Sciatica Pain

[David_H]

Hi all. I'd be interested to know if anyone can give advice or give their experience on the matter. I had back pain and pain and numbness in the front of my right thigh. MRI scan revealed nerve issues in L4/L5 area. Prescribed Naproxen. Not long been taking them long. I've been advised to stay active but finding it difficult as any sitting, lying down, inactivity results in quite severe pain in back and thigh during and after getting up. It's also painful at night so hardly getting any sleep. Just wondering if this is a familiar story and what strategies others have taken to reduce pain and speed up recovery. Thanks a lot

[Suzie42]

Naproxen is not enough for you. There are many other stronger nerve pain killers out there. Go back to your GP and tell him how you are still are after taking Naproxen.

[David_H in reply to Suzie42]

Thanks. I will

[BertoBishop]

I had to have steroid injection for sciatica and it’s been the only thing that’s worked. Maybe ask your GP for a referral..

[David_H in reply to BertoBishop]

Thanks for your advice

[arvine in reply to David_H]

Spinal decompression therapy, a form of traction, non invasive

[BertoBishop in reply to arvine]

Hey Arvine, this has never been offered to me - I have spinal stenosis. Has this been offered to you or did you ask and get a referral? Has it worked (sorry for all the questions!)

[arvine in reply to BertoBishop]

My late son jad this treatment many yrs ago for severe sciatica, and was very successful for him, I had MRI s done and scheduled an appt wth the facility , met with head chiropractor then,and advised this therapy could help me for spinal stenosis, bursted disk, and degeherative disease,required 20 sessions , first 2 weeks every day , then the remaining sessions spread out 2?or 3?a week it was pricey thankfully I have some insrance coverageto help.Im in ontario Canada dont know if you have this facility where you live, but for more info , google Durham spinal decompression therapy, Whitby Ontario, there maybe some other facilities in other countries or provinces, but at least you can get info and contact them for derails etc

[BertoBishop in reply to David_H]

You’re welcome mate

[ActiveFeet]

about 14 years ago I had an L4/5 injury. I could not stand and watch music or talk for more than 15min. I saw a physio who asked me to do core exercises. After a few weeks she sighed and said this is not working we need to get you doing something else. She went through the sports etc that I had done, she stopped at Karate, and said that would do. We don’t want you taking up something new at over 40.

After about 3 months back training the pain went and my core was stronger- even now when I feel a twinge I train at home and the pain goes. If you can drop the drugs and go for a strong core - I can now stand for hours without issue- hope this matches you form of injury

[David_H in reply to ActiveFeet]

Thanks very much. Yes I find sitting uncomfortable so having to eat standing up Paun only relieved when lying on back bit been told to keep active!

[ActiveFeet in reply to David_H]

Sitting and a lack of activity for a week or so (Xmas etc) often tells me trouble is coming. I am looking to move to tai chi for core exercise. Have you seen a scan of your. Disc damage? I was able to see core scan 5 years apart and be confident I had been lucky with my approach. As all injuries are different a measured approach is best. Karate was ok for me as I had 20 years history. For others just slow knee lifts and slow lowering every day may be better.

[David_H in reply to ActiveFeet]

So i can be pain free(Ish) at night if I lie on back and don't move about. I'm more resting than sleeping in that position. Getting up in the morning is worst time. Very stiff and painful and difficult getting dressed. I try to keep moving around on the day with frequent lie downs

Sitting on chair uncomfortable. I had similar problem about 20 years ago same l4/l5. Told this time not bulging but nerve irritation.

[cyberbarn]

This does sound like what I had a couple of years ago only it was on my left. It was during the pandemic lockdowns and no one would see me. It wasn't just the pain, I couldn't walk more than a few steps before the muscles in the front of my thigh stopped working and I would drop to the ground.

I can't take most common pain medication so I used hot water bottles, three of them, and found a comfortable position laying on my back on the sofa but propped up at the head end. I had to get up and move every hour to refill the hotties!

I am a post grad student at a university so I was able to consult them on line, and she said I had to wait until the acute phase was over before doing too much exercise. Yes, move if I could, but take it gently.

After about three weeks I started to sleep longer at night, and eventually I didn't have to get up at four in the morning to move to the sofa which was more comfortable than the bed.

