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Extreme Sciatica

carriede

By carriede,
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carriede

carriede

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Hello! We had quite the Thanksgiving around here...

You see, my left hip got out of wack back in January while I recovered from jaw surgery. I had to sleep sitting up for a week and it seems we didn't have a suitable chair...

So I went to physical therapy to get everything back into shape. Fixed my apparent leg length differences caused by my hip and possible bulging disc which was causing sciatica symptoms.

We made great progress and I stopped going when I was mostly healed but...

The sciatica is always kind of there and I have problems if I sit for too long.

NOW on Tuesday, getting ready to head to the in laws for the holidays, my hip started acting up - so I did some stretches I learned in PT ans SNAP! Something popped, huge pain, couldn't move.

Went to the ER that night. Nothing broken or out of place (but that's what they said before and then my physical therapist popped my hip into place so it must have not been in place?). Received pain meds, steroids, muscle relaxers.

--- Okay, here's the main point ---

Tomorrow I have an appt with the orthopedic surgeon, I'm hoping to get an MRI go get more information.

I'm can't walk or sit or even really lay down. The only painless position I can find is with my torso on the bed and my hips and legs hanging over the side. I have NO individual mobility and crawl around the house with DH's help to get to the bathroom - which is a whole other Ordeal.

I just don't know what to do next. The pain isn't subsiding, and I'm hardly sleeping. I'd just like to know, do any of you have any experience or advice for me?

Thank you!!

Signed,

Getting desperate

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carriede

carriede

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On 11/26/2023 at 1:22 PM, TravelingChris said:

You need nerve medication too - that is the only way to help severe nerve pain. I has excruciating sciatic nerve pain after my lower spine surgery and the only thing that helped was 30 mg of amitriptyline throughout the day plus strong narcotics.

 

I will pray you get relief.  

Thank you.

So the doc prescribed hydrocodone 7.5-325 up to 4 a day and Gabapentin 300mg x2 a day.

I'm a little concerned since the hydrocodone makes me pretty sleepy to begin with. Do you, or anyone, know more about these?

And I should have the MRI tomorrow, bht my insurance is old fashioned and is taking forever.

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Harriet Vane

Harriet Vane

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2 minutes ago, carriede said:

Thank you.

So the doc prescribed hydrocodone 7.5-325 up to 4 a day and Gabapentin 300mg x2 a day.

I'm a little concerned since the hydrocodone makes me pretty sleepy to begin with. Do you, or anyone, know more about these?

And I should have the MRI tomorrow, bht my insurance is old fashioned and is taking forever.

The Gabapentin will definitely help with pain. However, I found that it made me extremely sleepy the first several days. I have a couple different friends who have been taking Gabapentin for years with no issues. These friends are all glad to have Gabapentin and they have had NONE of the side effects I struggled with.

For ME, though, even though I adjusted and became less sleepy after the first several days, I did continue to be sleepy in general for the full time I took Gabapentin (a couple months), and I also was extremely spacey (lost blocks of time due to just moving slow or staring into space) and even had trouble putting words together if I was tired or emotional. Take this with a grain of salt, though--I have always experienced big responses to many medications, especially ones that are sedating.

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carriede

carriede

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18 minutes ago, Harriet Vane said:

The Gabapentin will definitely help with pain. However, I found that it made me extremely sleepy the first several days. I have a couple different friends who have been taking Gabapentin for years with no issues. These friends are all glad to have Gabapentin and they have had NONE of the side effects I struggled with.

For ME, though, even though I adjusted and became less sleepy after the first several days, I did continue to be sleepy in general for the full time I took Gabapentin (a couple months), and I also was extremely spacey (lost blocks of time due to just moving slow or staring into space) and even had trouble putting words together if I was tired or emotional. Take this with a grain of salt, though--I have always experienced big responses to many medications, especially ones that are sedating.

Thank you for sharing!

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cintinative

cintinative

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Gabapentin helped my nerve pain more than the opiate did. It's true that it makes you tired. The cloudy mind thing subsided after a bit.  I was hardly able to do anything anyway because the pain made thinking really hard.

PSA though--keep ahead of your bowels. The constipation caused by these (gabapentin and the opiate) can be ugly, especially when sitting hurts so much. Not to be gross, but I had to go nuclear on mine to get things moving.  Also PSA if you get nauseous they can prescribe something for that (the narcotic caused the nausea).  But, the anti nausea will likely also be constipating. 

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carriede

carriede

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Had the MRI follow up this morning. Doc says my L4/5 disc is in really bad shape. He's recommended strick bed rest, possibly with epidurals to help with pain management. I'll be starting the Gabapentin today in conjunction with the hydrocodone.

The next step is to wait and see if any improvement is made on bed rest - he made a follow up appt for 2 months out. Otherwise he recommends meeting with a spinal surgeon to explore options, either digging out/trimming the disc down, or fusion of the vertebrae as a last resort.

I guess the goal here is for me to move as little as possible to have the discs and nerves calm down. The pain management is just to allow for true rest. I understand this, but have a hard time with more pain management and not knowing if I'm further irritating my back, 'cause you know, it won't hurt to move. I guess I just have to force myself to NOT MOVE.

