Worsening sciatica - help!

Have you consulted with an orthopedic surgeon in recent years?

My wife was diagnosed with piriformis syndrome, and received treatment for that for several years, gaining very limited relief, before a visit to an ortho and subsequent MRI (Or CT scan - I can't remember which) confirmed that she has some bulging discs and degenerative disc disease.  Some time with a physical therapist, and the difference was amazing.

I last saw an ortho for my back in 2008 for a check up after the 2nd break - but that could definitely be an idea. 

Thanks, and I'm glad your wife has been able to find relief! 

I'm thinking it's time to find a new Dr. personally.

I don't know a lot about ART therapy but if you have a true structural (bone, bulging disks) type problem then I'd be worried that ART would cause more problems.

I totally know next to nothing on this subject, I'm just throwing out my first thoughts.

Good luck and I hope you feel better soon.

I'm not a doctor or physical therapist, and I think internet forums are bad places to get medical insights and opinions.

Those disclaimers complete:

I broke my back in a parachuting accident in 1987, and previously injured my neck in a flying accident.

I was diagnosed- quite some time later- with sciatica and scheduled for a rather invasive surgery- one of many I've had from orthopedic to less invasive cardiac procedures- when a physical therapist at the Henry Ford Hospital Center for Athletic Medicine told me, "You don't have sciatica, you have an issue with the connective tissue at the top of the muscles in your upper leg that attach close to your lower back."

I cancelled the surgery and weight trained at the Center for Athletic Medicine under the guidance of one of their Physical Therapists. The problem went away after four months work. It hasn't come back because I've maintained a reasonable regimen of keeping this area strong.

Lesson? Before you go under the knife investigate what options you can. When I borke my back the military doctors wanted to perform an invasive surgery that would have likely fused lower vertebrae. I'm glad I didn't do that. Same with the supposed "sciatica". Sciatica is a great "go to" diagnosis and is popularly administered since the health care industry is well equipped to handle it not only from a clinical perspective but also from an insurance/administrative one.

It might pay to get some additional diagnosis, but then again- I think you already knew that...

Thanks for the replies everyone - I really, really appreciate it. 

As much as possible I would not want to go with a surgery route.  I've said no to back surgery once, and I'm not willing to make that choice any time in the near future unless there is absolutely no other option. 

I've had x-rays, bone scans, CT scans and MRI's over the years and all results from all the different doctors have pointed to Spondylolisthesis which has led to the sciatica on my right side.  I'm going to see if I can see another specialist and find out if something has changed with my spinal alignment, or if there could be another cause as to why it's gotten so much worse lately.

I wish I could help but all I can do right now is sympathize.

I really never understood how annoying and painful nerve injuries could really be until the last 4-6 weeks.  I just posted in the injury forum about my "Meralgia Paresthetica".  Basically a nerve is getting pinched in my hip somewhere on the way to my leg.  After I run the pain is enough to just about make me fall over.  And now even when I'm not running it's numb all the time no matter whether I sit/stand/lay.  And that's just NUMB...I can't imagine if I ever reach the stage where it's painful no matter what position I'm in.

Have you thought about acupuncture?

Had (have) a herniated disk S5/L1 that used to give me horrible sciatic pain.  Almost had surgery but cancelled it.  Went to my chiro and they did decompression therapy (imagine being pulled on a rack, stretching out your lower back.)  Worked great!

Started to come back a few years later.  Found out that my tight hamstrings were contributing to the issue.  Even since then if I streatch out my hammies everyday I'm pain free.  Put a rope around your foot and lay on your back withy the other leg straihgt.  Pull up on the rope with a straight knee and hold for 2 seconds.  Lower it, rest for 3-4 seconds and repeat.  Turns out this really does the same things as the decompression therapy.  If I skip more than a week I can feel the nerve pain start to creep back in.

I do it in the eves while watching the evening news.

I have dealt with debilitating back pain for about 18 years.  At this time last year I was using a cane.  I had spinal injections.  I was told I had a minor herniated disc.  I went to several different doctors and three different physical therapists.

After an exhaustive run with a couple of neurologists, we went with Fibromyalgia.  I've been taking Lyrica for a year and a half now and I'm a new person.  It's amazing to realize that my bones and physiology are not what is wrong, the nerves are the problem.

I had to head off several surgeries at the last minute and I'm so glad that i did. 

Just a thought.

Ugh - that also sounds awful!  I hope you're able to get treatment for it? 

I tried acupuncture a few years ago without getting any relief from the sessions, but I also know a lot of people who swear by it, so it might be time to re-investigate.  Have you tried it and if so, has it given you any positive results? 

Thanks! 

Hmmm... I've been told by several doctors and therapists since the second break not to go the chiropractor route as it could cause even more damage, but the stretching is a very good point - I know that stretching and increasing my flexibility will definitely help, and I should really make time to do this more! 

Fibromyalgia is something I hadn't even contemplated, but something to look into.   Has taking the Lyrica alone been enough to turn things around for you, or have you been doing anything else in terms of therapy as well? 

Thanks! 

Wow, a lot of things I wish I could cover.  There are some good opinions and suggestions but as pointed out you have to take all this advice with a grain of salt.  What they have is not necessarily what you have.  Or, what works for one may not work for you.

