Sciatica

[Ancientrimer]

Worst pain have ever had - because I have high blood pressure am not meant to take ibuprofen and was prescribed cocodamol which has done nothing for pain. Any suggestions? I see clinical practitioner tomorrow so would love response before then. Thanks

[Koalajane]

I was prescribed amitriptyline for my sciatica which does help.

[Ancientrimer in reply to Koalajane]

Thanks for that Koalajane - it’s strange because amitriptylene used to be used as purely an antidepressant drug but now it seems to be used more generically. I will post up what, if anything I’m offered. This kind of pain subsumed my life and want to help Ukrainian relatives who have recently come to stay in my home.

[Koalajane in reply to Ancientrimer]

I thought it had worked really well. Unfortunately I stopped taking it thinking it had gone and it has come back and although not as bad as the previous dose where I could not walk for more than 2 minutes I still have some pain with the amitriptyline. However it has helped me sleep deeper and I don’t wake up in pain in the middle of the night.

[Ancientrimer in reply to Koalajane]

Ah, glad you added that. I don’t think there’s a wonder drug that suits everyone and don’t want to get dependent on any but at present will take anything and I want to learn which exercises are best for it as if I look online as usual there’s conflicting advice.

[Koalajane in reply to Ancientrimer]

The physio showed me some exercises but they were mainly stretching up and also to the side

[PMRpro Ambassador]

Is the sciatica being caused by tight muscles pinching the nerve? That is very common in PMR. Specifically it is usually the piriformis muscle as the sciatic nerve passes through the muscle. If so - stretching exercises for the piriformis muscle should help. Identifying and dealing with the cause of the pain is important.

Cocodamol probably isn't helping because it has no anti-inflammatory effect. Is your high BP not controlled with medication? I have never been told not to use ibuprofen because of BP issues - I take anticoagulant therapy and that is a consideration but my rheumy still instructs me to use it, together with a PPI to protect my stomach when it is frequent use.

[Ancientrimer in reply to PMRpro]

I am taking meds for high blood pressure but it’s still very erratic- however I’ve been taking one dose of ibuprofen in the morning to help me get going then don’t take anything else. Am not sure about original cause - I was clearing and tidying my house so my nephew and family could move in and I think the stretching and bending and lifting heavy bags into loft has caused it. I am at start of sciatica journey

[PMRpro Ambassador in reply to Ancientrimer]

I take a single dose of 800mg ibuprofen and sit with a hot water bottle over the low back area that hurts. Takes time though. I mean days, you have to be patient.

healthline.com/health/back-...

I REALLY don't advise some of these stretches but numbers 1, 4 and 5 are the ones that my rehab rheumy who triages the rehab physio and other treatments hands out. I can manage Nos 4 and 5 but at present I find No1 difficult - I can't manage to lift the thigh towards me. It isn't helped by trochanteric bursitis at present - when that isn't in play the exercises are easier.

[Ancientrimer in reply to PMRpro]

Thanks so much for these exercise recommendations- I will look at them later - must now activate myself

[PMRpro Ambassador in reply to Ancientrimer]

Yeah - well that's the hardest bit isn't it

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Some I wouldn’t attempt since knee and hip replacements, but others are fine……😊

[PMRpro Ambassador in reply to DorsetLady]

I can't kneel either - like knives going in. Not replacements though.

[SnazzyD]

Hello, I’d want the practitioner to find out whether the sciatica is due to nerves being pinched higher up at the spine level or nerves being pinched by specific tight muscles in the buttocks. Same symptoms largely and two different approaches. You can clam the nerve down with Amytriptyline but if your prirfomis muscle for example is tight as a drum you could be missing out on a a better resolution.

[Ancientrimer in reply to SnazzyD]

Great - I will pursue finding out root cause after doctor appointment tomorrow and let you know what’s said.

[piglette]

I agree sciatica is excruciating. In my case co-codamol, tramadol etc were a waste of time. I found that physio helped a bit. They used a TENS machine which helped a bit too, also exercise where you were supposed to tie yourself in knots. The good thing was it went away.

[Ancientrimer in reply to piglette]

Those last few words were what I like to hear piglette! It went away - I’m still optimistic that mine will too though at it’s most painful it doesn’t seem like it. Self-help is what I generally do but I have to admit defeat on this one. Thanks for replying. I’m amazed how many people have helped me with their advice.

[crazylady57 in reply to piglette]

That sounds like a glimmer of hope piglette. I've been in A and E, never in my life before, the pain in my hip and leg were excrutiating and went into spasm. I had co codamol, pregablim, nothing worked. I have to have an MRI now to see what's going on. I can't sit down. After 2 minutes the witchy muscle tightens up, goes into spasm, won't let me walk. Been going on since January. Why, what happened. I've got RA which is controlled and I used to go everywhere, but now I'm almost bedridden. Hospital gave me morphine and Tramadol, are you supposed to use them together. Help someone, advice needed. Thankyou

[PMRpro Ambassador in reply to crazylady57]

Now that is a question! There are studies that show that by using them in tandem tramadol and morphine have an infra-additive interaction, i.e. the effect is better. But there is some dispute and whether that is what they intended you to do is another matter. Poor practice if they didn't make that clear and give you instructions in writing since no-one takes in what is said to them in the ED!

