Advice re: Sciatica

[li10up]

What keeps bothering me is that I wouldn't really call what I'm experiencing painful...at least not compared to the fall I took. It is painful but in more of a severe discomfort type of way. Maybe my definition of pain or pain threshold is different. It's more like my leg and foot is really, REALLY deeply asleep...pins and needles type thing. Especially when pedaling. So is that pain? Wouldn't a bulging disc be more painful than what I'm describing? I can't recall if the dr. used the word sciatica or not. I think he just used the words like, pain of unknown etiology. So I'm not 100% sure of what the problem is. Also, when he moves my leg around I don't feel any pain in my back...if it was a disc problem wouldn't there be pain when he does this? If it's not a disc then what has been causing this for 8 years? My lower back is constantly tight, like a mini spasm. Putting on socks is a hugh chore, especially first thing in the morning. If it was a piriformis issue wouldn't doing those stretches hurt? They don't really hurt me. I know it is somehow related to that fall though. Maybe another MRI is called for. At least that's what I'm going to ask for. I see a different dr. tomorrow. Hopefully I'll find out something more. I just don't want to have to deal with this for another 8 years.

[li10up]

PABadger-you sound like you had it worse off than me. I couldn't move without muscle relaxants for about a week. I had two hugh bruises at the top of my butt - where it meets the back. Your ordeal sounds terrible but at least you knew what was causing the pain and they could fix it. I'm glad you are ok now. No lingering after affects I hope?

[li10up]

It sounded like Piriformis Syndrome to me and why I think getting the books will help. There are many, many causes for sciatica and she probably needs advice from a medical professional who deals with biomechanical issues for cyclists. The inflammation could be caused by jarring on the saddle and/or leg length discrepancy.

http://www.answers.com/topic/piriformis-syndrome

http://www.americanrunning.org/displ...rticlenbr=2056

As Baker says, "Pinched nerves in the back are the most frequent, but not the only, cause of sciatica. Occasionally, the nerve is pinched in a buttock muscle, the piriformis, rather than in the spine." This is why you must find out where the nerve is being pinched.

I would LOVE to know the source!! I've seen 3 different drs and not one of them has told me the source. Like I mentioned somewhere, "Pain of unknown etiology." How can I get them to figure out the source? It seems like I can't really do anything about it until that is nailed down. I'm I right? Also, if it was periformis would that last for 8 years? I'm so confused.

[KnottedYet]

Please ask a PT or OMT to check your psoas and iliacus. What you describe is pretty classic for iliopsoas spasm/tightness/structural shortening secondary to sciatica or back injury. This can start unilateral, and later become bilateral. Ask them if myofascial release (through the abdomen, a kind of deep massage) or strain-counterstrain would help. If they would help, the PT or OMT (or DO if you have access to one) will be able to teach you how to do both techniques on yourself.

[DrBadger]

li10up, how did the dr go today? any movement on getting another MRI? Hope all went well.
E.

[li10up]

li10up, how did the dr go today? any movement on getting another MRI? Hope all went well.
E.

Thanks for your concern. I appreciate everyone's advice.

The Dr. appt went well, I thought. He seemed genuinely concerned that this has been going on 8 years. He stopped the meds that I was on and started me on Predisone 60mg for 3 days, 40mg for 3 days, then 20mg for 3 days, then stop. He is hoping this will clear up the inflammation and relieve the nerve. I took my first dose Fri night. Had a bit of a problem sleeping - awoke with pain around 2am. but was able to get back to sleep around 4am. Had to get up at 5 to leave for the tour. I was so happy on this ride. I had no real pain in my legs or feet. A couple of times I could feel it coming on so I just quit putting so much pressure on my pedals. The pain down the back of my left leg was practically non-existant! However about 3 hrs after the ride the pain was back with a vengeance!

He also scheduled me for another MRI. They should be calling me within 10 days to set that up. He said something interesting to me which could explain my problem. He said that I could have a disc that slips out of place and then returns back to place after awhile and that could be why I'm barely noticing anything for awhile and then bam! it flares up on me and I'm hurting. Does this sound possible to you ladies? He said that could also account for the disc problem not showing up on the first MRI. I do remember not being in much pain by the time they got me scheduled for the 1st one. Anyone know if this is possible - for a disc to move in and out of place?

