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Sciatic pain woke me up

Posted by Kristie on 5/31/04 at 14:40 (151624)

I had the worst sciatic pain last night. It actually woke me up while I was sleeping. I happen most often if I'm sitting for too long. I guess I was sleeping in a bad position. I last for a couple of hours. I was hoping the pain would go away and after several hours took some pain pills.
Does anyone know what cause sciatic pain? I just had PF release surgery on May 7th and still have my cast on. But I have had this sciatic pain for two years now. Maybe someone knows a similar web sight for this problem? Thank you.

Re: Sciatic pain

Julie on 5/31/04 at 16:29 (151637)

Sciatic pain is caused by impingement of the sciatic nerve. You should consider consulting a chiropracter or osteopath: manipulation may help.
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Re: Sciatic pain woke me up

Julie on 5/31/04 at 16:34 (151638)

Kristie, I've just responded to your question on the Ask the Doctor board: sciatic pain is caused by impingement of the sciatic nerve. There are a number of websites that can give you information about sciatica: here is a link to a very good one:

http://www.spine-health.com/topics/cd/d_sciatica/sc01.html
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Re: Sciatic pain woke me up

wendyn on 5/31/04 at 22:18 (151665)

Kristie, I don't know a lot about what causes sciatic pain - but I know it can be awful. You have my full sympathy!

Re: Sciatic pain

elliott on 6/01/04 at 08:22 (151675)

Julie, thanks for that valuable link; I've bookmarked it. I'm still struggling with sciatica, going on 5 years now. I think that site should have given a bit more prominence to the possibility of a tight (piriformis) muscle as the cause, as mention of that is minimal and somewhat buried. Judicious stretches can rule out tight muscles and an MRI can help rule in discs. Given the risks of disc surgery, I think their 6-12 week threshold is too low, at least for those who have not reached a point where their situation requires immediate attention, which is most people. But loads of valuable info--I've been looking for that nerve-roots-down-the-leg chart for some time. Thanks! Speaking of surgery, how is Nancy doing?

Re: Sciatic pain

Kristie on 6/01/04 at 08:55 (151679)

What is a osteopath? Thank you so much for the web sight.

Re: Sciatic pain

Julie on 6/01/04 at 09:14 (151684)

Kristie, an osteopath is a practitioner trained in the human structure. Osteopaths treat spinal problems by manipulation and soft tissue massage. If the pressure on your sciatic nerve is being caused by, for instance, a herniated disc, osteopathic treatment may be able to correct the problem. Here is another website for you to look at: http://www.osteopathy.org.uk/ois/faq/index.shtml

Osteopathy is more common in the UK than in the US. If you decide to have your spine looked at, you might find it easier to locate a chiropractor. I don't know whether your doctor would give you a referral (that would be possible here in England) but you could try starting with him or her.
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Re: Sciatic pain

Julie on 6/01/04 at 09:24 (151688)

Hi Elliott

I'm glad the link was useful. I think the whole website is very good.

Nancy is fine. The surgery - which in her case does seem to have been absolutely necessary - was successful, and she has had good PT ever since. She's just been discharged from it and sent off to do her exercises on her own for the rest of her life. She's almost pain free, apart from occasional setbacks, and is pretty well back to normal life. I'll tell her you asked.

Have you ever identified the root cause of your sciatica? (Forgive me if I should know the answer and have forgotten!)
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Re: Sciatic pain

john h on 6/01/04 at 09:40 (151691)

