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Old 09-07-2012, 01:59 PM   #1
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Sciatic type pain - no back pain?

Hello, this is my first post. You need to know my 'back-story' (pun intended). I'm currently experiencing severe pain in my left-thigh (only). No back pain, no lower leg pain. I'm told [I]most[/I] sciatic pain originates in the lower back. So, I'm wondering if [I]this[/I] episode of sciatic type leg pain is [U]other[/U] than back-induced.

Six years ago, I encountered similar thigh pain - but was accompanied with lower back pain. At that time, I visited an orthopedic doctor and had an MRI. The MRI revealed moderate stenosis in L4-5; multi-level degenerative change of the lumbar spine; and disc desiccation from T12 to S1.

In short, the doc informed me he didn't do spinal column replacements - and I should seek 'pain management.' Not liking that recommendation, after trying chiropractic, bought a Teeter Inversion Board. That appeared to work! At least, the pains went into remission - for six years.

Now: the inversion therapy isn't working magic. And, for the first time ever, I have resorted to Ibuprofen - 1600mgs per day. I wake up in the morning to severe leg pain. I take 800mg Ibuprofen, and wait - for minimal pain relief. 800mgs more by noon. Pain is at its lowest by late afternoon. I haven't exceeded 1600mgs - yet. I do not relish ingesting pain pills - but, desperation prevails.

So, folks, I'm actively seeking the collective wisdom of this Back Problems Message Board.

Thanks ~ james (Oh! I'm 75-years old)

 
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Old 09-08-2012, 01:52 AM   #2
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Re: Sciatic type pain - no back pain?

Hi James -- welcome! Some folks swear by inversion boards; others think they carry too many risks. Be careful with too much NSAIDs; they can wreck your stomach, even at the recommended dosage if taken for a long time.

The sciatic-type pain may well originate in your back, but could also be caused by something other than a back problem: hip or knee problem, for example. If your pain has persisted for more than two weeks, I would make an appointment with the doctor. If your pain does come for your spine issues, there are many measures that can be taken short of major spine surgery.

 
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Old 09-08-2012, 06:59 AM   #3
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Re: Sciatic type pain - no back pain?

Hi SweetPeainSF, I totally agree with your reply. Currently taking 2400mgs Ibuprofen to cope with the pain - and 2400 isn't working all that well. I figure, come Monday, if pain level hasn't abated, I'll make an appointment with Sansum Clinic in Santa Barbara. I'm thinking the first order of the day will be an attempt to determine what's triggering the sciatic nerve pain - and go from there. Boy! sciatic pain can really capture all one's attention.

Thanks ~ james

 
Old 09-08-2012, 10:22 AM   #4
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Re: Sciatic type pain - no back pain?

Welcome to the board. I am assuming your pain is in the back of your thigh, since most people think of a pain that runs down the back of the leg a sciatic-type pain. Would that be what you are experiencing?

Sciatic pain usually originates in the lumbar spine when some issue is compressing a lower lumbar nerve that feeds into the sciatic nerve. This "issue" may or may not cause symptoms in the back as well.

Another option () is when the actual sciatic nerve becomes inflamed, irritated or scarred. The pain can feel just about the same. Given what the original MRI revealed years ago, it would be amazing if this new pain is not caused by some problem in your lumbar spine. Disc dessication and stenosis are both degenerative processes, and I've never heard of a case that got better with time.

Inversion boards can be useful for some early spine problems. The danger is if there is a bit of instability in the spine (such as could occur with degenerating facet joints and spondylolisthesis, for example). You could end up in more pain if you happened to have some stability (which you might not know about). So for these reasons, many doctors, PTs, etc. are not too enthused about back patients using inversion boards.

It might be time to go to a new spine specialist, have a new MRI and see if you have any new problems that are now making the sciatic pain worse. In the meantime you can ice your lower lumbar back frequently to begin with. It is safe to "ice" 15-20 minutes at a time every hour, almost around the clock, as needed. Sometimes people respond to a combination of ice and heat.

