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Suspected Sciatica

As a bit of background I have had horrible time with Patella femoral pain (PFPS) over the past 5 months after being very active with skiing/weightlifting. This has included some neropathic pain at the kneecap (friction sensitivity, temperature dysfunction).

I have been doing Hip exercises and ITB stretches as prescribed by physio. 3 weeks ago I felt pain in my LEFT glute which I assumed was due to a strained TFL as a result of the stretches. This persisted for about a week and a bit and went away.

last week I felt the same thing happen in my RIGHT glute, this has progressed this week into slight pain down the side of the leg. overall the pain is very mild, just a slight burning sensation in the glute. What is a major worry for me is that my RIGHT foot has started to feel slightly numb (especially sitting) as well as occasionally the whole leg. I have not lost any sensation, it just feels "off".

The knee expert is slightly concerned that I may have some lumbar damage which has contributed to the neuropathic pain in the knee caps persisting and is recommended getting an MRI. I am seeing my GP on Friday.

I am feeling extremely low partly as a result of the long road of my knee issues.

So I was wondering if people could help me with a few points:

1. Most sources seem to be extremely positive about the prognosis of Siatica for most people (80-90% full recovery with a month or two). Obviously a forum for persistent spine problems is going to a bit biased towards chronic outcomes but how reassured can i be by this figure?

2. As to the cause of the sciatica, I am suspecting some sort of issue with piriformis as i have been trying to affect some sort of change in Hip mechanics for my knee any experiences? I am not sure if the bilateral presentation is important?

3. If i do decide to get an MRI can an expert tell the difference between an asymptomatic herniated disk and one that is pressing on a nerve?

Thanks for your help



  • LizLiz Posts: 7,832
    edited 09/18/2014 - 3:46 AM

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • I have sciatica in my left leg, in my butt, thigh and foot. I also have some numbness. I have spoken to many doctors who said that most sciatica caused by a disc buldge / herniated will heal itself in 85% of the time. That is great! The nerves take quite a bit of time to heal so that is why the effects can last even longer than that. I would recommend the MRI, only because for me personally, it allowed my doctor to see the exact cause and the physical therapy to be aimed at fixing it, not just guessing.

    Surgery is not common place and I think there are many success stories of people who healed completely but they are out living life and no longer surfing forms on such issues as they no longer have them.

    I had severed sciatic 8 years ago and refused surgery, it healed but it took about 6 months. I didn't have a problem since 3 weeks ago when I injured myself weight lifting.

    Absolutely is possible! :)
    Dani Rae
  • Most cases of sciatica will resolve on their own. It is the most common form of low back pain flare ups. Almost all of us will have some form of lower back pain in our lifetimes at least once.
    Surgery for sciatica is not always or even often recommended. A surgeon can tell if a disc herniation is compressing a nerve or not by the imaging studies done , your symptoms and his exam.

  • handyman24602hhandyman24602 Posts: 13
    edited 09/18/2014 - 9:26 AM
    Sorry to hear you have injured yourself again. I'm hearing from a few people at work/socially that they have recovered from it so it gives me hope, its still very early days.

    Certainly my knee issues have made me hyper aware/paranoid about any new condition and hard to deal with physcologically.

    I certainly feel foolish with all the weightlifting/skiing, then again my posture has been aweful for the past 5 months with knee pain so that might of done it.

    I'm leaning towards an MRI just wondering if they will pick an asymtomatic disk and say thats the problem. I guess if all is fine with disks (50%? of people) then It will point me in a better direction.

  • Ya not happy I am suffering again either but I did it to myself, I up'd my squat weight knowing my back is a weak point. Even though I have strong core muscles I have suffered with scoliosis and back issues (pulled muscles and one time sciatica) for years. I know better.... I think I let my form slip and BOOM. I end up with this.

    Lesson without a doubt learned. Once I am back to normal (praying that will happen without surgery) I plan on KEEPING that in mind.

    the MRI may show findings that have nothing to do with your pain, so true. But typically they can see when the nerve is actually effected. Some have the herniation with no effects at all and never even know it. It would be nice to know just you can take a bit extra care as well?

    I am overly sensitive to my body as well, I feel EVERYTHING. To be honest, I also suffer from Health Anxiety so I want the tests done immediately. LOL

    Best of luck to you!
    Dani Rae
  • Yes was on the squats and more 6 months ago, wondered if it has contributed, get the feeling i would of felt something at the time.