If one has back pain you are almost fortunate to have sciatic pain because your problem can usually be identified without much of a problem and better yet can be corrected either through surgery or exercises. In nearly all cases the sciatic pain is caused by a disc pressing on a nerve in the lumbar region. Most usually in the L5/S1 L4/L5 area. If it is a bulging disc disc can actually pull back on its on with certain exercises. With sciatic pain one should certainly have an MRI as this is the best diagnositc tool going for this pain. I had low back surgery about 23 years ago. At that time about 50% of the pain was in my leg and 50% in my low back. After surgery my leg pain was mostly gone but I still have pain in the low back area. Back pain is similar to PF in that the most difficult problem is to identify exactly what is causing the pain and with sciatica you have a major clue. A good book that shows you how to do the exercises that could help to cause a bulging disc to pull back in is 'Back In Shape' by Dr. Steven Hockschuler of the Texas Back Institute. You can order it at Barnes and Noble or I think you can get it on the Texas Back Web site at http://www.texasback.com . Sometimes a TENS Unit can help with sciatic pain. Your Doctor has to prescribe it and they can be rented to see if it helps before buying one. I assume you have seen a Spine Specialist for your condition? If not you most certainly should. Do you have any numbness associated with your sciatic pain? Can you walk across the room on your toes and then walk across the room on your heels? The thing one has to be concerned about is that you do not do irreversable nerve damage by not correctiong the problem. Normally you will know before this happens because you could develop drop foot or experience severe weakness in the leg.I definitely would see a spine specialitst and not a run of the mill Orthopedic Surgeon. Since my surgery they have come up with many new procedures such as minimally invasive surgery which can be done from the front and they do not have to cut through the large back muscles which leads to a long recovery period..

Re: Sciatic pain

elliott on 6/01/04 at 09:50 (151694)

An MRI picked up a bulging L4-L5 and a dessicated L5-S1 disc; the L4-L5-S1 connection is the clinical diagnosis. My sciatica started two months after that bad surgery on my first foot, but no one will say the two are definitely related. It is chronic and driving me crazy, but according to several doctors is just not considered worth risking operating on, and it might resolve on its own (but it's been 5 years). A few things about it are atypical from a doctor's perspective, e.g., it doesn't hurt more when I sneeze. It is now bilateral, but much worse on the original right side. A few months ago, a co-worker all of a sudden got the very serious kind of sciatica (e.g., trouble even walking, no feeling in leg), had surgery shortly thereafter and is doing fine. The decision in such circumstances is easy. But I personally know several who have had my kind of sciatica, had the surgery and were left worse. This sciatica thing is wearing me down and depressing me further, but my foot problem is still numero uno, and may in fact be causing it. Even though I wasn't really a believer, I finally decided to see a chiro (less risky than surgery, certainly), and had substantial relief of one part of my sciatic pain after visit 1, but after 9 more visits, no more change. I'm starting to think that's as far as chiro will take it.

Re: Sciatic pain

elliott on 6/01/04 at 10:12 (151701)

John h, thanks for the response. Maybe that book's worth a look. But what do you do after you've been there done that: seen numerous spine specialists of all kinds, done all those stretches and then some, back is now strong and more flexible than just about anyone else around you, and still have the problem? It seems to become a question of surgery or bust. Yes, there are newer surgical techniques, but the more you look into it, the more muddled the picture remains. For example, I have heard that the micro-disc surgery, while more minimally invasive, is also harder for the doc to see exactly what's going on, just like with other surgeries, and unless it's right there where he goes in, he may miss the root cause of what's going on, and then it will not be successful. What about when you have sciatica originating in multiple places? They can't just cut you up everywhere; there'll be nothing left. I now have driving lower back pain at times (usually after extended sitting or sleeping), and I'm not sure if that would be cured with an operation for sciatica.

If there's a discussion of sciatica, it's only a matter of time before someone pops in and says just read (buy) Dr. Sarno's book and be cured. To premempt that, I don't deny that stress and anger can increase back pain, but I am for the most part pain-free when standing. So my problem with Sarno's 'it's all the anger in your mind' thesis is that when I sit down I'm instantly angry, when I stand up, instantly happy; sit down--angry, stand up--happy.

