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ISO advice/support -- chronic sciatica with no relief

vvv03vvvv03 Posts: 11
I started having painful sciatica down my left leg that manifests when I am sitting down approximately 2 years ago which has gotten progressively worse over time. Given that I have a desk job, I spend my days in a lot of pain.

Here's what I have done so far: 2 highly regarded acupuncturists, 2 highly regarded chiropractors, 3 physical therapists (2 not so good, 1 great), XXX Orthopedist, XXX non-surgical spinal specialist, 2 pain management docs. I have had 2 spinal MRIs and 2 Pelvic MRIs. I have tried prednisone (5 day course), meloxicam and tramadol. Five cortisone epidurals. None of these things has worked. My spinal MRI shows small disc herniation on the left side of L5-S1. My pelvic shows chronic denervation and fatty infiltration of the left gluteus maximus which verifies that there is definitely some sort of nerve damage or impingement.

I'm writing because I went to my Pain Management doctor yesterday to go over the results and his basic message was "I have no idea what is causing this and you may have to live with it the rest of your life." He ordered another MRI of the nerve root, though he said it's rare that there is ever a lesion there (I don't think I'm even going to do it, as he was clearly grasping at straws.) He tried to refer me to a neurologist in the practice, but I'm starting to realize it's not a quality practice (the patients can be downright creepy if I'm being honest). I have been dealing with this condition rather stoically and optimistically up until now, thinking someone is going to figure it out and I won't be in so much pain anymore. I almost burst into tears with his response, especially because he said that if epidurals didn't help, surgery on the disc would not either.

If anyone has any advice, support or recommendations, I would be ever so grateful. I am in NYC and have CIGNA insurance (the reason I am going to a shady pain management practice is that I have an HMO type insurance right now and can't go out of network, but starting in January, I will be able to go out of network as well.)

Thanks in advance for any and all replies.


  • Have you ever had any nerve tests to identify the pain generator? I'd see another doc for a second opinion. You're clearly in pain. There are lots of different things they can try. In my experience even PT is more effective once they know exactly what's causing your pain. The feeling of sciatica isn't always caused by damage in your spine. Im surprised that you haven't had an EMG. A referral to a board certified spine surgeon for diagnosis (not necessarily surgery) changed my treatment. I lingered in pain management without improvement for a long time. I have the same insurance as you & I've never had problems seeking 2nd opinions. I've had a lot over the years!
    Osteoarthritis & DDD.
  • Vvv03 - Wow, I've been through just about everything you have been through - most recently the 5 day prednisone treatment, just finished today - plus the EMG that English Girl advises, which sounds like the right advice to me too.
  • That sounds horrible. I am 33 and get very frustrated that I'm limited and have constant pain down my right leg so I've been there. I am on a gabopentin nerve block pill called Gralise and it has made me feel a lot better. I also get Epidural Spinal Injections (ESI) and they have relieved my pain for three months each time my pain management doctor has given them to me. I have been in a six year journey trying to find some relief after I had a failed microdisectomy for a herniated disc also in L5 S1. I would ask to be referred to another doctor. I have had many times where I wanted to give up because there are a lot of doctors out there that are of no help. Good luck!
  • vvv03vvvv03 Posts: 11
    edited 12/15/2014 - 9:24 AM
    thanks for the advice. I did have an EMG early in the process with a "reknowned" Pain management doc (quotes meant to denote sarcasm.) He said I had piriformis syndrome (he is a piriformis specialist). He never shared the EMG results with me, though. I will likely have another EMG when I go to the spine surgeon in January.
  • , however I have included the link to a listing of physicians and practices where you can research the doctors in your area.
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