S1 Sciatica numbness - how long does it last?

S1 Sciatica numbness - how long does it last?

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seaniboy
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S1 Sciatica numbness - how long does it last?

Hi I'm new to this forum - 48-year old male - and would really appreciate any advice people have to offer.

About 9 weeks ago (end of September) I fell over very heavily playing tennis. Two weeks later I had the classic sciatica symptoms: back/leg pain that made it terribly hard to get out of bed and quite impossible to drive or sit at a desk. I tried physiotherapy and a range of painkillers which made some improvement. But my MRI scan subsequently revealed a herniated L5 disc.

My specialist is hoping that it will heal of its own accord with conservative treatment; but he has also said that ultimately L5/S1 decompression surgery may prove to be the only solution. I'm not desperate to have surgery if it can be avoided; and so am willing to put up with the pain for a little longer to give the natural healing processes more of a chance.

Although the back pain has largely gone away now, I still have to take quite high dosages of pain killers as I have quite a lot of leg pain plus total (S1) numbness in the 4th/5th toes, heel, and outside of my right leg. Sitting/driving for any prolonged period of time is still almost impossible. As a researcher my work involves a lot of time at a computer in front of a desk, so, aside from the discomfort, this is a big deal for me professionally.

While I am not experiencing the same degree of excruciating pain that I was, 4 weeks ago, the level of discomfort has more or less remained constant over the past three weeks. I think if natural healing could not cure these symptoms, I would have to opt for surgery in the new year.

My specific question relates to what forum members' experiences of numbness/loss of sensation in the leg has been.

Have people found that the numbness just suddenly goes away one day? Or does feeling come back over a period of time? (If so, how long?)

And as for the operation itself. I have heard (some!!) people report that they woke up to discover themselves completely free of leg pain afterwards. But nobody seems to comment on the numbness. Does that disappear straight after the operation? Or does that take a while to come back? (does it ever come back?)

Thanks for your help!!

What i would like to know is what people's experiences

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Sapa
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Hi Seaniboy

Hi Seaniboy,

I think everyone would be differnt. Myself, I was hurt almost 3 years ago, and have herniations at L4/L5 and L5/S1. The second is compressing the nerve root, causing lots of pain and numbness in my right leg. When I was first hurt, the numbness was in my toes on the outside of the foot, and I only had pain in the back of my upper leg. Then the numbness went away. I was doing Physiotherapy at the time, and chiropractic. In the last several months, the pain and numbness has come back with a vengance! It's to the point I can't sit, lie down, stand or walk too long at once. And I'm taking lots of pain killers that just take the edge off a bit. I'm going for surgery Dec. 10th, and hopefully it will help the pain in my leg. But the doctor said I may always have some numbness and tingling in my leg - depending I guess on how much the nerve is damaged.

I've heard others with similar experiences, and others who say the numbness goes away as soon as they have an operation. I think it depends on how much and how long the nerve has been compressed.

Hope you get some relief soon, take care,
Sandy

Missy0417 (not verified)
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Hi this may have helped me a bit

Hi,
I posted earlier in the other forum, for new comers. Well, I need to understand how this sciatica works, and possibly that's what's occurring with me.

From my experience, I had a lot of pressure on the sciatic nerve with my first surgery and the disc matter was again on the sciatic nerve. After the first surgery, very gradually and slowly, the feeling came back and I had lots of PT. I had trouble with balance, which I have to say I do have to still be careful of like if I am in the garden, and trying to take big steps. I think perhaps those of us with discs blown, will have balance issues because we have lost that cushioning!

Maybe from what Sandy is saying, I could right now be having a vengeance of the numbness, pain and so on that could go away eventually. I hope so, and hope so for you, too, Seaniboy.

