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Neurology  (Expert Forum)
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Syatic nerve
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MedHelp Member's Question

Syatic nerve

by Danaperret, Jan 26, 2002 12:00AM
I have severe pain from a pinched syatic nerve. My doctor has advised me to stay off my back for a few days and lay on a heating pad( its been 5 days). Yesterday I spoke with a nurse , she couldn't believe the Dr. told me to lay still on my back. She said I was making it worse!She said, " everyone knows you have to work a syatic nerve out"....She thinks I should get up and move around, stretch and bend !..... I can barely sit!!!! Who is correct?             Thanks,Dana
Doctor's Answer

by CCF-Neuro-M.D.-JT, Jan 27, 2002 12:00AM
This is actually controversial.  There have been several research studies that tried to determine which treatment advice is better. The most recent is a Norwegian article that looked at 5 different research studies comparing bedrest vs. activity in over 1400 patients with back pain including sciatica. After 3 weeks, there was no difference in the amount of pain in either group and their overall conclusion was that there no difference in the outcome.



However, realistically the treatment plan should be individualized for each patient. For my patients, I determine how far I go diagnostically depending on the patient's clinical history and examination. The next steps would be an MRI and then EMG as necessary. If the MRI does not show anything that needs emergent surigical or medical intervention, then I usually recommend stretching exercises, common sense in your daily activities (like not overdoing it at the gym or lifting things that are too heavy), but usually not bedrest. I'm not sure there's a right or wrong answer to this, but hope those suggestions help.
Member Comments (17)

by Nickmbb, Jan 26, 2002 12:00AM
To: danaperret
Hi, I am not a MD but I got to tell you, I had MAJOR problems with my lower back 4 years ago, were I couldn't even get out of bed for a few days from a spasm that happen out of the clear blue while I was working at my desk. I had a MRI done and showed that my last 2 disc were herniated and causing pinching of the sciatic nerve. For months, I was having severe pain in my butt, and left leg....I couldn't sit in a chair for more than a few minutes....it was hellish. Are you having pain in your leg(s)? Or did you experience a severe lower back spasm.



If you had a spasm, there isn't much you can do until the pain subsides and you regain some ability to move around. Your nurse may not understand just how painfull you back is feeling. I was put on naproxen and told to stay in bed for no more than two days. I was also told to be careful with heating the area too much as it could cause the spasm to get worst. After 2 days, I started do simple leg stretches (laying on my back, bring one knee very slowly to my chest and vis-a-vera).  



What your MD said and what your nurse stated are subject to what is brother your back. You should get a MRI done ASAP, to see if it actually is a disc problem, where PT and drugs would help you.



One last thought, I never thought my back would feel better after all the pain I had...but 4 years later, I learned how to sit correctly, changed my posture, learned how to even walk correctly, I do back stretches every morning, and because of this, I avoided surgry and my back is controllable. (But now I'm dealing with whiplash...LOL). Good luck, and have faith...it will get better.

by etmercado, Jan 27, 2002 12:00AM
I  too had this problem but it was 5 yrs. ago. it was in my left side going through butt into leg. i was put on bed rest for a couple of days then physical therapy for 5 months, WHICH MADE IT WAY WORSE!!!!!!!!!!!!!!!!. my L5-S1 disc ended up herinating. had a MICRODISCECTOMY surgery. this helped, greatly to releave pain. but 2 months later lower back started hurting again without leg pain. had another surgery in oct. of 2000, "ANTERIOR LUMBAR FUSION w/ SCREW CAGES and BONE GRAFT."  had this for degenerative disc at same spot.  now doc. wants to put in PEDICLE SCREWS , which means #3 surgery.  i am in constant pain everyday. i live on the heating pad all day and soak in hot tub for an hour. the tub is the only thing that helps , that is until i get out, then it comes back.i've heard alot of bad things about the PEDICLE SCREWS, SO I DON'T THINK I'LL GET THEM. in my case phyiscal therapy made it worse after 5 months of it. I was 25 at the time , now I'm 30.i would get an MRI .everyone is different!!!!!   I DID MINE PICKING UP 1 GALLON OF PAINT,   GO FIGURE.    GOOD LUCK.

by eloridas, Jan 27, 2002 12:00AM
To: danaperret
I was very interested in seeing what the doc said: CCF-Neuro-M.D.-JT .  I have had a compressed S1, ever since I could remember--some docs say I was born with it--needless to say, sitting is the worst.  I had been always told both ways, but with my PT--she had another suggestion--AND for me has worked the best.  My Physical therapist explained that if you reverse the position, as much as possible from what causes you pain--in my case sitting and reverse that position (don't get scared--not that far--but if you place pillows under the lower part of your legs with you laying face down.  (I've had alot of PT--this actually was very relaxing)  If you get in the hadit of maybe watching TV this way, and periodically raise your upper body by pushing up with you arms.  I've always found this to the only way I get relief now.  Hope this helps!

by eloridas, Jan 27, 2002 12:00AM
To: danaperret
OH and what etmercado said about heat--you may not want ot lay on a heating pad, but hot shows are great for loosening up tight muscles.

by Bilbo Baggins, Jan 27, 2002 12:00AM
I am looking for advice on how to reduce the pain in my right hip/leg area. I think its the nerves are pinching and it does not go away for long periods of time.  I assume its the sciatic nerve.  Is exercise better or just relaxation(not bedrest)?

by munster, Jan 28, 2002 12:00AM
To: comment for nickmbb
I have some questions for you.  my symptoms sound so similar to the ones that you were describing and more.  Could you please email me so I can ask you some questions without taking up a bunch of space? I will wait for your response and if there is none then I will go ahead and post in this forum for you.

Thanks in advance--Maggie       ***@****

by Gimpy, Feb 11, 2002 12:00AM
I have had Syatic pain for over a year. Mainly down the left side but sometimes down both sides. My left foot has also been known to go to sleep.  I have had two rounds of physical therapy and 3 cortizone shots between L4 & L5.  The doctors now want to do surgery.  Anyone out there had this?  What can I expect?  Has anyone tried laser therapy?

by Cornbread, Feb 22, 2002 12:00AM
To Gimpy,



Hi.  I just had surgery on 2/12/02.  I herniated l4 & l5.  Apparently one disc in l4 or l5 was completely removed and the other partially removed.  I was in pain since the first week in January 02.  The neurosurgeon I consulted with recommend surgery.  I was in alot of pain, couldn't sit, stand or walk without pain.  The recommendation he gave for surgery was that 1)  mine was a significant amount of herniation to the discs.  2)  waiting could pose problems with reflexes (my right leg was bearing the brunt of the pain) 3)  I could develop lifelong numbness in some areas. 4)  this procedure, IN ACUTE CASES (ie where an injury has occurred)has been done for 20 years and the success rate is up around 85-90% according to some circles.  I feel pretty good 10 days after surgery.  I supposed to take it easy for the next 3 weeks still, but I am progressing well and am happier now.  Life was pretty bleak in late Jan and early Feb for me.  I'm 31 and am married with a 6 month old.  I'm looking forward to being with them, pain-free, that's why I decided quickly on surgery.



Let me know if you have more questions.



by kimie, Mar 10, 2002 12:00AM
I have had sciatica no and of for 21 years.

I have never before had the pins and neddles in my left foot,

pleas can anyone advise?

by rawry