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Sciatica

Posted by wendyn on 1/14/05 at 20:14 (167202)

Ok Carole and Dorothy (and anyone else who would like to play along) - since you've had (have) sciatica....can you describe what it feels like?

I have had what's been diagnosed many times as sciatica. It is pain that originates in my lower back and radiates down my leg. Both the front and the back of my leg get very sore, and the soreness is distinctly nerve pain. My skin becomes very sensitive to touch and to changes in temperature.

What I have now is very different. It is a very deep, almost cramping pain - and it wraps from the back of my leg around to the top of my foot. My left butt and hamstring hurt the worst (but the pain on the top of my foot is a close second).

It is way worse from sitting (especially long car rides) and sometimes even laying on that side.

I would appreciate any comparisons to what you have dealt with....merci in advance...

Re: Sciatica

Carole C in NOLA on 1/14/05 at 20:31 (167204)

Wendy, my sciatica hasn't been officially diagnosed but to me there is no question. Like yours, it starts in my lower back and radiates down my leg. But with me, when it gets bad it leads to muscle cramping and joint pain as well. It does hurt my butt, as well as the nerve path, but the hamstring doesn't hurt as much as in Achilles tendonitis. Probably most of the pain is in my butt and thigh but that varies and there's plenty to spread along the entire nerve path.

The muscle cramping leads to really SHARP pain when I try to get into Frank's pickup truck, for example, since my left leg doesn't want to lift that high. Now when it gets really, really bad, my leg can't hold any weight on it and wants to buckle.

Mine gets worse from sitting, but that can be ameliorated if I can stuff a pillow next to my lower back just so (and it's hard to get it adjusted right). I can't lay on my left side for long, and it helps to lay on my right side, pull my knee nearly up to my chin and put the knee on a pillow.

Mine will stop hurting if I would just lie flat on my back, but I can't sleep that way.

Hope this helps some.

Carole C

Re: Sciatica

Dorothy on 1/14/05 at 22:53 (167216)

What I experience has not always been the same over the years (first developed with pregnancy, years ago), but has always been sciatica. Sometimes one area of the 'path' is more painful than the rest and another time another area will be more painful. The left bum has always been the most involved and sometimes the pain results in muscle spasms (isn't this a lovely image?) in that area. It all begins in the lower back, left side, across the upper left bum and down the left bum, back of the thigh and down the calf, more toward the outer side of the calf muscle; and I think the Achilles and foot problems are related to the back/sciatic nerve problem but the most recent doctor said 'they're two different problems....' and that was that. I disagree, but I'm not a doctor (see my posts on 'Ask the Foot Doctor'...) All made much worse by prolonged sitting and sometimes by any sitting. It's usually aching, but sometimes (down the back of the thigh) it's VERY sharp and it does make for a weakened feeling for walking and movement. I'll try to think about it with more attention and see if I can describe it better. Oh, sometimes with sitting, it gets very numb and 'needley' in the left bum. Later ~

Re: Sciatica

Julie on 1/14/05 at 23:42 (167218)

Dorothy, I am not a doctor ;-) so who am I to question your Doctor, but there is an excellent chance that your Achilles and foot problems are related to your back/sciatic problems. When my PF began, it had been preceded a couple of weeks earlier by a minor back injury. My podiatrist thought it was almost certainly related. Indeed, he believed that many if not most cases of PF are related to compression of the sciatic nerve. It has always made sense to me. The sciatic nerve is the longest nerve in the body, with branches that supply various areas of the lower limb right down into the foot. Impingement doesn't always result in the classic sciatic pain: sometimes only the distant branches are affected, so there can be foot pain without butt-and-thigh pain. In your case you seem to have the lot.

My podiatrist's view probably isn't mainstream, but I think it's a reasonable one.
.

Re: Sciatica

Julie on 1/15/05 at 00:17 (167220)

Wendy, I haven't had sciatica (except that it was thought by me and my podiatrist that my PF was triggered by compression of the sciatic nerve) but what you describe certainly does sounds like sciatica. Sciatic pain presents in different ways and in different places, because the nerve is so long and so complex, with so many branches. There is a good description of the sciatic nerve and sciatica on the excellent spine health website:

http://www.spine-health.com/topics/cd/d_sciatica/sc01.html

and another at

http://www.back.com/symptoms-sciatica.html

And here are pictures of the nerve and its branches:

http://www.nlm.nih.gov/medlineplus/ency/imagepages/19503.htm

http://images.google.co.uk/imgres?imgurl=http://jonesandsmith.net/images_evidence/Sciatic_nerve_injury.jpg&imgrefurl (not sure this one will work, but if it doesn't, go to google, search for Sciatic nerve: images, and you'll find it in the third row down).