Anyhow I felt encouraged that maybe I'm getting somewhere on this.

[li10up]

I'm feeling a little out of sorts today. I went for a walk and when I got back I didn't feel quite right. I took my HR and it was 58. A few minutes later I took it again and it was 48. My HR is normally around 70. Is this anything to be concerned about?

[KnottedYet]

A disc is like a jelly bean with a gooey center. If the "shell" of the jelly bean is cracked, the jelly and the goo can ooze out. It can also ooze back in. Kinda like those kid's toys of the chicken with the gooey egg-blob that comes out when you sqeeze it, and goes back into the chicken when you let go. when your disc is under pressure it can squeeze out the goo, when the pressure is off the goo can go back into the disc's "shell".

Sorry, not a good description. But really, it's not the disc that moves, its the gooey inside stuff.

What you want to figure out is what is causing the pressure that moves the goo in the first place.

As far as not feeling normal and the decreasing heart rate: please call your doc or the on-call doc for his practice. If you can't reach him, call your pharmacist.

[li10up]

KnottedYet - thanks for the info. I did call later that day and spoke to a nurse. She didn't seem to be concerned and told me to continue with the med. I took my resting HR this morning before I got out of bed. It was 46. I guess the cycling has made my heart stronger...hence a lower HR.? I was just surprised to see it that low. I'm feeling fine this morning.

[tulip]

I would suggest getting to the source of the pain and addressing that rather than treating the symptoms.

I'm not a doctor, but I can speak to my experience. I had similar pain from a fall, although it did not go all the way to my foot, just to my knee. It got to the point where I could barely sit down and walking was difficult. My hamstring muscle was very tight, too. The doctors wanted to give me medications and send me on my way without getting to the cause of the pain.

I started going to a chiropractor and it has helped tremendously. I also started doing pilates to strengthen my core and improve my posture. That, also, seems to have helped. I can sit, ride my bike, and walk without pain. The only thing that is still uncomfortable is lying down on my back flat. If I put a pillow under my knee, I am comfortable.

I took prednisone for an eye problem years ago. It has some serious side effects. For me, it was dizziness, weight gain and very dry skin. Just keep that in mind.

Best of luck.

[pikato]

I've been talking about sciatica on my blog this week. There is something up with our work chairs, because another coworker & I have the same issue. We've been trying everything for it, but yesterday I got so bad, I couldn't even sit down without having tears in my eyes. So I scheduled a full body massage. I must say, possibly one of the most painful things in the world when that woman was massaging the sciatic area. BUT, I'm happily sitting at my desk, pretty much pain free.

[plantluvver]

I have sciatica exactly like you describe it, but mine started mysteriously. I went to a chiropractor, because of a recommmendation from a freind. (previously I thought the were quacks.) They diagnosed piriformis syndrome, and adjustments gave me IMMEDIATE relief. At its very worst, my entire leg went numb (before seeing her.) I still have a small area of numbness about two inches in diameter, right under my little toe. My sciatica can recur if I get stressed or travel , or just sit too much. but I haven't had a real recurrance for several years. My hamstrings are incredibly tight, which also contributes. And when not in pain, I have better things to do than stretch.

Since you had an injury, I don't know if yours could be the same cause.

I have also heard strange things about some Chiropractors, such as requiring payments in advance for two years of treatments, requiring lengthy periods of treatments. ( I had six or eight twice a week, while the pain kept recurring and I was taught stretches) Mine was done at a school clinic, so they weren't making money off of me. The one time I saw a private chiropractor, I only saw her twice, sadly, she is too far to go by bus.

After one thing I read about neck adjustments, I will never allow those! I don't know what risks if any come from lumbar manipulations.

I have seen acupuncture work extremely well for various things, but I have not used it for this.

But just my personal, anecdotal experience, for what its worth. And I think I will also take a look at that book sounds right on the money.