After a few weeks I was able to walk again without the severe thigh pain, but that was when I realised I couldn't lift my leg properly. I tried to get into the car, sat on the seat and swung my legs in like I usually do, but my left leg didn't join me!

Eventually the NHS physio kicked in, they thought osteoarthritis, rheumatologist though... well, actually, I don't think she does think! But she said no to the OA and said maybe the spondylolisthesis I did get an MRI six months after the acute attack and there was no evidence of anything. Well, no, of course not, what ever it was had resolved!

I still get sciatica, but never as bad as that attack. As I can't take NSAIDs or codeine, I just rely on paracetamol which should be taken regularly, as in four times a day every day, rather than just when it hurts, and ibuprofen gel when it gets bad plus my beloved hot water bottles.

[bookish in reply to cyberbarn]

Hi, if you are needing that level of paracetamol on a regular basis it would be worth looking into glutathione and cysteine. Although glutathione should only be depleted significantly with high doses, a regular lower dose may also have a negative effect (a sustained dose of upper allowable level can be as bad as a single big overdose), and if you (like me) are genetically predisposed to lower glutathione levels already, this could become a problem. theconversation.com/we-need... Cheers

[cyberbarn in reply to bookish]

I have read that article and it is talking about overdoses for the most part. My point is paracetamol doesn't work if you say have a headache that has already started and you take a dose of paracetamol. It works better if you start taking it the day before. Clearly we can predict headaches which is why ibuprofen often works better. But for low to moderate pain, or taking the edge of higher levels of pain, it is best to take it regularly at the advised dose rather than occasionally when things get worse.

[bookish in reply to cyberbarn]

I know what you mean about taking the edge off chronic pain, although I found that magnesium did the job better. If you read other stuff on paracetamol, you will find that the level at which gluthathione-affecting toxicity can be a problem is really quite low, varies between men and women, and of course that takes no account of whether you have an expressed polymorphism.

[cyberbarn in reply to bookish]

Magnesium can do the job if someone is deficient in magnesium. Not everyone is. And yes, everyone has a different genetic makeup, hence for some codeine doesn't work at all, some are off with the faeries with the lowest dose, and for others again they are in the Goldilocks zone.

[bookish in reply to cyberbarn]

Yes, I agree. I found that amitriptyline affected me considerably at low doses, whereas my MIL needs a vast amount to have the same effect. But don't agree about the deficient in magnesium bit - magnesium is needed for many enzyme reactions and for methylation, so you may not be deficient in serum but in cells and that isn't checked as often if at all. Same applies to the B vits - a 'serum deficiency' is all that many doctors still look for, treating B12 as a blood disorder, when it is primarily neurological and may never show in bloods. Fortunately there are many now who do understand that, and who use it for nerve pain treatment irrespective of cause.

[David_H in reply to cyberbarn]

Thanks very much. Most useful hearing others stories

[David_H in reply to cyberbarn]

Hi. Just discovered it's l5/s1 so the one below the one I had last time. Doc suggested tramodol along side the naproxen but think I'll see how it goes for now as I don't like mixing meds too much

[cyberbarn in reply to David_H]

My GP suggested tramadol and naproxen together, it is like taking co-codamol which is paracetamol and codeine, as tramadol is codeine related and naproxen is an anti-inflammatory. But everyone is different, you can try the tramadol on its own and see how you go.

[bookish]

Hi, with the range of other issues that you have mentioned I'd seriously be looking for something systemic such as a vit B12 deficiency as well as treating the immediate problem/s. The IBS alone could be significantly interfering with your ability to absorb many essential nutrients and vitamins. Anxiety and nerve/neuro issues and bladder and sciatica all could be B12 and/or folate. Have you got copies of test results forthose and full blood count? It is important not to supplement until tested, especially orally as this may obscure diagnosis and not fix the problem. Any family history with the Bs? A vit D and magnesium check could be useful too. Cheers

[David_H in reply to bookish]

Thanks a lot. I recently had some blood tests. Wasn't mentioned bur I'll take a look ta

[bookish in reply to David_H]

Hi, unfortunately you can have a cellular B12 deficiency at any serum level, and in the absence of enough B12 serum folate may actually show high, not low. Doctors generally not well informed and can be hard to spot. Lots of tests which may help to show an issue, hence need for FBC as well (MCV, MCH, Hb, RDW etc). Some other tests not frequently done may be useful but basically all tests can show normal and you still benefit from B12 injections - about a third of those who benefit have normal bloods, just so you are aware. Good luck.