One thing that kept me going when I was dealing with debilitating sciatic pain for about five years was the following: lie flat on the floor in a straight line, knees bent, feet flat on the floor, pelvis in a neutral position. Arms should be as close to the sides as possible, palms facing up toward the ceiling. Head should be positioned so the chin is just very slightly tucked toward chest. (The idea is to have as much of the spine in contact with the floor as possible.) Now, relax and breathe deeply from the belly. You can stay in this position for five minutes or as long as is comfortable.

I do this the proper way for the first minutes, and then I sometimes use my arms to hold a book and stay this way as long as is comfortable. This is a natural form of traction and it allows the discs to unload. I found that when I just couldn't stand the pain a moment longer, if I could lie down even for a couple minutes, it would allow me to go a little longer. I have been known to find a slightly out-of-the-way piece of floor in an airport and lie like this while waiting for my flight, etc...a bit strange, but it allowed me to get where I needed to go!

Do you have any arthritic pain in any other joints? I have found a Schiff product called Move-On Ultra to help ease my joint pain.

Hope you get over this bout of sciatica soon, but if not, please have a consultation with a different spine specialist (either orthopedic spine surgeon or neurosurgeon who limit their practice to neck and back issues).

 
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Old 09-08-2012, 11:51 AM   #5
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Re: Sciatic type pain - no back pain?

Hi teteri66, I welcomed your detailed response. It's weird - that's what worries me. The pain appears to be centralized on the outer left side of my left.thigh - only there, but really there! No pain below knee. No pain above thigh. [looking down at my leg, I'd say pain central was at 9:00 o'clock] My original/only sciatic bout of six years ago was considerably different. I had lower back pain + thigh pain. And, every home remedy appeared to help: inversion board, various stretching exercises and ice. Didn't employ any Ibuprofen.

This time: nothing appears to work. 2400mg Ibuprofen helps - only to a point. Ice hurts. The old stretching maneuvers hurt (on hold till the pain subsides?). Inversion therapy - questionable. Heat appears to help. This time, the sciatic pain doesn't respond. The pain hangs in there 24/7.

I agree, given the deterioration visible on the old MRI, one would logically bet the lower back/spine is implicated. But . . . ?

You stated:[COLOR="Blue"] "It might be time to go to a new spine specialist, have a new MRI and see if you have any new problems that are now making the sciatic pain worse." [/COLOR] That was a timely and appreciated suggestion. A few minutes before reading your reply, I was entertaining the thought to launch a new 'square one' - new spine specialist and new MRI. Maybe, something additional has been added to the mix in the past six years.

You also mentioned [COLOR="Blue"]"arthritic pain."[/COLOR] I'm not aware of any arthritic pain - anywhere. Tween now and Monday, I plan to spend time researching a new orthopedic facility {also closer home} and new doctor. These items I will definitely pray about. I'm discovering how consistent pain stimulates/increases one's prayer life.

Thank you teteri66 ~ james

 
Old 09-08-2012, 08:48 PM   #6
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Re: Sciatic type pain - no back pain?

Do you mean the pain is on the outer side of the thigh?

 
Old 09-09-2012, 07:07 AM   #7
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Re: Sciatic type pain - no back pain?

[QUOTE=teteri66;5052596]Do you mean the pain is on the outer side of the thigh?[/QUOTE]

[U]Yes![/U] It that suggestive of something? ~ james

 
Old 09-09-2012, 10:08 PM   #8
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Re: Sciatic type pain - no back pain?

Are you familiar with a "dermatome map?" You can find them online. It is like a roadmap to the spinal nerves, showing which spinal nerve innervates which particular area of the body. It helps a doctor to know where to begin looking for a problem...like if you tell the doctor your big toe is numb, he/she will immediately suspect a compression or irritation of the L4 nerve root.

The IT band also runs along in outer thigh, is a large muscle and attaches at the hip close to where the piriformis attaches. Sometimes when the piriformis is inflamed or irritated and taut, it can have an effect on the IT band. I'm sorry but at the moment I am not remembering your specific symptoms and am too tired to go back and look right now!!

 
Old 09-10-2012, 12:44 PM   #9
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Re: Sciatic type pain - no back pain?