My ED source asks is it oramorph you have been given?

And says make sure to take a laxative if you do use them.

[PMRpro Ambassador in reply to PMRpro]

PS - I would call 111 and ask for advice

[Ancientrimer]

Sorry to hear all this dad2cue. I just hope that mine is caused by something very simple and short lasting - we have to live in hope don’t we?

[Fudgethecat]

I think you need to listen to your neurosurgeon. Has he told you what the permanent nerve damage will lead to? Depending on which level the nerve is being squashed on its exit from your spine he can tell you what might happen. Not wishing to scare you but you could lose bladder/bowel control and/or the use of your legs. If the problem is getting much worse then you really must take this seriously. If the pain has gone then the nerve is at serious risk….. (I’m a retired physio in a previous life)

[Daffodilia]

I did core exercises and applied ice to back three times a day - when a bit better did Pilates and walking- only sit for 30 minutes without moving. It is better but comes back after gardening so use ice again. Still do Pilates and walk a lot. GP can give you core exercises.

[tcron72]

Hi there, I had a lot of problems with sciatica which was caused by a disc bulge pressing on the nerve. After months of physio things settled down, then one bad stretch and a long car journey and I was bed-bound. GP prescribed gabapentin which targets nerve pain and I was on max dose of 3600mg daily but still needed morphine (oramorph) and diazepam. Ended up having an operation in Nov as I could barely crawl and couldn't stand. 7 months on I am now starting light jogging and building up strength again but it has been a painful 12 months or so! My advice would be to push your GP to refer you for a scan as that is the only way they can properly diagnose, the only issue you may find is that there is a long wait. I paid for private as I do not have insurance. Even with diagnosis, for months I was told to manage it rather than take intrusive action of surgery, only when it really deteriorated did I end up having the op. Do whatever you can to manage the situation with your back and hopefully it won't ever get as bad as mine did!

[AliDeJ]

Hello.Sciatica has a root cause. Make sure you are not given inappropriate exercises without a proper diagnosis. If they don't offer you an MRI this time, go back!

[Ancientrimer in reply to AliDeJ]

Hi Pixie, yes I totally agree about diagnosis - which was why I went to my nhs walk-in last week. But nurse didn’t listen to history of symptoms and told me they couldn’t give me anything anyway so she didn’t know why I was there. I said I needed a diagnosis and to be listened to! She sent me away - after 3 hour wait - saying I should have an x ray as she thought it was my bones???!!!I’ll see what doctors say in an hour.x

[Pixix]

I’ve had sciatica for four months now, diagnosed by GP…first thing is to make sure it is sciatica, but assume you have been diagnosed! I’m not being rude, a lot of people assume they have sciatica from their symptoms and it can be other things! I cannot take ibuprofen and was taken off amitryptylline for a completely different medical condition! I was put on duloxetine two weeks ago, but sadly the nausea & vomiting were too much during a weeks trial…BUT duloxetine is similar to amitryptylline, so bear it in mind, lots of folk don’t get the side effects! Otherwise, I take tramadol, but nothing truly controls it. I was put onto tramadol for injuries from a car crash, though, I don’t think it’s necessarily recommended for sciatica!! Tramadol does not remove the pain, just helps a bit…sorry!

[Uglow]

I had 5 days of diazepam to release nerve then I took paracetamol regular for 5 days diazepam addictive so they only give 5 days 5 mg it does work.

[Ancientrimer]

Thanks for this info, Uglow, all tips are very welcome. It would be great if paracetamol worked for me but so far it hasn’t. Will let you know what doctor says.x

[Fudgethecat]

I totally understand you being afraid of the surgery. Personally, I would only accept spinal surgery as the last resort. But (and it’s a big but!) if you’re being seriously advised that you need it then I do think you need to get it done before it’s too late. Spinal fusion isn’t fun but as long as you’ve got an experienced surgeon (check them out online) you’ll be fine. Maybe ask if you can meet someone who’s had it done by the same surgeon…? Good luck 😉

[Stifffingers]

Feel your pain ! I had crippling Sciatica for Months. Eventually agreed to have Steroid injections in Hospital under X-ray imaging. First one never touched the sides!!?Second one , around 8 weeks later, kicked in after about 6 weeks. Now apart from a slight “ bite” occasionally , back to normal.

[PMRpro Ambassador in reply to Stifffingers]

My rheumy is far more subtle: prods the area until I scream loudest and inject in soft tissue there. Always works and avoids the joint problems.