I,m not really a newbie, but I rarely post on here. Just read. I,m a seventy year old female. I,ve had a bad back for years. I was a nurse for thirty years. The normal back pain was tolerable with otc meds, but the past four or five months I have had severe back, leg and knee pain. It gets so bad at times I will cry like a baby. I,ve had an MRI and have been told I have bulging disks, stenosis and arthritis of the spine. I,ve been to my regular doctor and he gave me Cortisone shots, which only worked for about three weeks, then the pain came roaring back. I,ve taken every OTC and prescription med out there. Most of it doesn,t even touch the pain. Lortab seems to be the only thing that even slightly takes the edge off. My doc told me I,ve come to the end where he can do much more to help me. He wants me to go to a pain management clinic. Problem is, they want to schedule for two months away. I cannot wait that long. The pain is life changing and so severe I can,t even function most of the time. My doctor gave a an injection of Toradol and prescribed Neurontin yesterday. The injection did nothing. I,m at the end of my rope. Can anyone give me some advice? Oh! The doctor told me the pain was caused by a pinched sciatic nerve.
Last edited by joykay13; 03-31-2012 at 11:11 AM.
The Following User Says Thank You to joykay13 For This Useful Post: cavalery (04-28-2012)
I would suggest you make an appointment with a spine specialist rather than dealing with this through your regular doctor. Their knowledge is somewhat limited, and you may have more wrong than what he has diagnosed. This would be either a fellowship-trained orthopedic spine surgeon or a neurosurgeon who limit their practice to the neck and back.
Were your injections done under fluoroscopy? If not, you have no assurance that the needle was placed in a location that might actually help your problem.
The pain management clinic may be appropriate down the road, but until you have an accurate diagnosis and plan of treatment, it is in some ways "putting the cart before the horse." Most pain management physicians come from a background in anesthesia. Some know more about spine issues than others, but the knowledge is all based on how to relieve your pain rather than trying to figure out the best method to resolve the problems that are the pain generator.
Have you had a flexion/extension x-ray to check for spondylolisthesis? Many times it is picked up on MRI, but, not always. This slippage can be a condition that results in sciatic pain. If your pain is mostly coming from stenosis, a decompression of the nerve may be the best way to resolve your pain.
Sometimes people have good luck using a method of treatment developed by Robin McKenzie. When the exercises are performed faithfully multiple times per day, some people are able to get the pain to move up from the leg and into the lower back. He has published a number of books and his methodology is used by many PTs around the world.
Usually the first thing a spine surgeon will do is prescribe an epidural steroid injection and send the individual for a course of physical therapy. If you should develop bladder or bowel issues such as incontinence, you should consider it a medical emergency and either call your doctor ASAP or go to the emergency room for treatment. This is an indication of the development of cauda equina syndrome and you would need immediate attention to avoid having it result in permanent nerve damage. This is something anyone with lumbar disc issues needs to be aware of --know the symptoms of CES so you can act promptly if one should develop.
You can use ice or a cold gel pack for the pain... 15-20 minutes on your lower lumbar area per hour, being careful to protect the skin. Some people find the use of heat rather than cold comforting. I bought an infra-red heat pad and used it a lot before I had surgery, preferring it to ice.
Try to keep walking for exercise. It is important to maintain some sort of muscle tone and conditioning.
It probably won't help to know this, but many people are affected by sciatic pain. You just have to find ways to cope until you can get some effective plan of treatment. I was just remembering today how I couldn't stand long enough to shower. It's a bit like childbirth. Once the pain is resolved, one tends to forget about it fairly quickly.
I have been in the same situation for 20 + yrs now. Had spinal fusion due to pinched nerve/herniated disk 2 yrs ago and I am still in pain and can’t sleep anymore. I have numbness, pain and a prickly burning sensation in my legs no matter what position I sleep in. I also itch due to it cutting off my circulation. Drives me crazy. Going for my 4th opinion but doubt I will get anyone to help. Surgery was my last resort.
I currently have a major herniation at L3-4, which is directly above my 2-level fusion that was performed 9 years ago. I won't get into all the treatments and things that I've already had, but I will tell you that my Dr. has started me on a newer pain pill called "Nucynta". I had never heard of it before, but for me it has worked really well. My body chemistry is such that nothing they gave me in the last 15+ years (Percocet, Lortab, oxycontin, you-name-it) would even touch the pain once, much less on-going. Well, Lortab worked for one day, but I built up an immunity to it almost immediately. Nucynta combined with Flexeril has worked wonders on me. Now, I'm not sure what will happen when I stop taking it, but I've still got a few weeks left before I have to find that out
Just something you might look into. Hope you find relief soon.
I have had nerve blocks done on my facet joints, but they were done with just lidocaine, which is a numbing agent. I had one other nerve block done, but it didn't do much for me. It wasn't done at the source of the problems though, which is why it didn't do anything. I have also had injections done on my right SI joint. They aren't really anything to worry to much about, as long as your doc knows what he is doing. They use x-ray guidance to make sure they are hitting the right area.
You may have a bit of discomfort for the first couple of days from the injection. Ice will help some with that. Each person reacts differently. Some have relief immediately and with other people, it takes a few days for the injections to start working, especially the steroid aspect of them. You shouldn't really feel much for the first few hours because of the numbing medication they inject as well.
I have always done things like that under sedation. It keeps the freak out factor non-existent!
I was having major pain up to 4 days ago .It is much better now.I would have to say the 12.5 lbs I lost in the last month was the answer.My dr told me that the extra weight im carrying and the pot belly really puts large strain on the lower back/sciatic.I also stick with the diet, stretching and pool.I got all the stretches off this site and I did like Robin Mckenzies book "treat your own back".The worry and stress that comes with a bad back is scary.I was hurting for 8 months till I lost and will continue to lose the extra pounds.hope all the best for you.Take care.
[QUOTE=teteri66;4956821]Is this being done for diagnostic purposes? May 23 seems like a long time to have to wait.
Are you under the care of a spine specialist? I learned the hard way one can waste a lot of time in pain going to a well-meaning internist or PCP.[/QUOTE]
No, its being done for pain relief. I,ve had the MRI,s done already. The nerve block will be done under florscopy so they know exactly where to put it. I,ve been in alot of pain today. It seems to come and go in intensity. Did any of you experience pain in your groin or knee? That seems to be where most of my really intense pain is. So much so, I can barely bear weight on my foot or leg most of the time. The hip and groin is excruciating.
[QUOTE=joykay13;4957154]No, its being done for pain relief. I,ve had the MRI,s done already. The nerve block will be done under florscopy so they know exactly where to put it. I,ve been in alot of pain today. It seems to come and go in intensity. Did any of you experience pain in your groin or knee? That seems to be where most of my really intense pain is. So much so, I can barely bear weight on my foot or leg most of the time. The hip and groin is excruciating.[/QUOTE]
Groin pain and hip pain are two of the things I experience with my SI joint issue. The hip pain more than the groin pain. I also get some in the knee, but that's not often either, unless I am really flared up.
The pain has been more then intense for over a week. I,ve been to my GP twice and the ER once. No one seems to realize how bad the pain really is. A shot of Toradol? Come on! Thats like getting an injection of Advil! The doctors act scared to give you anything anymore. I am not a drug seeker for Christ,s sake! Thats why the appt. with the pain management clinic and I,m not sure how much it will help or how long it lasts.