Re: Sciatic pain

john h on 6/01/04 at 10:44 (151705)

Elliott: I truly can empathize with you as I have had back pain for over 23 years. I think that nearly all back pain patients agree their pain is worst when driving or sitting. My back pain is not as bad when standing but when PF came along I was between a rock and a hard place. I have had epidurals,radio frequency lesioning, facet injections. discograms, 4 MRI's,chiropractic,accupuncture formal rehab with exercises and of course surgery. My back was at its best before PF when I could exercise to my hearts content, run, play basketball,etc. I still had flare ups but they would be gone in a few days. Once PF hit my back went south fast which told me that all my exercise played an imnportant part in keeping my back in shape. Much of back pain is muscular and even sciatic pain can be caused by contracting muscles in the back. Surgery of course is the court of last resort and your mind will tell you when you have reached that point. Have your Doctors ever given you a diagnosis? I was at the Texas Back Institute in Dallas last month and visted with one of the more prominent back specialist in the nation. Very impressive person. He wanted a more current MRI and current Discogram (don't they all). As Dallas is 300 miles away it is sort of hard to set all this up. I do know I have three deteroriated disc starting with S-1 to L-3. Above that all look good. This Doctor is one of several who is authorized by the FDA to use the new artifical disc which have been used in Europe for some time. I apprecaite what you are saying about reading a book as for long time back cases rarely is reading a book going to help. You did not mention if you have tried a TENS unit. I really think it is worth a try. It is not cure but may help you deal with the pain. I sometimes use Lidocaine Patches which may be of benefit to you. They must be prescribed and they are expensive but can help. Many Doctors have never heard of them but your drugest will be aware of them.They are impregnated with lidocaine the substance dentist use to deaden your gums. They do numb your back or where ever you place them but not to a great depth. Many people with shingles use them. Another item I bought that helped me deal with back pain was the Sweedish Bed that is made of memory type latex. Very supportative with no spots that press into your back. I placed it on an adjustable bed with a remote control so I can raise my feet or head for best back comfort. You probably alread know that raising you legs unloads your back and can make your back more comfortable.After a back problem I found that laying on the floor and placing my legs on an ottaman with knees bent at a 90 degree angle would often reduce the pain. PF and back problems are truly a double edged sword. It hurts to stand and it hurts to sit. My wife always wants to go for a drive and not how many times I tell her that driving is not a source of pleasure for me but a source of pain she does not understand. I still mow the yard, work and carry on but in the words of the Buddah 'This Sucks!'

Re: Sciatic pain

john h on 6/01/04 at 11:04 (151709)

Elliott: Sammy Sosa the famous Cubs slugger sneezeed a few weeks ago in the club house and has not played ball since. It strained his back and he is not expected back for another 3 weeks or more.

At the health club I attend there is a Doctor who has a locker next to mine. He is about 44 years old and has had a bad back for over 10 years. It got so bad last year he could barely function as a Doctor. He had surgery and had three disc fused in the low back. He has been pain free since and does all the things he had not done in 10 years. His wife is about 38 and last year she had both hips replaced because of a congenital condition. One of her children faces the same thing. I am always amazed when I see a guy like Joe Montana who had back surgery and then the next year comes back to play NFL football and be an all pro.. Yes, like PF back surgery can go wrong so when the pain gets bad enough it gets down to decision time. The major decision then is who is the most qualified to do this procedure.

Re: Sciatic pain

elliott on 6/02/04 at 08:38 (151765)

John, I tried a TENS unit for my foot way back when my TTS was bad; didn't like it then either. I'm not really interested in it for my back. I'm way past the point of needing it. Unlike the foot, the back problem is less painful and has temporary remedies (e.g., getting off my butt). It's the forever thing that's heavy.

Re: Sciatic pain

Dorothy on 6/02/04 at 10:43 (151783)

If physical pain is to be part of your daily/regular life, maybe explorations like the Darlene Cohen website (her books are also available) would be useful. This is not to suggest that you or anyone abandon efforts to find 'cures', but maybe in the meantime, while waiting and looking....
I am very sorry you have pain and these problems, as I am that john h. does, but I am appreciative that you both share your ideas, knowledge and processes here.