Any insights or recommendations?? Thank you all for your help - I'm trying hard not to get overwhelmed!! My in laws are here taking care of the kids and the house. DH has been able to take off work this whole week to help me, but thats not a long term possibility. Lots of changes ahead...

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cintinative

cintinative

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1 minute ago, carriede said:

Had the MRI follow up this morning. Doc says my L4/5 disc is in really bad shape. He's recommended strick bed rest, possibly with epidurals to help with pain management. I'll be starting the Gabapentin today in conjunction with the hydrocodone.

The next step is to wait and see if any improvement is made on bed rest - he made a follow up appt for 2 months out. Otherwise he recommends meeting with a spinal surgeon to explore options, either digging out/trimming the disc down, or fusion of the vertebrae as a last resort.

I guess the goal here is for me to move as little as possible to have the discs and nerves calm down. The pain management is just to allow for true rest. I understand this, but have a hard time with more pain management and not knowing if I'm further irritating my back, 'cause you know, it won't hurt to move. I guess I just have to force myself to NOT MOVE.

Any insights or recommendations?? Thank you all for your help - I'm trying hard not to get overwhelmed!! My in laws are here taking care of the kids and the house. DH has been able to take off work this whole week to help me, but thats not a long term possibility. Lots of changes ahead...

Wow, that's really, really hard.  I hope the gabapentin gives you some relief. 

Why do you think it won't hurt to move? Are you getting that much relief from the pain meds? 

Honestly my family couldn't survive with me on bed rest for two months. I would be looking into surgery unless there was some thought that the insurance would not pay.  I'm glad your doc is referring you. I know people who have had their spine wrecked by an orthopedic surgeon. It's good that your guy knows his limits.  And--spinal surgeons get booked up. I would make an appointment now. If you cancel it, you cancel it.  

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Terabith

Terabith

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I’ve been on gabapentin for 23 years.  It doesn’t make me feel sleepy or foggy, though I guess maybe I wouldn’t know any difference because it’s been so long.  I don’t remember it having that effect when I first started taking it either.  It has been a miracle for my anxiety and mood, though. Miraculous. 

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Soror

Soror

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I'm very sorry.

I've had pretty bad sciatica this year but not to the same level as you. (excuse the run-ons I'm having keyboard trouble) I found the most relief from- steroids, gabapentin, and ibuprofen. I did PT but it didn't help. If anything her advice not to do anything made it worse. Gentle, slow walking was very beneficial *for me.* Sitting around was out of the question but lying around wasn't much better. Too much sitting (especially driving) or lying around caused flare-ups. I figured out that if I was lying down I needed to lie on my back with a pillow under my knees. This was not natural to me but I adapted. Now, months later I added in sleeping some on my 'good' side but I still cannot sleep on my 'bad' side even for short periods. I tried that here a month or so ago and had a pretty bad flare. Even now, 11 months later, if I drive too much I will get some pain. I had constant pain for probably 7 months. That was in every position I had pain. I didn't sit on the couch for many months. I would stand, kneel, sit on a hard chair, or on a yoga black on the floor (with my knees folded under me). At the worst, I took opiates for pain. I think this was about 3 times. They were minimal help with the pain but they knocked me out so I didn't have to feel it. Gabapentin was a godsend. It helped me sleep and with the pain. Now, that I'm finally pain-free (except flares) I still take it to help with sleep. I never did get an MRI, even with the PT advocating it. I gave up trying to get one. At that point, I'd decided surgery wasn't worth it for me and I was tired of fighting (besides the $$$). My mobility is still limited some but it is so much better than the beginning. At the beginning 'bending over' I could maybe reach my knees and that was with great pain and effort.  I've done yoga for years and reaching my toes was alwaysan easy feat. My walking speed is still slower, especially going up hills. My husband was always a slower walker than me but now I set the pace or he leaves me in the dust but it has improved greatly. If I was dealing with what you were dealing with I'd certainly consider surgery. I know if it had been much worse or if I had been stuck at that worst part for very long I couldn't have made it. 

 

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Harriet Vane

Harriet Vane

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I'm so sorry for the bad news.

When my husband had a herniated disk, we got opinions from three doctors. One advocated immediate surgery. One advocated bed rest and possibly surgery down the road. One advocated PT and promised he could avoid surgery. In my dh's case, he was able to do PT and avoided surgery and is doing really well now. 

His problem is different than your problem, so I would not presume to know the best course of action for you.

BUT--

Please consider getting another opinion. Stopping movement is a really extreme course and has its own set of risks--at the very least talk to someone else about the pros and cons of PT versus bed rest. 

I hope you feel better soon.

 

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carriede

carriede

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Small update:

I've mostly been marking time these past two weeks. New appointments are just scheduled so far out... Finally got into see the referring doctor for the epidural yesterday at the pain management center, and the procedure is scheduled for next Wednesday!