Small branches of the posterior tibial nerve, itself a branch of the SN, end in the instep, which could explain the new pain in the top of your foot.

The pain in the front of your leg that you describe as part of your 'usual' clutch of symptoms could be due to compression of another nerve (possibly the femoral nerve if the pain is in the front of the thigh).

Whatever you've got, I hope it gets better soon! And your cold!
.

Re: Sciatica

Dorothy on 1/15/05 at 02:29 (167226)

To Julie - I agree fully with you. When the doctor said that, I just kept my views to myself; he was very sure of himself. This is a new doctor to us as I finally decided to leave the part-time (in every sense of the term) one we had been seeing. The new one may or may not be better; he seems nicer and he is full-time so I'm hopeful. We don't have a lot of doctor choices and I don't need to annoy the one I have. I use doctors' knowledge and access very selectively. I don't go to them very often and even at that have had some very bad experiences; on the other hand, I've had some good experiences, too - so it works out, I guess. In any case, I agree with you and your doctor and I just do what I can to take care of it. I think YOUR podiatrist sounds very wise! I am glad you have good doctors and we want them to take the very best care of you!!! :-)
Dorothy - still not a doctor - oh, wait; I see I'm not on Ask the Foot Doctors

Re: Sciatica

Julie on 1/15/05 at 03:44 (167227)

Dorothy, doctors are funny, aren't they? I except you and myself, of course - oh, wait, I remember, we are not doctors.

This has always reminded me of a psychology project a friend of mine did during my first year at Antioch. He asked people to list as many characteristics and attributes of an elephant as they could think of. The assumption was that a subject's answers indicated whether he or she was 'whole-oriented' or not. Not many doctors are whole-oriented - able to look at an entire, whole person, rather than as a collection of limbs and other bits, and ragbags of isolated symptoms.

I think my podiatrist was sensible and experienced - he is podiatrist to two football teams, so he sees plenty of the stuff that goes on around these boards - but he wasn't right about everything: exercise, for example, and he was a bit too keen on surgery for my taste (not that he ever suggested it to me). But like you, I am selective. He was right about taping and orthotics, two lynchpins of my recovery.
.

Re: Sciatica

Kathy G on 1/15/05 at 09:12 (167244)

Wendy,

It sure sounds like siatica to me. Mine starts in my lower back and buttock and goes down the inside of my leg but the doctors have commented that it's more common for it to go down the back of the leg. I like to be unusal. My big toe hurts when it's inflamed, too. And it's very different from muscle pain, it really burns.

My first attack of sciatica came in the middle of the night. I was nineteen years old and scheduled for allergy testing the next morning and got about two hours of sleep. I remember I was such a zombie and my back hurt so much the day of the testing that the intradermal tests didn't bother me at all.

When it acts up,I take muscle relaxants and pain killers and it usually lasts only a few days. Stretching and heat will help it, too. Driving absolutely kills me when it's hurting. Too much driving will trigger it off, too. On one of our trips to Prince Edward Island, I was in the throes of an attack and it was a fourteen hour drive. We divided it up into two days but it was a very painful two days. All I could take was tylenol because I couldn't take anything that would make me groggy while driving. Made a long trip seem even longer.

Hope you find something that will help you with it. My chiropractor can sometimes help me but not like in the old days, when my osteopath really could alleviate it.

Re: Sciatica and bike riding?

Kathy G on 1/15/05 at 10:32 (167253)

I've just started riding my husband's recumbent bicycle. When I say started, I'm not kidding. So far, the most I can do is seven minutes which is pretty pitiful. Of course, I really ease my way into any exercise program because I never know how my body will respond. I'm only doing it on the days when I can't take a walk and my back/feet/body feel well enough to do it.

His old upright bike killed my back but other than a little soreness in my calves yesterday, I haven't noticed any more or less back pain. Have any of you found riding the recumbent bike to aggravate your sciatica?