As far as ART (Active Release Techniques) goes with aggravating your problem was the practitioner a Chiro?  ART is more about acute problems and microtears but I wouldn't think it should aggravate your chronic problem.  I'm very NOT familiar with ART but if you felt good about the practitioner then go back and tell him/her what you're experiencing.  With something as long standing as yours it won't be fixed in a treatment or two.  If you weren't comfortable with the person then maybe try someone else but tell them what oyu've experienced.  I would expect you should feel some improvement fairly quickly - say 3 to 6 treatments (but I don't know ART).

It is very common for Drs and PT to say don't go to a Chiro.  It is not professional.  Go with what you feel is helping you. 

Fibromyalgia is a possibility due to your chronic problems but it is a diagnosis of last resort.  That is after all other options have been illiminated then it is by exclusion of all else fibro.  Check out "Callanetics" for your chronic pain (an exercise routine).

jldicarlo - I hope you're getting lots of attention on your problem.  Don't wait to get treatment. 

There is generally constant pain in the lower right quadrant of my back - depending on how much exercise I do, the pain can get infinitely worse.  This pain can be anything from a constant throb/ache to stabbing pain. 

The pain also shoots down my legs into my hamstrings and while the majority of the the pain (generally a burning feeling that intensifies with increased activity) is in the belly or middle of the muscle, but often times I will also feel it in the outer side of the hamstring. 

Short version... ouch. 

The ART guy (after examining me and confirming prior diagnoses of sciatica, etc.) told me flat out that while he's able to help a number of people with the same condition, it's entirely possible that I would be worse after treatment.  So far, I've been for 1 treatment about a month and a half ago, and I'm definitley worse. 

I'm willing to go back and let him know what's going on, but of couse his hours of operation coincide perfectly with the hours that I'm supposed to be at work.  I'll think about going back to him and letting him know what's going on.  It very well could be that I should have more treatments before completely writing the whole process off. 

You just described what I have been dealing with for years now. Piriformis compressing the sciatic nerve. It's been chronic and the pain is proportional to the number of miles I run. Last year as I trained to BQ it was so bad I couldn't sleep and could barely run. Went to a my PCP who's daughter is also a marathoner, he sent me to a chiropractor who focuses on sports-related issues. At any given time there are 2-3 other people from my running club in there when I'm being treated.

ART works for me in managing the pain through the season. I go twice a week to the chiropractor. I still have pain, especially when sitting at my desk or in the car, but it's under control. I also ice after a long run and take the occasional NSAID. I also think treatment is very much dependent on the quality of the chiropractor. Like in any profession, some are talented, some are quacks.

Thanks for this!  I don't like knowing that someone else has dealt with this pain, but it is comforting to know that the pain can be mitigated. 

The ART doc that I went to is also a chiro and he's the one who told me to not EVER go to a chiro because of the ?Spondylolisthesis.  Of course, it's also after seeing him that things have gotten exponentially worse and I'm at the point of being woken up by the pain as well as feeling it during the day.  I also find that I'm a lot more restless during the day as it gets increasingly difficult to find a comfortable position for very long.  Did you have this as well? 

Have you had an MRI? Do you have a herniated or degenerative disc? Hard to belive that you would not with your history.

Many bulging and herniated discs in the low back and neck can now be treated with non-surgical spinal decompression. Non-surgical spinal decompression came out about 2000. The machine gently distracts the spine creating a negative pressure within the disc. This allows the bulging nucleus to be drawn back into the disc which the body is unable to do with the constant effect of gravity. This is not the same as traction which the body fights and cannot create the needed negative pressure within the disc.

Spinal decompression is an FDA cleared treatment and has had several studies including a 3 year long study by the Mayo Institute confirming the efficacy of this treatment. As mentioned it is non-surgical and there are no side effects. The typical treatment series lasts about 2 months and actually treats and cures the disc as opposed to just attacking the symptoms.

Our clinic is run by a chiropractor that has been in business since 1968. He started using spinal decompression in 2005. Our success rate is over 90% in treating our patients with herniated and protruding discs that qualify as candidates. To qualify as a candidate we review the MRI to determine the severity of the disc herniation(s). If it is something that can be treated we then need to have a couple of x-rays taken to determine whether your spine is stable enough to handle the decompression.

While there are a few different spinal decompression machines I can recommend the Axiom DRX 9000. We have 3 of them and they are one of the best, if not the best, that are made.

More details can be found at http://www.back-pain-causes-and-relief.com/spinal-decompression.html

Sean

Definitely. I sit at a desk for work and find that the longer I sit the worse it feels. Same goes for long car rides. One thing that helps at work is to get up every hour or so and walk around the office. You can also do a piriformis stretch on the chair at your desk. There are some videos on YouTube that show how to do this, and it does help.

Unfortunately the best treatment for piriformis pain is rest. My chiro and PCP are fully aware that I am not going to stop running so everything now is about management. Fortunately I do not have the issue when I'm biking, so for the winter I will drop mileage on the run and do mainly swim/bike training. 

If you have other complications then maybe you should see a new practitioner. As is always pointed out by others, this is not the place for medical advice, it's for sharing experiences.