    Saw my gp , she wouldnt refer me for an MRI at this stage as its only been a week or two says it very likely to go away, maybe im worrying too much about this at the moment?
  • Yes, it is far too early to order an MRI unless you had other symptoms that indicated some nerve compression.
    The thing with MRI is that the report lists all anatomical findings, and many of them have nothing to do with the symptoms you are having.......they are simply anatomical. If there were a nerve pinched or a herniation it would show but that doesn't mean that it is the cause of the pain you are having, which is why it is ONE small part of the total diagnostic procedure for spine problems. Herniations can exist, and if they don't involve the other structures or nerves in the spine, it most likely is not the cause of the pain.
    Hang in there, it is very early days for a flare up of sciatica, and if it persists for a month or more, then it might be time to see your primary again for further follow up. In the meantime, read the links to the left of the forum for stretching and excercises that might help ease some of the pain, use ice and heat, whichever helps more.
  • So I went to a physio.

    He thought I had a mild disk bulge, pirformis wasn't overly tight. Although I did not have a positive straight leg test, or a positive test on anything that put pressure on the sciatic nerve .

    Gave me some mckenzie exercises, advised me not to sit for too long, think about posture. Felt some immediate relief after stretchs and massage. Symptoms seem to changed to a sore lower back, slightly off feeling in right leg (almost pre-pins and needles), burning pain in buttock has subsided to annoying twinge every once in a while during sitting.

    Wasn't hasn't helped is that I fainted on the train on Monday, which has never happened to me before (anxiety?). The paramedics found out I have a minor heart defect. At this point I feel a little cursed!

  • handyman24602hhandyman24602 Posts: 13
    edited 09/30/2014 - 12:19 AM
    Week three:

    Symptoms seem very variable, I still have a weak right leg, and on/off sore back. The numbness in my foot has subtly changed into a light tingling/ light burning sensation in Big toe and under foot.

    Glute pain has come back a bit last night keeping me awake. Its strange because sometimes I can sit for 30 mins to an hour without it hurting, other times it goes crazy when I'm lying down.

    Spoke with my GP again she is not sure it is true sciatica becuase I dont have a issue with the leg test or any pain coughing sneezing.

    Just worried its going to get worse.

  • Hello Handyman! First, let me say that I'm sorry you're going through this. And fainting on the train? That had to have been pretty scary! I just wanted to see if you have thought about seeing a holistic Dr? Of course, I'm not suggesting that this should replace your regular medical care, but to compliment it. I didn't find my holistic Dr until I was too far gone. Otherwise, I think he could have really helped me. If nothing else, the treatments I had, which included acupuncture, cupping, moxibustion, & homeopathic injections helped me to relax & this might be helpful to you too. I did get some physical benefits as well- when I left the appointments, I walked straighter & with less pain, but these effects were only short term for me. Again, I was way far gone by this time with a huge herniation that was crushing my sciatic nerve. Western Medicine is starting to become more accepting of Eastern Medicine, even if it's to compliment the other. I had the approval of my treating physician (Interventional Spine Specialist/PM) at the time & he even asked me to get some cards from the holistic Dr, so that he could use them to refer other interested patients. Also, this holistic Dr is on staff at the local hospital here, which is a step in the right direction in getting it more seriously considered, especially by insurance companies.

    This is just a thought. In any case, Welcome to the Spine Health Forums. I have found a lot of helpful information here & the support from members & moderators has been great! I wish you the best of luck in finding the source of your pain & the relief you need!

    8/28/14 Discectomy, Laminectomy, Foraminotomy L5-S1
    9/15/15 Surgical Debridement of infected surgical incision & drain seroma; wound vac applied
    10/21/14 L5-S1 Osteomyelitis & Discitis; 10/23/14 Bone & Tissue Biopsy = MRSE
  • Thanks im a scientist so I dont put alot of value in alternative therapies, i guess you have to believe they work.

    I am getting paranoid that my kneecap neropathy is somehow linked to this, that there is a connection with CRPS/RSD, but i dont see how sensation in the front of the kneecaps would be affected 5 months ago in isolation?

  • Symptoms seem to be changing daily. Glute pain has disappeared , replaced by mild stinging in calfs. My LEFT and RIGHT foot is feeling numb when I am sat down. getting scared by these changes!
  • When do you return to see the surgeon?
  • sandi said:
    When do you return to see the surgeon?
    I haven't seen a surgeon yet I'm hoping it won't come to that, 3 weeks so far.

    I see my physio again on Thursday might discuss an MRI referral. Pain is relativity mild but annoying. My main concern is that it is progressing or more accurately changing. First it was in my hips, then my glute , then foot numbness/ tingling, now calf/ankle/foot pain in both legs (but mainly one).