This is a far cry from the sixty to ninety minutes of moderate exercise the new guidelines call for. Now, I ask you, how many people have time in their lives to exercise that much every day? Ironically, I have the time but the reason I do is because of my stupid physcial problems. If I didn't have those, I wouldn't have the time either. So I have the time but not the capability.

Re: Sciatica

Dorothy on 1/15/05 at 18:43 (167274)

Sometimes I find that trigger point therapy helps. Have you ever tried that, Kathy G??

Re: Sciatica

Kathy G on 1/15/05 at 20:10 (167283)

My chiropractor uses trigger point therapy frequently. For example, if my rotator cuff is acting up, he presses in an area in my arm pit, making sure he is well out of range if I decide to kick him and it makes the pain go away. The reason I might kick him is because it hurts like the dickens! The results are quite amazing. My daughter hurt her rotator cuff while playing tennis and was told she'd have to sit out the rest of the season. She went to him three times and was back on the court.

He uses it for my TMJ, too. It's never helped my sciatica that much, I'm afraid.

Have you ever tried doing it on yourself? I can do it for the rotator cuff pretty well but not as well as he, or my husband, can. It would be pretty tough to do on your own back, though, wouldn't it? Talk about making a muscle spasm worse!

Re: Sciatica

wendyn on 1/15/05 at 20:54 (167287)

Kathy, if you roll your back around on a tennis ball, you can get a very similar trigger point release effect. Just don't put it near your kidneys.

And if anyone walks in the room while you're contorting on your back - be prepared for some pretty strange looks.

Re: Sciatica and bike riding?

wendyn on 1/15/05 at 20:58 (167288)

Kathy, I know most of us are very busy - but I think that when it comes to exercise, it's a matter of making it a priority.

It's not easy to fit in 60 to 90 minutes of exercise, but I think most people could come close if they really tried. I don't know that the exercise even has to be continous, so a half hour walk at lunch and half hour in the garden in the evening could count one day. Another day could be an hour of yoga, and another day could be an hour at the gym.

For many people, even a little would be better than none at all.

Of course, that's all easier said than done when you've got physical restrictions - I know.

Re: Sciatica

Dorothy on 1/15/05 at 21:08 (167291)

I'm not sure to whom you're addressing your question, so I'll just jump in.
First, re the rotator cuff: my husband has intermittent problems with it and we have some exercises that (so far - knock on wood) are VERY effective for him. If you want, I can try to post those.

Second, the best trigger point work that I can do myself involves using the Theracane (which I learned about on this website!). It came with an instructional video for different trigger point areas. Other than that, I have some books (what else is new...) that I'm going to list and post as soon as I can pull the info. together.

You know, 'pressing on an area in the armpit' is also effective for lifeguards and riot-control! :-)

Re: Sciatica

wendyn on 1/15/05 at 21:09 (167292)

Kathy, I'm going to work on the stretches that you and Dorothy gave me. I guess it really makes me wonder though - if this is sciatica, then what is that other pain I've called sciatica all these years? They are most definitely different.

Re: Sciatica

Dorothy on 1/15/05 at 21:14 (167295)

Julie - Can you clarify: what is the difference between sciatica and compression of the sciatic nerve?

Re: Sciatica and bike riding?

Dorothy on 1/15/05 at 21:21 (167296)

I haven't tried a recumbent bike, but it makes sense that it would put less pressure on the pathway of the sciatic nerve than the upright bike-riding position does, as well as causing less compression/pressure to the lower back that either simple sitting upright does or the scrunched-over riding position does. The Great Lance Armstrong writes of 'my back hurts... my feet hurt....my legs hurt....'
As for upright riding, I think it might depend on how the bike's seat and your seat work together, as to whether it is 'hitting' on the nerve, for example. I love riding my bike so much but have stayed off it for quite a while (see 'feet', 'back', 'bum', 'sciatica'.... general 'complaints'!! :-)

Re: Julie

wendyn on 1/15/05 at 21:23 (167297)

Those were great links Julie, thank you! Well, that answers one question. That pain on the top of my foot is my deep peroneal nerve (another branch off the sciatic nerve). I found a diagram of that nerve, and it follows the path of my pain EXACTLY.

Well, nice to have some variety I suppose. I've had so many issues with my post tib nerves, I guess it's a nice change of pace to experience pain from a different nerve.

