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Old 03-03-2012, 11:55 PM   #1
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Unhappy Sciatica pain that is agonising.

I am a seventy year old female and relatively new here. I have yet to post. Just mainly reading others posts trying to get some info that might help. I have had back pain on and off for years, as I worked as a nurse for over thirty years. Only in the past year has it become unbearable. My doctor ordered an MRI and it showed multiple bulgings, a slipped disc and stenosis. I was given a cortisone injection which did very little. He put me on Voltaren and Lortab, which tends to make me sick at my stomach if I take the full dose. I waited two months while in extreme pain to see a pain management doctor. By the time I got into see him, my pain had subsided. He wanted to give me a nerve block. As my pain was greatly reduced, I refused. Now, two months later my sciatica is back and worse then ever. I have tried every rx and over the counter med. you can name. Nothing helps. The small amount of relief I do get is from sitting on a heating pad. I refuse to have surgery, as my lungs are compromised and I,m leery of the anesthetic. Also, my age is a consideration. I,m hoping someone can give me some new advice. Thank you in advance.

 
Old 03-04-2012, 06:38 PM   #2
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Re: Sciatica pain that is agonising.

I wonder if you can think of anything that caused the pain to dissipate or to return. How long after the injection did your pain subside? Sometimes the injections can take some time to take effect, and this may explain the two-months' worth of relief you had.

You mentioned that you are currently taken Voltaren and Lortab, one or both of which make you sick. Is that the Lortab? And is it the oral Voltaren or the gel? If your most troublesome pain is the sciatica, have you tried any nerve medications? (Neurontin is a popular one.) You also might consider using Lidocaine patches, which are a great topical treatment, or accupuncture.

Do you know what is causing the stenosis? If it is caused or contributed to by facet hypertrophy, you might want to consider taking an anti-inflammatory (either NSAID or steroid).

Have you tried physical therapy or do you practice any regular core strengthening? Having a good, solid core is often the best way to prevent the damage from worsening or to assist the back in healing itself. There is some possibility that the discs can heal themselves, particularly as you seem adamant not to have surgery.

Finally, and I know a lot of posters are anti-chiropractor, but you may want to ask your doctor if chiropractic care is appropriate for your situation. I went to one chiropractor who did no manipulations, only percussive treatment to activate the nerves. I don't know whether it actually did anything, but I felt really good afterward. And this type of treatment does not pose the same type of risk of worsening your condition that spinal manipulations would.

 
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Old 03-04-2012, 09:06 PM   #3
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Re: Sciatica pain that is agonising.

Unfortunately depending on the extent of your stenosis, it can be one of those ailments for which there is little effective treatment other than surgery.

I know in my case there was just a tiny pin ***** of space showing on the MRI, leaving almost no room for the nerves. I could get some relief from sitting, but other than that, there was little I could do to or the various specialists could do to effect the stenosis.

Have you tried using ice or a cold gel pack when you are in lots of pain? Sometimes that is just as effective as pain medications. Because of the nature of stenosis, pain meds have little effect. Some people get some relief from the type of drugs given for nerve pain like gabapentin or Lyrica, etc.

A course of physical therapy can give you a series of exercises that you can do to build up strength in the core and back muscles.

These conservative measures may provide some relief, but without surgery, I'm afraid you will need to look to pain management to make the situation tolerable. Generally, as we age, stenosis continues to grow worse.

 
Old 03-04-2012, 09:40 PM   #4
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Re: Sciatica pain that is agonising.

Tetonteri's comment re: sitting down made me think of a couple of pain relief techniques that were helpful for me pre-surgery. During PT, the therapist would use distraction on my lower back and showed me how to do that on my own, at home. I also found some help when sitting in an office chair and using my arms to push up and get some lifting/distraction that way. Sort of like leaning on a shopping cart, which is one of the common indicators of stenosis. None of this provided permanent relief, but may provide temporary relief or give you a cumulative effect.

 
Old 03-05-2012, 05:27 AM   #5
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Re: Sciatica pain that is agonising.

Please explain what you mean by "distraction." This tip could be helpful to many!

 
Old 03-05-2012, 06:31 AM   #6
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Re: Sciatica pain that is agonising.

No, I haven,t tried PT or Chiro, but would as a last result. I took Neurontin years ago and got some relief, but the pain wasn,t as bad at that time. I may talk to my doctor about giving it to me again. It,s the Lortab that will make me sick if I take a full dose. As far as when the cortisone kicked in, it took about a week to ten days and yes, I do believe it was the shot coupled with the Voltaren tablet 100 mg a day that helped with the inflammation and lowered my pain. It is better today, but that seems to ebb and flow. I can get up in less pain and just as soon as I,m on my feet awhile or do much of anything, it comes back in full force. It appears as if I have to get the inflammation down to get the pain to subside. Thanks for all your comments.

 
Old 03-05-2012, 07:58 PM   #7
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Re: Sciatica pain that is agonising.

I hope that decreasing the inflammation provides relief for you. If you have inflammation, you might want to consider using ice or alternating ice with the heat you indicated you have been using.

As to my earlier post -- I meant TRACTION. Sorry. I guess that the pain meds were typing for me.

At the physical therapist, traction can be done either with a traction machine, or the PT can use a strap across your hip pointers and pulls mechanically on your hips to try to increase the space where your discs should be. This method works well for temporary relief from stenosis due to disc bulging/protruding/extruding discs. I have a cervical machine for home use, not sure if there are lumbar machines for home use.

At home, you can lie on a sturdy table with your legs hanging over the edge. Make sure that your upper body is on the table face down, with your hip pointers at the very edge and allow your legs to hang over toward the ground. If your table is not high enough for your legs to hang freely, bend the knees while keeping your feet on the ground. The force of gravity will lengthen your lower back and may provide some relief. If you don't understand my instructions, ask for training from a PT. As with anything, if you experience increased pain, then discontinue.

 
Old 03-05-2012, 09:21 PM   #8
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Re: Sciatica pain that is agonising.

There is a newer drug, similar to Neurontin, but with fewer side effects for most people, Lyrica. You might try that to see if it will help. Personally, with my sciatic, I got no relief from any drug...the nerves were just too squished for anything to make a difference. The only thing that saved me was that when I sat down, most times the pain would go away. But, eventually (like several years later) I had to choose between almost being a hermit or taking a risk on surgery.

 
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