    I'm just wondering where this is heading? it does feel like it's getting better.
  • Then the next step would be to consult with a spine doctor........not a chiropractor, nor a physiotherapist, but a spine surgeon. He can examine you and make the referrals you may need for further imaging and testing.
  • sandi said:
    Then the next step would be to consult with a spine doctor........not a chiropractor, nor a physiotherapist, but a spine surgeon. He can examine you and make the referrals you may need for further imaging and testing.
    In the uk here so a referal to a nhs consultant would be months away. Gp wont order an mri untill at least 6 weeks.
  • Ok, I don't know if im paranoid but I feel like Ive got something going on with my hands now! Ive been waking up with numbness in my little finger in the morning. I've read this could be because im sleeping funny on my elbow. What are the chances issues with lumbar and cervical spine could appear within 3 weeks of each other? Getting super anxious thinking this is something to do with MS.

    I'm guessing its much more likely that I lying down more on my arms a lot more than usual, I think my doctor is going think I'm going mad.
  • it is possible it could be ulnar nerve compression......if you do a search, you can look up the symptoms on the internet and see if those are similar to what you are experiencing.
    It is also possible that you can have nerve issues in the cervical area.
    Do you have private insurance as well ? If so, perhaps you can make an appointment with a spine surgeon sooner rather than having to wait for the NHS to get you in.
  • handyman24602hhandyman24602 Posts: 13
    edited 10/07/2014 - 12:05 AM
    It all seems very odd to me this happening at the same time. I'm not sure if its in both hands yet, i have brought a elbow splint to wear at night I see if this stops it. I did hit my funny bone about a week ago so maybe that's the cause and I am going a bit mad.

    I don't have insurance but I could pay for a private MRI and then discuss this with a consultant for about £400. my sciatica symptoms have reduced somewhat over the past few days which is good, I hope it continues this way.

  • bilaterally from leaning forward on desktops, counters, even my cane and walker after surgery, so it is not impossible to occur.
    We don't always realize how much we put our weight onto our forearms and elbows to compensate for our spines when the pain is bad......we even do it when we are working on a computer....
  • My best advise with the NHS is be annoying! Keep pushing & pushing. As symptoms change go back to your GP. I know some people who are fantastic at getting the NHS to run like lightening!! often with back pain they drag their heels because a huge percent of people's pain just goes away & they never need diagnostic tests or specialist treatment. I know it's incredibly frustrating! Push, push, push!
    Osteoarthritis & DDD.
  • Week 7 update:

    I was going to say it seems to be getting better, but i guess its more accurate to say its changing. Certainly the pain in my bum(s) seems to of greatly reduced.

    Current symptoms:


    - small pain in bum when sitting, seems to be getting milder, and not present for prolonged periods.
    - increased sensation in back of calf's, slightly stingy sometimes.
    - occasional mild pain in big toe
    - feeling of numbness in little toe, big toe, top and bottom of foot and ankle, this varies between foot and place. No actual loss of sensation or absence of reflex reactions.

    -occasional feeling of motor weakness in right leg, this is occasionally replaced with hip pain that travels to the knee upon initial walking.

    My symptoms are suggestive of disk herniation; worse with rest and improves with activity. However, they are not mechanical in nature, McKenzie exercises seem to have no effect and I have a negative SLR test. I am slightly worried at what kind of pathology can cause bilateral effects across multiple dermatomes?

    Currently continuing with physio. My GP has ordered blood tests to discount neuropathic disease, I think this was influenced by my reports of numbness in hands at night and continued knee sensitivity as well as sciatica.

    Still no MRI or referral to spine specialist, I'm seeing my GP again on monday to discuss the blood results . She thinks the symptoms are too mild for referral as of yet.

  • EnglishGirlEEnglishGirl Posts: 1,825
    edited 10/29/2014 - 8:40 AM
    Good luck! I had trouble trying to diagnose myself in the past. Some pain would reduce with exercise only to be replaced with a different pain. Standard McKenzie exercises made me hurt more. Once I had my diagnostic tests it all started to make sense. I have many different things wrong with my spine. Activities would help with facet joints or SI for example but because of bone-on-bone & 'Modic changes' they would increase my overall pain. Ugh!
    I'd keep a 'diary' of your pain. What makes it worse/better, activities, time of day, meds etc. it might help convince your GP that you need diagnostic tests & a referral & it will be useful for your specialist once you get there!
    I remember my physical therapist (for sciatica) thought that 'changes', particularly getting the pain up into my bum then back, was a good result.
    Osteoarthritis & DDD.
  • So its almost the new year.

    My symptoms have reduced to occasional pain in hips, right leg still feels very weak after standing up going down stairs.

    I had my MRI results back. "Not much to see here" was the first the main point. Commented on incidental tiny disk bulge not compressing dural sac or nerve root. So it seems the no obvious smoking gun in the back excluding a mistake or a reabsorbed bulge. Dr prescribed me neuropathic drugs and said she could do nothing more except refer to the pain lead at the surgery to see if he had any thoughts.

    My alloyodia in my knees and now calf's has increased and am now worried that everything is either caused by CRPS/RSD or MS?

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