Mary

[li10up]

Well, I got the results back of my MRI. Nothing for them to report other than some signs of arthritis. So it's looking more and more like Piriformis Syndrome.

It sounded like Piriformis Syndrome to me and why I think getting the books will help. There are many, many causes for sciatica and she probably needs advice from a medical professional who deals with biomechanical issues for cyclists. The inflammation could be caused by jarring on the saddle and/or leg length discrepancy.

http://www.answers.com/topic/piriformis-syndrome

http://www.americanrunning.org/displ...rticlenbr=2056

As Baker says, "Pinched nerves in the back are the most frequent, but not the only, cause of sciatica. Occasionally, the nerve is pinched in a buttock muscle, the piriformis, rather than in the spine." This is why you must find out where the nerve is being pinched.

SadieKate, thanks for the links. I re-read the article at answers.com and it says, "Treatment for piriformis syndrome includes avoiding activities that aggravate the condition, such as running and bicycling." That's not too encouraging. My doc hasn't called me back for a follow-up so I guess he's done with me. Looks like this is just something I'm going to have to live with.

[Rai Sue]

Wow, I hope you figure out what is causing your problem.

I really recommend finding a physical therapist who has experience with athletes, and who maybe does some chiropracter moves. Mine really got my back into alignment, and made me see how out of shape my torso was in, compared to my legs (which bike a lot). In addition to the readjustment, she made me realize how important it is to keep my stomach and back muscles strong. If I don't do my pilates-type exercises a few times a week, my back starts to hurt again. But with strong-core muscles, and stretched out hip & leg ligaments, I really feel normal most of the time. Maybe see if doing pilates helps?

I injured my lower back (not sure exactly how) about a year and a half ago. It actually took me a while to figure out it was my back, b/c i was mainly (at first) only feeling pain in my hamstring. After I realized that it was probably my back, though, i started trying to figure out who to see for something like that. Once i finally got x-rays and an MRI, they told me i had a bulging/herniated disk. I was bummed, but compared to you I now feel lucky to get such an easy diagnosis!

Of course, they said that with a bulge like mine, probably the only solution was surgery. They also said that if such injury didn't go away w/in 6 weeks, it would likely not go away on its own. I was willing to do surgery if nothing else worked, but luckily the PT had an affect on my case.

I do notice that around my period, i get a lot more lower back pain, and I think i'm relapsing until I realize what's going on.

The whole diagnosis took about 3 months, what with all of the appointments, during which time all of the pain really made my ability to deal with stress (usually i'm pretty laid back) much more difficult. It really affected my tolerance for everything, probably because I was never comfortable--sitting, lying down, standing, etc, and it was hard to focus entirely without the pain in the background. It was mentally and emotionally draining, so if you're having trouble, realize that that is pretty normal when you're in pain a lot.

I also figured out that I had switched bikes, and the one i was riding was slightly too big and was exacerbating everything. So I switched back to my old trusty steed. Another friend with a similar injury (and my PT, who is a mountain-bike fanatic) told me that more upright bike, like a hybrid or cruiser, would be better for lower back pain. (that's for transport, not sport))

Everyone's different, so I hope this helps you (or someone)

ANd, if anyone wants a physical therapist who's great with backs in San francisco, let me know and I'll give up my recommendation!

Rai Sue

[Dogmama]

What kind of doctor are you seeing? Your need a SPINE SPECIALIST.

I had a slipped disc in my neck causing numbness & pain in my arm. Saw an ortho who took an x-ray and immediately referred me to an ortho who specializes in spinal surgery. The MRI showed disc problems, but DID NOT show the disc impaled in the spinal column OR the massive amounts of arthritis in my neck. MRI's are NOT foolproof. The doc operated primarily because my symptoms were so bad. He was aghast to find the mess in my neck (surgery took a lot longer) because THE MRI DID NOT SHOW THESE PROBLEMS.

If you can't ride without pred, it needs to be fixed. Period. You can't take steroids forever. And you should not have to compromise the quality of your life.