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Sciatica pain and treatment options
Hi,
Here's my situation, I am a 37 year old male suffering from severe sciatica. I believe it was caused by a ski injury about ten years ago. Two weeks or so after the accident I was all better with the exception of a little lower back pain.
Flash forward about six years and after a day of mountain biking I developed very severe sciatica. After two weeks of loss of mobility and pain I finally went to see a local Orthopedic/Sports Medicine Doctor. He told me that I most likely have a herniated disc or discs but needed an MRI to be certain. I couldn't afford the MRI at the time so he treated it with oral steroids. I felt better the next day and within 5 days the pain was completely gone.
Flash forward another two years and the same thing happened, received the same treatment, and it cleared up again.
Just two weeks ago it started up again including some off and on lower leg numbness. I called the Doctor I had been seeing and he says he doesn't want do that treatment option again as it's just a "band-aid" cure. He wants to do the MRI and Cortisone injection therapy. I explained to him that I am out of work and have no medical insurance and there's no way I can afford that. He says that's the only way he'll proceed, so he is not going to be an option.
Here's my questions?
1) Is there any logical reason I couldn't do the oral steroids again? I know they work and being that this only happens every couple of years I would prefer that route.
2) Should I necessarily be seeing a specialist like an Ortho, or would a general practitioner possibly be a better route? Would they possibly be more willing to treat with oral drugs as opposed to more expensive options?
3) Should I mention to the new Doctor having seen the old Doctor about this? My feeling is I should. However, I hear a lot about Doctors having preconceived notions on treatment due to a previous Doc's diagnosis.
I apologize if this was so long but I wanted to make sure I gave as much info as possible. As I mentioned I'm out of work and have no insurance so I need the cheapest possible treatment option that can get me back on my feet and free of the pain. I have no problem with having this fixed permanently down the road when I have insurance and a paycheck coming in, but now is just not an option.
Thank you so much in advance for your help, it's greatly appreciated.
Here's my situation, I am a 37 year old male suffering from severe sciatica. I believe it was caused by a ski injury about ten years ago. Two weeks or so after the accident I was all better with the exception of a little lower back pain.
Flash forward about six years and after a day of mountain biking I developed very severe sciatica. After two weeks of loss of mobility and pain I finally went to see a local Orthopedic/Sports Medicine Doctor. He told me that I most likely have a herniated disc or discs but needed an MRI to be certain. I couldn't afford the MRI at the time so he treated it with oral steroids. I felt better the next day and within 5 days the pain was completely gone.
Flash forward another two years and the same thing happened, received the same treatment, and it cleared up again.
Just two weeks ago it started up again including some off and on lower leg numbness. I called the Doctor I had been seeing and he says he doesn't want do that treatment option again as it's just a "band-aid" cure. He wants to do the MRI and Cortisone injection therapy. I explained to him that I am out of work and have no medical insurance and there's no way I can afford that. He says that's the only way he'll proceed, so he is not going to be an option.
Here's my questions?
1) Is there any logical reason I couldn't do the oral steroids again? I know they work and being that this only happens every couple of years I would prefer that route.
2) Should I necessarily be seeing a specialist like an Ortho, or would a general practitioner possibly be a better route? Would they possibly be more willing to treat with oral drugs as opposed to more expensive options?
3) Should I mention to the new Doctor having seen the old Doctor about this? My feeling is I should. However, I hear a lot about Doctors having preconceived notions on treatment due to a previous Doc's diagnosis.
I apologize if this was so long but I wanted to make sure I gave as much info as possible. As I mentioned I'm out of work and have no insurance so I need the cheapest possible treatment option that can get me back on my feet and free of the pain. I have no problem with having this fixed permanently down the road when I have insurance and a paycheck coming in, but now is just not an option.
Thank you so much in advance for your help, it's greatly appreciated.
You are welcome! I am postop (3wks) anterior cervical discectomy and fusion C4-C7 and my surgery was a complete success. I was fortunate that my neurosurgeon advised surgery "sooner rather than later" and my nerves "woke up" rather quickly. I am grateful for his skill and that I had such a good recovery. Fear sometimes causes people to put off a needed surgery and hearing about bad outcomes can increase that fear. I am always happy to report good outcomes and encourage people to listen carefully to what the doctor is saying. Most of them have only the good interests of their patients at heart.
Comfort measures (ie pillow under the legs) can vary from individual to individual. Lying flat may have improved your spine alignment in such a way as to reduce the compression on the affected nerves. But don't be surprised if the numbness returns -- nerves can be very tricky and don't always respond on a linear basis.
Plain ibuprofen is fine -- and probably less expensive. Use caution in the amount you take over a 24hr period and read the label for dosage recommendations. Long term use of these medications can result in changes in kidney function etc.
Keep looking for a kind soul to help you out -- perhaps your situation will improve and allow you to take more proactive approaches once you have insurance.
Keep me posted!
Comfort measures (ie pillow under the legs) can vary from individual to individual. Lying flat may have improved your spine alignment in such a way as to reduce the compression on the affected nerves. But don't be surprised if the numbness returns -- nerves can be very tricky and don't always respond on a linear basis.