The Gabapentin hasn't been helping, so the doc upped the dosage and the frequency. 😳 But I am off the hydrocodone, except I take it if I'm leaving the house and have to move a lot - which is just to doc appointments. I'm currently managing the pain with a Tylenol/Advil cycle, heating pad, and just staying in the two mildly pain-free positions I've found. Hopefully the Gabapentin will kick in and I can reduce all that too. Or the epidural will just be amazing and fix everything. 🤞

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Jann in TX

Jann in TX

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On 11/30/2023 at 10:49 AM, carriede said:

Had the MRI follow up this morning. Doc says my L4/5 disc is in really bad shape. He's recommended strick bed rest, possibly with epidurals to help with pain management. I'll be starting the Gabapentin today in conjunction with the hydrocodone.

The next step is to wait and see if any improvement is made on bed rest - he made a follow up appt for 2 months out. Otherwise he recommends meeting with a spinal surgeon to explore options, either digging out/trimming the disc down, or fusion of the vertebrae as a last resort.

I guess the goal here is for me to move as little as possible to have the discs and nerves calm down. The pain management is just to allow for true rest. I understand this, but have a hard time with more pain management and not knowing if I'm further irritating my back, 'cause you know, it won't hurt to move. I guess I just have to force myself to NOT MOVE.

Any insights or recommendations?? Thank you all for your help - I'm trying hard not to get overwhelmed!! My in laws are here taking care of the kids and the house. DH has been able to take off work this whole week to help me, but thats not a long term possibility. Lots of changes ahead...

I went through a VERY similar ordeal that ended up being my L4/L5. In my case I bent over wrong picking up a baby blanket!   I waited it out for a few years but ended up getting a spinal fusion (going in through front not back) after trying steroids and tons of PT. 

I IMMEDIATELY felt relief as soon as I woke up in the recovery room!  I wish I would have done the surgery YEARS EARLIER!

Due to insurance rules- the Dr's cant really tell you your best option-- they can give you ALL of the options and it is up to you to decide the one to take.   Once I made up my mind to go for the fusion my Dr said he was relieved as that is what he wanted to do YEARS before but was not allowed by regulations to steer me in that direction.

Once disks start to deteriorate they DO NOT REGENERATE/HEAL.   Disks do not settle down-- inflammation (if that is part of issue) may calm down and you can get used to the pain (so it may seem less but you are just stronger mentally to push through it).

My spine Dr also had me interview 2 other spine Drs so I could compare their treatment options and surgical styles.  Trimming/digging has a much higher rate of additional surgeries so I chose fusion.  My Dr's rate of additional surgeries was very very low so I stayed with him.

Healing was much like a hysterectomy or a C-section.  Once my tummy healed I was good to go.  I did have bending and lifting restrictions for a few months.  It has been 14 years and still no back related sciatica pain! 

 

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carriede

carriede

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7 hours ago, Jann in TX said:

 

Due to insurance rules- the Dr's cant really tell you your best option-- they can give you ALL of the options and it is up to you to decide the one to take.   Once I made up my mind to go for the fusion my Dr said he was relieved as that is what he wanted to do YEARS before but was not allowed by regulations to steer me in that direction.

You know, I wonder if this is happening with me. Every nurse and doctor I've met, in a world where they see tons of different cases, seems a touch alarmed and very earnest after talking with me and reviewing my files. But the "let's try this and see" is the mantra. I'm so lucky to have my in laws come and help with the kids, but this can't go on for months.

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carriede

carriede

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On 12/15/2023 at 10:47 AM, Jann in TX said:

Healing was much like a hysterectomy or a C-section.  Once my tummy healed I was good to go.  I did have bending and lifting restrictions for a few months.  It has been 14 years and still no back related sciatica pain! 

I'm so glad you've had such success! Which vertebrae did you have fused? Do you feel like it affects your ability to move or bend or whatever? My doc said fusion was a last resort and "LIFE CHANGING", and it kinda scared me.

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Jann in TX

Jann in TX

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Fusion was LIFE ENABLING!  Sure-- I have a little trouble  bending over to tie my shoes-- but I can do it if I prop my foot up.  That is really the only limitation-- my fusion was L4-L5

Fusion gave me my life back.

One word of caution about waiting too long like I did.  I was having horrible pain AND headaches the months before my surgery.  Even though recent MRI scans did not show anything other than the degenerated disks, I had a BONE SPUR that was actually poking into my spinal cord-- I was leaking spinal fluid.  Dr said if I had waited much longer I would have been permanently paralyzed! 

I did do my research on HOW the surgery would be performed-- some Drs enter through the back-- this type permanently weakens back muscles.  I chose through the abdomen-- a GS came in and did the initial incision (Like hysterectomy) and moved the organs to the side, exposing the spine.  Another option would be to go in through left or right side and do similar.  It took 3-4 weeks to recover from the incision/organ moving-- but after that I was good to go.  I only had hard pain drugs the first three days and regular ibuprofen after that. My core was weak before surgery (because I could not move!) so my total recovery was 6 months in a soft brace then 6 months of PT-- but the PAIN WAS GONE!

 

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