No point in getting bored with the same old, same old.

;)

Re: Sciatica

Julie on 1/16/05 at 02:54 (167310)

Dorothy, here's an attempt at making a distinction.

'Compression of the sciatic nerve' describes what is happening: the sciatic nerve is being compressed by something that shouldn't be in contact with it, i.e. a bulging disc, an osteophyte, a tumour.

'Sciatica' is the umbrella term for the disease, i.e. the collection of symptoms, that result from compression.

Hope this is accurate and useful!
.

Re: Julie

Julie on 1/16/05 at 03:59 (167313)

So it's the deep peroneal nerve, is it, Wendy? Now that's interesting! As you say, no point in being bored with the same old, same old....:) I hope this new nerve knows who's boss and shuts up soon.
.

Re: Sciatica

Julie on 1/16/05 at 04:02 (167314)

Dorothy, your rotator cuff exercises, please? (That's another of my issues - not serious, just niggling). I have a couple of good ones, but would be glad to have another or two.
.

Re: Sciatica and bike riding?

Julie on 1/16/05 at 04:06 (167315)

Kathy and Dorothy. The recumbent bike could probably be helpful for sciatica: it would stretch the tightened hamstring and gluteal muscles.
Better for folks with back issues than the upright and scrunched-over positions, which can cause compression, as you say.
.

Re: Sciatica

Julie on 1/16/05 at 04:10 (167316)

Wendy, it was sciatica too, in all probability. Sciatica presents in many ways, because of the complexity of the nerve which with its branches supplies so many different areas of the lower limb. The only difference is that your 'old' pain may also have involved the femoral nerve, which supplies the front of the thigh.

(That's the nerve I'm growing ever more familiar with these days. It's at L2 and exits between the L2 and L3 facet joints.)
.

Re: Sciatica and bike riding?

Julie on 1/16/05 at 04:21 (167317)

I agree with you, Wendy. Another point is that the 60 minutes doesn't have to be all at once. Ten minutes walking to the shops, fifteen minutes of vacuuming, all count. The Guardian is doing a three-part Fitness supplement, and yesterday it included a list of '100 ways to get fit'. It included stuff like this:

Ditch the TV remote control - getting up and changing the channel manually will burn 10 calories per day.

Stand when travelling on public transport and attempt to balance in a Tai Chi fashion, gently 'rolling with it' - a good workout for the core stability muscles that girdle the lower spine.

Fidget - research suggests that many people who don't exercise maintain a low body weight simply by constant, non-intensive fidgeting.

Crumple newspapers after reading and pre-recycling- works the muscles of the fingers and wrists and helps prevent carpal tunnel syndrome.

Wesr lace-up shoes, not sli-ons - works the thumb and finger flexor muscles.

Don't use an electric toothbrush - the wrist muscles have to work harder with a manual toothbrush.

Sit on a fitball - requires contraction of the core stability muscles.

Don't make internal phone calls - walk over to the person, using up six calories for every minute of walking.

Use roll-on doedorant not spray - works the wrist flexor and extensor muscles.

....I'm getting tired. You get the general idea. :)

Is the pedometer craze something that began in the States and migrated here? You buy a pedometer and aim for 10,000 steps a day. A great way of getting in at least some of your 60 minutes. Not perhaps the solution for people with PF, though...
.

Re: Rotator cuff

Julie on 1/16/05 at 04:24 (167318)

I meant that I have a couple of good exercises, not a couple of good rotator cuffs. I have one good one of those, one not so good one.
.

Re: Rotator cuff & Exercise

Kathy G on 1/16/05 at 09:14 (167325)

I, too, would be very interested in any exercises you can suggest, Dorothy. I know about the one where you make your fingers walk up the wall. Oh, poor Julie, she's cringing at my description of exercises! But I bet you both know the one I mean.

As for the frequency of exercise, I forget vacuuming the house, washing the floor, walking to the supermarket from a far-away parking space, going into the bank instead of using the drive through, running up and down the stairs five or six times a day; these are all exercise. I guess they all contribute to the general measure of activity and I think I probably get a whole lot more exercise than I think I get. If I didn't, I'd be sitting down all the time and I'm not. As my husband says, I have to stop comparing myself to the old me and realize that the new, more limited me, isn't that bad!