Plain ibuprofen is fine -- and probably less expensive. Use caution in the amount you take over a 24hr period and read the label for dosage recommendations. Long term use of these medications can result in changes in kidney function etc.
Keep looking for a kind soul to help you out -- perhaps your situation will improve and allow you to take more proactive approaches once you have insurance.
Keep me posted!
Hi Kittyluv1,
Thank you for your quick response. Your info was not only helpful, but helped clear up some questions and concerns. I certainly appreciate it.
As far as updates go: I had been sleeping with two pillows under my legs as well as two behind my shoulders. This was a treatment recommended for my father when he had sciatica twenty some years ago. Two nights ago I decided to stop doing that and sleep flat on my back. The feeling had completely returned to my leg the next morning. It of course hurts quite bad, but the numbness is completely gone. I am currently looking for a Doctor and will post my progress.
One more question: You recommended Advil or Aleve. Are these preferred over regular Ibuprofen which is what I'm currently using?
Thanks again for all your help.
Thank you for your quick response. Your info was not only helpful, but helped clear up some questions and concerns. I certainly appreciate it.
As far as updates go: I had been sleeping with two pillows under my legs as well as two behind my shoulders. This was a treatment recommended for my father when he had sciatica twenty some years ago. Two nights ago I decided to stop doing that and sleep flat on my back. The feeling had completely returned to my leg the next morning. It of course hurts quite bad, but the numbness is completely gone. I am currently looking for a Doctor and will post my progress.
One more question: You recommended Advil or Aleve. Are these preferred over regular Ibuprofen which is what I'm currently using?
Thanks again for all your help.
Welcome to the Back and Neck Community. Members are here to provide assistance and support to individuals experiencing symptoms related to possible abnormal conditions related to the cervical and/or lumbar spine. The advice given is non-professional and is based primarily on personal experiences. Please post on the Expert Forum if additional medical advice is needed and one of the medical doctors will assist you as appropriate.
Your initial injury was a rather long time ago and your condition has waxed and waned over the years being aggravated by the subsequent traumas. If you did not have a baseline x-ray or MRI done previously, the doctor who treated you was treating your symptoms appropriately with steroidal meds to reduce the inflammation and hopefully ease the pressure being placed on your affected sciatic nerve. The fact that your response was favorable indicates he was correct in diagnosing you with a probable herniated disc. He is probably reluctant to continue applying this "band-aid" without confirming the extent of damage that may have occurred to your spine over the intervening years. Medical practice involves a certain amount of liability and he would rather have documented evidence that his plan of care is appropriate. If there has been increased degenerative changes you might not be respond as well to steroids and he would be at a loss on how to proceed without the MRI.
That being said, you could seek another medical opinion and be very up front and honest regarding your history and the treatment you have received. Doctors are much happier to work with individuals who don't hide anything. I think many doctors are faced with more and more of their patient's losing or not having medical insurance and you might be able to find another one who can continue conservative txmt until your situation changes.
Any self txmt would be to take anti-inflammatory meds such as Advil or Aleve, but these would not be as effective as a prescribed steroid such as a Medrol dose-pak.
I do hope you can find help to ease your current discomfort, but you do need to be very careful that you try and avoid any further trauma to your back. At some point you might cause damage that can not be easily repaired. An orthopedic spine specialist is your best option for treatment and if there is significant nerve involvement, might mean a referral to a neurosurgeon.
Post back and let us know of your progress
Best wishes ----
Your initial injury was a rather long time ago and your condition has waxed and waned over the years being aggravated by the subsequent traumas. If you did not have a baseline x-ray or MRI done previously, the doctor who treated you was treating your symptoms appropriately with steroidal meds to reduce the inflammation and hopefully ease the pressure being placed on your affected sciatic nerve. The fact that your response was favorable indicates he was correct in diagnosing you with a probable herniated disc. He is probably reluctant to continue applying this "band-aid" without confirming the extent of damage that may have occurred to your spine over the intervening years. Medical practice involves a certain amount of liability and he would rather have documented evidence that his plan of care is appropriate. If there has been increased degenerative changes you might not be respond as well to steroids and he would be at a loss on how to proceed without the MRI.
That being said, you could seek another medical opinion and be very up front and honest regarding your history and the treatment you have received. Doctors are much happier to work with individuals who don't hide anything. I think many doctors are faced with more and more of their patient's losing or not having medical insurance and you might be able to find another one who can continue conservative txmt until your situation changes.
Any self txmt would be to take anti-inflammatory meds such as Advil or Aleve, but these would not be as effective as a prescribed steroid such as a Medrol dose-pak.
I do hope you can find help to ease your current discomfort, but you do need to be very careful that you try and avoid any further trauma to your back. At some point you might cause damage that can not be easily repaired. An orthopedic spine specialist is your best option for treatment and if there is significant nerve involvement, might mean a referral to a neurosurgeon.
Post back and let us know of your progress
Best wishes ----
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