapy 

3) Epidurals 

4) a TENS unit

5) ibuprofen 

6) lidocaine patches 

7) yoga 

8 neurosurgery 

9) gabapentin/lyrica 

10) Cymbalta 

11) exercise 

12) probably more but I'm too tired to think any further,  it's been a long day, and I'm exhausted but riddled with insomnia 

Warmest regards to all

Josh

 

 

Thank you for your response.

The following link will take you to a summary of what I was referring to regarding physicians practicing a reluctance to prescribe opiates. How Fear, Misinformation, Stigma Have Devastated Pain Patients (filtermag.org)

While the article centers around Oklahoma, it elaborates how apparent misinformation and misunderstanding from the top of the medical practice chain has had a nationwide effect.

I hope you find relief from your insomnia soon.

[+ LIguy]

I've suffered from sciatica for years.  Gabapentin was a godsend. I was able to walk and it edged the pain out however I would have very painful episodes that I was able to sooth with a few large doses of gabapentin.  I went to pain management for years and was given an rx for gabapentin and oxycodone/acetometophin.   There was nothing else they could do for me as I have blood issues and epidurals and surgery are out of the question.

[+ FreshFluff]

PT is the gold standard of conservative care, but I found that it intensifies flares. It tended to flare it. It was more effective in preventing and minimizing recurrences. 

[Guest]

9 hours ago, LIguy said:

I've suffered from sciatica for years.  Gabapentin was a godsend. I was able to walk and it edged the pain out however I would have very painful episodes that I was able to sooth with a few large doses of gabapentin.  I went to pain management for years and was given an rx for gabapentin and oxycodone/acetometophin.   There was nothing else they could do for me as I have blood issues and epidurals and surgery are out of the question.

I’m amazed that you could stay with those meds for an extended period of time.  Were you not able to determine where the impingement on your nerve was coming from?

[+ sniper]

Google "sciatic nerve flossing." I do it every day and about a month after I started, my symptoms became less severe and less frequent. It's easy to do, and also is not something that feels like it's doing anything WHILE you're doing it, so people tend to give up on it.

Back stuff is hard. You really do need to do the PT exercises every damn day and it can take months before you start feeling better. I was nine months in and ready to give up and ask for surgery when  one morning I woke up and suddenly found I could walk downstairs without hanging on to both bannisters for the first time in years.

[+ Axiom2001]

17 hours ago, FreshFluff said:

PT is the gold standard of conservative care, but I found that it intensifies flares. It tended to flare it. It was more effective in preventing and minimizing recurrences. 

A few years back, I had a legit massage when I suffered a bout of sciatica pain; afterwards, I could barely walk, for I was in so much pain.  I almost had to crawl to my automobile. 

Thanks for your post

Edited October 27, 2021 by Axiom2001

[+ Pensant]

Although I’ve rarely had any low back issues, I’ve found active release therapy to be effective for other musculoskeletal issues, like foot pain (I run and hike) and shoulder pain (from lifting and biking).

[Luv2play]

1 hour ago, Pensant said:

Although I’ve rarely had any low back issues, I’ve found active release therapy to be effective for other musculoskeletal issues, like foot pain (I run and hike) and shoulder pain (from lifting and biking).

I had ART on my shoulder a few years after a waterski accident that resulted in a torn rotator cuff. It worked pretty well and have not had a recurrence of the pain in over 20 years.

[+ Lucky]

Gabapentin was the worst drug for me. Horrific side effects, mainly a disturbing brain fog.

[Rudynate]

On 10/24/2021 at 2:42 PM, Axiom2001 said:

For over two months, I've had a recurrence of sciatica problems.  Prior to that time, I had physical therapy treatments that greatly helped.  About three or so weeks ago, the horrendous pain in my calf area reappeared.  I went to an orthopedic/joint center and relayed my condition to my physician.  He checked the most recent Xray and told me of the options that could be provided to me.  He mentioned additional physical therapy or my being administered an epidural shot.  I requested a prescription for pain, a placard, and one for a walker.  The next day I made appointments for eight sessions of additional physical therapy. 

To date the excruciating pain prevails, and I continue to have difficulty walking.

My question is: have any of you had an epidural shot administered to you, and what were its initial effects?  I don't want to wind up being paralyzed in the end if I choose this as the last resort.  

Epidural injections are iffy - they can work well or not at all.  I have had quite a few.   I was in such severe pain that I was always ready to try another epidural injection even though they were unreliable.  Ultimately,  I underwent a multi-level lumbar fusion which I have never regretted.  

I have neuropathy in my feet as a result of the spinal problems and cymbalta works like a charm.  I don't know if it would work for sciatica.