[auntysue]

Hi, im on some real heavy duty pain killers, non of which help when my sciatica kicks in. However, sounds daft but 500mg ibuprofen, prescribed by doctor works!

[David_H in reply to auntysue]

You just never know do you

[arvine]

I had trapped nerve actually ruptured disc, over year ago, same symptons you describe, I went for decompressin therapy, non invasive but stretches spine only millimeters each session, takes pressure off discs allowing disc to heal , thereby relieving nerve pain,

[David_H in reply to arvine]

Ooh that's bad! Luckily mines just bulging

[arvine in reply to David_H]

Still would take pressure off nerve, allow disc slip back in between vertabrae

[hypercat54]

First I agree with what Suzie said. You need painkillers and not just a muscle relaxant. This is nowhere near enough. Go back to your doctors. You could try asking for pain patches too.

I have spinal stenosis and the first real sign was crippling sciatica. Its is agonising isn't it. I found a couple of things which did help a bit.

First walk as slowly as you need to and try not to bend the affected leg much to get it moving slowly. The pain will ease a bit for a short time. When it starts again just slow down again etc. or rest. The key is gentle exercises to get the sciatic nerve moving gently. If you overdo it then it will start jangling like someone is applying a hot iron to it.

At night lie on the unaffected side and put your affected one on top of it trying to keep it as straight as possible. This helped me and sometimes allowed me to sleep.

The sciatic nerve runs almost straight down your side so keeping your leg straight helps to keep it away from the nerves which are at the bottom of your spine in a narrow space.

Also some very gentle massage can help too. Not hard but soft. Good luck.

[hypercat54 in reply to hypercat54]

I forgot to add that warmth really helps. In the winter I would sit with a blanket round my affected side which would ease the pain a bit. It makes the nerve a bit more pliable and less stiff from cold.

[David_H]

Thanks a lot. Mines a bit different in thar the leg paun is confined ti tip of thigh only. I can only get relief from pain at night by lying on my back but then I find I can't sleep hence me posting at 3am!

[Micro]

I have various pain from lumbar spine joints and FM which affect my back and legs. Then I woke up with a different pain as well, down the front side of my thigh. I could barely walk. Bad enough before the new,pain.

A chiropractor managed to get rid of the new pain over about 6 sessions, two a week. Sounds similar to your problem. Have to pay unfortunately.Here £45 a session..

He can’t seem to improve the original lumbar joint pain however..for that I have spine injection, nerve block type, Radio something jabs.

Steroid injections did not work for me. Good Luck.

[David_H in reply to Micro]

Thanks. Yes I tried steroid jabs when I had similar problem about 20 years ago and they didn't work eithet

[abellemed in reply to Micro]

Hi there! How long did you have to wait for your radiofrequency nerve ablations? I assume you are in the NHS in UK, and as I can't afford to go private, I am having to wait over 2 years for mine! I was put on waiting list in August 2023 by the local pain clinic. In the meantime my dihydrocodeine pills don't work any more so have become almost immobile.

[Micro in reply to abellemed]

This time I paid for myself, approx 2,000£ cos desperate at the time. NHS next time. 3 year wait….Unbelievable. Up to this last one it’s only been a couple of months wait. Two years.. not ok whatever it’s for GRRR

I feel Noritriptilyne must be helping a bit at the level I’m allowed but it’s not enough on its own. Pain still reaches an 8/10 thru the day. Impossible to function. I’m still allowed a little Oramorph but some doc will eventually start another stressful process when it is spotted. ‘

[Micro]

hope you got the above info. My phone refuses to type after that. Good luck !

[abellemed in reply to Micro]

Yes, I did get it - and thanks! However, you say you'veen given Oramorph, well I do remember having it as a liquid a couple of years ago when I was getting frequent sciatic pain on top of the nagging pain on standing/walking and it sent me all absent/dozy so I never pursued it. I did wonder, though, how long did your radifrequency ablations last? It seems like I won't get mine till "sometime in Spring", so I might need to go back to the Oramorph before then! After Xmas I'll ring my GP (new one but equally unhelpful), ask them to "expedite" my ablations (as suggested by Pain Management this morning). Anyway, thanks again for replying and best wishes for Xmas!