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persistent sciatica
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persistent sciatica

I am a 30 yr old woman,I have complex partial siezures, hypothyroidism, and a history of endocarditis + spinal epidural abscess(C3-L5) in 1997, and post strep glomerulonephritis + pulmonary edema in 2003.About 3 months ago I had a bad case of sciatica. what started as some numbness in my right leg off and on, quickly progressed to severe cold/burning pain in my thigh, numbness in the rest of my right leg and weakness ,especially in my big toe area. I was also having trouble urinating. I went to the emergency room and they did x rays,(Normal) catheterized me for residual urine(180 cc's) and drew blood for ESR (30something)They palpated my lower back and when they pressed on the sciatic nerve it was really painful,I didn't have any back pain at the time though so that was a surprise to me. I was told it was sciatica and sent home.I followed up at the clinic the next day and the doc ordered an mri(which would take a while to get approved)I went home and slept for 17 hrs and when I woke up the symptoms were gone. over the next few weeks the numbness came and went and I started having low aching back pain on the right side radiating to my hip. eventually it stopped going away, and then it started waking me up at night(as though I had been laying on it and needed to change position, only to find that I hadn't really been laying on it-it was just a constant ache.)Now it aches worse when resting or lying down, and does not seem to be aggrevated or relieved by any movement or position.The MRI was just approved,Should I still do it though my current symptoms are better than before?
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Avatar_n_tn
I would still advise to proceed with the MRI

The tests you have had done have been unremarkable, but are not specific enough to find the underlying cause

More specific tests to find out where the problem is and what it might be are MRI and EMG
The sciatic nerve should not be palpable in the lower back, so its unclear what area was tender ?it may have been a vertebrae or paraspinal muscle
The low ESR makes it less likely that an infection, such as another epidural abcess (abscess) is present, although a localized area of infection may not elevate the ESR
The urinary trouble would suggest that the problem is higher up than the sciatic nerve, at the lumbosacral plexus and/or lower spinal cord.

In any case, it is important to do an MRI to evaluate for an epidural abcess (abscess), prolapsed disc, vertebral fracture, or other cause of potential compression of the spinal cord or adjacent nerves

Good luck
3 Comments
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Avatar_n_tn
after reading my own post I wasn't sure if it was clear that the pain is constant, never goes away(on a 1-10 scale it is 3-4 during daily activities, and 4-5 at rest.) the pain is tolerable but the fact that it never goes away is affecting the way I feel, I have lost weight as my appetite is poor lately and I am constantly tired due to tossing and turning at night.
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Avatar_n_tn
I don't know if the docs read these comments or not but I have decided to go ahead and have the mri as I cannot reach the ordering physician to get his o.k. on skipping it. In addition the lower back/right hip ache has has now started affecting the left lower back and left hip, has moved up about 4 inches to include a larger portion of my lower back and I am starting to have much more frequent urination again which was the first symptom previously before I began to have trouble urinating, and I'm dribbling urine again. the lower lumbar bones have become very painful to the touch, but as long as I don't touch them it's ok.
   My current plan is to have the mri tuesday as scheduled, and call to schedule an appt at the clinic for friday to check in with the doc there(I've been needing to do that anyway as I seem to have a stubborn boil in an unpleasant area of my anatomy)
Good luck to every one on this forum.
  If by chance the docs do read this...I would still be interested in any input you might have for me.
    -Thanks
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