Pre-PF, I used to do actual daily exercise. For many years, it was 'Sweatin' to the Oldies,' then it was the Nordictrack, then the Health Rider, then the treadmill and then a walk each day. I also used the weight machine. Now it's a shorter walk, and it's usually every other day, now augmented with the bicycle. And lifting weights is out of the question with my arthritis. My upper arm muscles are pretty saggy compared to what they once were and I know I've lost some of the strength in my hands but that's all arthritis related.

I do know I can't possibly be getting the amount of exercise I used to get because but I tell myself, 'It's better than nothing at all!' And if I fret about it, I'll just raise my blood pressure and cause myself needless anxiety.

Re: Julie

Kathy G on 1/16/05 at 09:41 (167329)

Wendy,

Variety is always nice. Life can be so boring!

I've never asked. Are you studying to become a lawyer?

Re: Rotator cuff & Exercise

Dorothy on 1/16/05 at 12:15 (167339)

'As my husband says, I have to stop comparing myself to the old me and realize that the new, more limited me, isn't that bad!'

Your husband sounds like a wise and good guy and I vote with him - even without knowing the 'old you'.

Or is this another New Hampshire thing: being an old ewe and dressing a moose?

Re: Kathy

wendyn on 1/16/05 at 12:30 (167343)

Kathy - maybe. I'm slowly working through an undergrad degree majoring in Law and Society. I haven't been able to cut my work hours back to part time, so I can only take 2 classes at a time.

In about 4 years, there will be a good window of time where it may be possible for me to consider law school. Of course - many, many things have to line up just so for that to work out. Hubby's health being one major consideration. So, we'll see. It is my long range plan for now, but it's entirely possible that may change.

Re: Rotator cuff & Exercise

JudyS on 1/16/05 at 20:19 (167382)

New Hampshire state quarter: 'Live Free or Die'

That was part of my Sofa Girl education......

Re: Rotator cuff & Exercise

JudyS on 1/16/05 at 20:24 (167384)

What fashion are moose being dressed in these days? I hear pink is in and pointy toes are out......

Re: Rotator cuff & Exercise

Kathy G on 1/17/05 at 14:25 (167408)

Seriously, one of my husband's friends gave us some moose meat a couple of years ago. He got it with a bow and arrow! Both my children and my husband ate it but I couldn't bring myself to eat Bullwinkle. On the other hand, I'm the least adventurous eater on the planet.

They decided it was too lean and kind of tough. I don't think you'll see them out hunting moose although the herd needs to be thinned. Too much building and they poor moose have nowhere to go so they appear in people's back yards.

Dorothy, I, too, think my husband is a wise and wonderful guy! And I loved the pun!

Re: Kathy

Kathy G on 1/17/05 at 14:26 (167409)

I salute you for being able to raise a family, work full time and take two courses, along with your nagging pain. You are my hero!

Re: Kathy

Kathy G on 1/18/05 at 09:06 (167451)

Correction on the moose. He didn't get it with a bow and arrow. He does hunt with one but it's in another season. He used some sort of gun but I don't know what kind. Obviously, one with big bullets!

Yes, Judy, 'Live free or die.' There are so many things about NH that just make me want to cringe! But there are also some nice things, too!

Re: Sciatica

skully on 1/19/05 at 00:16 (167516)

When I first felt my sciatica, I thought I had an ovarian cyst or something. It was like a severe menstrual cramp - not around the time of my period - in my lower back. I didn't do anything but take PMS medicine for a day or two, then griped to some girlfriends. Later that day I couldn't sit because it hurt worse and worse. Later I could not stand. I ended up in the doctors office. I could not sit, stand, lay down - just sheer misery. The doc gave me some lorcet plus and that helped but didn't cure it. She sent me to PT and it made it worse so I never went back. I did the exercises they told me to do though - the ones that didn't hurt.

It finally went away but comes back when my foot is the worst. First my left foot with the osteochondral defect and the tts starts screaming, then the sciatica on the other side starts up. Eventually they battle and I must surely be hell to live with.

The neurotin that they gave me for my tts helps my sciatica too though, so that is good.

My sciatica starts with that cramp, and if I don't get off my feet, will start running down my leg. I feel it in my back, my butt, my thigh, it skips my knee, and then I feel it in my calf and the arch of my right foot. It burns - the tts rarely really burns like the sciatica does. It hurts bad in a different way, doesn't really BURN.