Sciatica, course of action?

02-20-2021, 07:58 AM

Male, early 70's, fairly fit, distance walker/hiker for years. Over the last couple of months experiencing fairly painful left leg discomfort extending down below knee above calf when walking. Some discomfort in right leg, but mostly transient. There is no back pain. Have had to stop distance walking all together as walking is quite painful. Sitting, reclining, sleeping are not painful, but standing up and walking any distance is, although somewhat relieved by bending forward. Had this about 3 years ago after a minor injury but it went away in a couple of months. This time it seems worse, but I could be wrong. Consulted Ortho doc who took x-rays and did examination, really found nothing all that abnormal for my age. Suggested a lower disc may be pressing on the sciatic nerve and as I bend over the pressure is relieved. Prescribed Gabapentin for pain and wanted me to start prednisone after I get my last covid vaccination. Suggested a steroid injection if needed down the road. Signed up for some PT to see if it might help relax or reposition the disc. I assume this is a reasonable course of action, should I feel reassured that this will clear up eventually as it did previously?

02-21-2021, 06:05 AM

That's a very aggressive treatment plan. And it does sound like a disc issue. I'm going thru that as well though I have multiple disc issues along with scoliosis and some stenosis. I think you'll find PT very helpful. be sure to continue doing the exercises they give you at home!

02-21-2021, 01:57 PM

I've had the shots in my back twice, they worked but the didn't last. I have trouble sleeping as I have to get twisted in the right manor to be pain free. The best thing I have tried successfully was a tens unit. I tried gabapenten, but it did nothing for my pain even when coupled with tramadol. It would give me brain fog, so I quickly stopped taking them.

02-21-2021, 03:15 PM

The Gabapentin is doing nothing other than making me sleepy and I am going to quit taking it after a couple of days. My neighbor is a good friend and my primary doc. and has prescribed prednisone with a tapering dose which was helpful last time I had this for awhile but ultimately stopped working when I finished taking it. However this thing eventually did go away for several years. I have a second covid vaccination coming up so I will start taking it a couple of weeks after that to see if it might be helpful for a bit. I simply would like to be able to walk again without pain for awhile. I am lucky as I can sit or lie down or sleep without pain, it could be worse.
Thank you for your comments.

02-22-2021, 05:26 AM

Take the gabapentin at bedtime. My doc put that on the prescription. I must admit that I sleep better than I have in YEARS! Rarely wake up in the middle of the night to go to the bathroom. Hate that I'm not going to be on it permanently! I'm on 300 mg at this point.

02-22-2021, 06:56 AM

I take 300mg. twice a day and can adjust the timing a bit to get closer to bed time. I don't think it has done much for my sciatica, but you are correct it is a good sleeping aid.

02-22-2021, 08:26 AM

You could try celebrex plus Robaxacet...

If nothing serious, maybe chiropractic and physio?

q

03-11-2021, 07:28 AM

After a couple of weeks of PT stretching exercises and gabapentin and no improvement, I had a second appt. with the Ortho doc who I originally consulted with. After some additional examination and discussion the decision was made to schedule an MRI for a more detailed look at what might be going on, feelings that some stenosis could be a concern rather than a disc . Also will begin a course of oral steroids next week after getting past two weeks of the second covid vaccine.

03-11-2021, 11:58 AM

Good you're having further testing. Let us know the outcome.

Why steroids?

q

03-11-2021, 12:09 PM

Steroid injections seem to be an often prescribed course of action for back pain, calm irritated nerves etc. However usually temporary at best, this from friends with long term back issues. My internist prescribed oral steroids for this same malady about three years ago which provided temporary relief, with the hope that they might do more. Ultimately it did go away, from the medication kick starting the healing process? I rather doubt it but will give them a try anyway as NSAID's seem to do little and I have stomach issues that I don't wish to irritate along with the rest of this.
Thank you.

03-12-2021, 12:10 AM

Hope it gives you longer time reprieve.
How long is the course of steroid?

q

03-12-2021, 05:02 AM

The steroid course is a ten day tapering dose from start to finish.
The leg pain is always there when walking, tolerable in the morning becomes less so as day goes on, walking to the mail box is a chore. My wife fractured her hip several months ago, it was repaired surgically with a rod in the femur and screws, she is doing much better than I am.

03-12-2021, 12:09 PM

Have you been checked for bursitis?

q

03-12-2021, 12:49 PM

[QUOTE=quincy;5509406]Have you been checked for bursitis?

q[/QUOTE]

A reasonable suggestion that perhaps bares investigating although it was not mentioned in the examinations that I have had from the ortho docs. This does not seem to be joint related, the most intense pain upon walking or standing seems to be below the knee above the ankle, the side of the tibia, as I visualize it not sore to touch or swollen, although I know that pain often is referred. There can be pain across the glutes and when moved in a certain fashion one can what seems like fee nerve discomfort going down the leg. The pain can dissipate when bending at the waste which from what I have read is not unusual with certain types of spinal stenosis. There is a bit of minor numbness and pins and needles on occasion that may indicate a more nerve related malady? Thank you for that suggestion and it certainly is worth investigation.

03-12-2021, 10:47 PM

Hard to say what exactly is going on, but it could also be a combination. Does sound like nerve impingement...could be from inflammation of a muscle pressing on a nerve or from the back.
I must say that sitting in certain positions can make my my hip and leg pain and numbness worse...depending on the day.

I hope you find the answers. I would push for further testing tho.

q

Sciatica, course of action?

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