Hi teteri66, No, I'd never heard of a "dermatome map." I spent a few minutes Googling. Honestly, I was unable to make much usable sense of it. {I'm not the sharpest tool in the shed}. Your mention of iliotibial band syndrome {tight IT band} did strike a chord. Years ago, when an avid runner, I '[I]discovered[/I]' the tight IT band syndrome. It caused a painful left knee. Sport's doc determined a slightly shorter right leg may have triggered the problem. I religiously performed IT stretching exercises - and employed a 9mm heel left in right shoe. It certainly helped. Course, the tight IT band caused soreness in the knee area, even slightly above knee. [U]But not in upper thigh[/U]. This morning, I tried doing a few standing IT exercises. It didn't hurt leg. Maybe it even felt momentarily better. Certainly something to consider. Ah yes, the "piriformis." Don't know if he should be suspect or not.

[B]However[/B], Yesterday I experienced a "eureka moment." It's probably key here. I reviewed my Lotus Organizer notes. [B]Bam![/B] Why hadn't I made the connection. Maybe, cause no discomfort presented. On 8/27/12, a 5-cu ft chest type freezer was delivered to my house. I'd cut out a plastic pad for the 22X28" 70-lb chest to sit on. So, I attempted to wrestle/manhandle the freezer into position atop the plastic pad. The pad wanted to scoot with the freezer. I ended up actually lifting the bulky 70-lb freezer squarely onto pad. Having dealt with 'lower back issues' for nearly 50-years, I consciously knew my back was vulnerable. I did try to be careful. I didn't feel or sense I'd crossed the line of impropriety on 'safe lifting.' Course, I knew that really wasn't possible. Mission was accomplished with zero back discomfort - or so I thought.

On 8/28/12, the following morning, my first Organizer entry read: [COLOR="Blue"]"Today . . . woke up with MUCH upper leg pain. First notation of sciatic pain - consider inversion board."[/COLOR] The awareness of leg pain was evident - but didn't impair mobility. I did purchase Ibuprofen just to have on hand. Still, the 'light' hadn't dawned: you induced the sciatic pain from improper lifting. I guess a total lack of any lower back pain had blinded me to the reality of cause-and-effect.

On 9/3/12 (Monday), the pain had increased sufficiently to warrant 'experimenting' with Ibuprofen. And, I've been using Ibuprofen daily since. 2400mgs per day {my set max} only works to the point of being able to function - still hurts. During the night, the Ibuprofen wears off and I wake up with severe pain in my outer left thigh - no pain anywhere else.

teteri66, and readers, I welcome your comments and recommendations. My current thinking: 1) now that I connected the dots between lifting episode and leg pain, it appears only logical to attribute the sciatic type pain as linked to my aged and defective lower back; 2) On the hope that 'time' may work to put leg pain into remission, I'm thinking maybe the best plan is to keep taking up to 2400mg Ibuprofen and practice 'watchful waiting' for another week - or two; 3) start a new square-one. Make an appointment with a new back specialist at an orthopedic facility and start from scratch - new MRI. I think making an attempt to look for new/additional causes might be in order. Not knowing what's causing the outer thigh pain isn't good; 4) the weird part: only pain {but lots of it} is in the outer left thigh. No where else . . .

james

 
Old 09-10-2012, 11:47 PM   #10
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Re: Sciatic type pain - no back pain?

Oh, the incredible value of keeping a journal! The pain may be a flare of the IT band. Or, your inadvisable lifting may have caused some damage to the disc or some inflammation, either of which could be pressing on the nerve bundle responsible for ennervating the outer thigh. The compression of the nerve could be in the central canal or in one of the foramen (where the nerves exit the spine) or even away from the spine. It could simply be a strained muscle.

I think it's time for a new assessment. Given that the cause of your pain might be coming from a myriad of sources, you might want to see a family doctor or a sports medicine doctor first, as he/she may be able to rule out possible sources. (Many of the more in-demand spine surgeons won't make appointments without a referral from another doctor, to ensure that their time is spent on patients who have received a full work-up and tried conservative measures.) You might also want to ice the lower back/buttock area OR the outer thigh itself. As you seem to be an impeccable chronicler, your notes should help the doctors.

 
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