I know I wanted the second surgery (last June) because the disc was on the sciatic nerve a second time, and I believe it was on it for a few months before I saw the surgeon. I remember I wanted that surgery because the less time the nerve is compressed, the better the improvement of numbness, etc, that could reside. But, if there are going to be these rebounds of pain and numbness, is there really a good chance of being ahead? Maybe I am actually affected by that first surgery, where the nerve pain and numbness was so bad. So, I would say, see what your doctor says. And don't let it go too far. If the doctor is good and you have heard good news about him or her, then don't let it go too far. In my case, I had no way of knowing it was blown for a couple years until it really went WICKED bad and I could not move. And, then surgery followed like three months later which was as soon as I could find a good surgeon. I think a good surgeon, today, will not rush it but do surgery when it is really needed.

My chiropractor went into chiro because she was not having any luck with her disc issues, and never had surgery. She did end up with numbness, and so on, but she does say that the body does have a way of dealing with things like that. Good luck, and try not to worry about it too much! I know it is hard, when you need to keep sitting in that chair doing your work, and you are in pain! It isn't fun! And, imagine I may be crazy, but you really do gain a high pain tolerance over time, too. But then again, it is hard to get a pain tolerance to nerve pain - that is the worst.

seaniboy
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Hi Sandy, Thanks for your

Hi Sandy,

Thanks for your kind words and for replying so quickly.

I'm very cheered up by your news that the numbness went away eventually. But very sorry to hear that it has returned of late. What kind of PT were you doing that cured your numbness?

I really hope your date with the surgeon goes well - I'll keep my fingers crossed. Do let me know how it turns out - I'll be thinking of you! - and I'd be interested to hear in particular what happens about the numbness after the operation.

Good luck!

Sean

seaniboy
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Hi Missy, Thanks for your

Hi Missy,

Thanks for your detailed reply! When you say the feeling came back very slowly and gradually after your first surgery what are we talking? Weeks? Months?

What I'm trying to find out is whether the numbness is because the nerve is compressed or whether it is because the nerve is defunct and has to regenerate.

But thanks for your advice on the surgery front. How did you find the improvement second time around?

Sean

gwennie17
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general comments about sciatica --

Just to clarify a point: the posters are talking about different issues. There is a "sciatic-type" pain that most of us casually call sciatic pain. It usually runs down the back of the leg, usually stopping around the knee, but sometimes going into the foot. It is almost always caused by a compressed spinal nerve.

Sciatic is technically a collection of symptoms that is caused when one of the five nerves that come together to form the sciatic nerve becomes irritated, inflamed or otherwise damaged. The nerves involved are L4, L5, and the sacral nerves S1, S2 and S3. When the nerve or nerves are irritated, pain is felt in the lower back, buttock and one or both legs, or part of a leg, sometimes going into the foot. You all know the feelings: pain, numbness, muscle weakness, tingling, pins and needles, feeling of heat, etc.

The other problem is true sciatic nerve pain. This occurs when something pinches off the sciatic nerve that branches at the end of the spine and goes down the back of each buttock and leg. In 15% of the population, the sciatic nerve goes through the piriformis muscle (located in buttock)rather than under it. If there is any swelling of the piriformis, it can squeeze on the sciatic nerve, causing the same feelings one has when there is a herniated disc or compressed spinal nerve. Other tissues can affect it, too.

None of this matters to the patient, but it is an important difference to the doctor as it will determine the type of treatment you receive.

lsteller
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Hi Sean

I can relate to what you're going through. I still have sciatic pain, mostly in my right leg, since my surgery. I also sit at a desk at the computer for long periods of time. One thing that has helped me (recommended by my cousin, who is a nurse) is a device called a Back Joy. It is not a cushion, it's an orthotic. Somehow or another it makes sitting in a chair a lot easier. I could never do the 2 hour drives to see my surgeon without it. You can Google it and see what it's all about. If you have a Bed, Bath, and Beyond locally, you can get them there. If you have their 20% off coupon (BB&B's), you can get one for about $40. The other thing that may help you is a TENS unit. I got one during the course of treatment for my injury and I still use it occasionally. Our nerves affect the muscles in our butts, and can really cause some knotted muscles at times. The TENS unit can help to settle those down. Also, if you have a shower massage, you can turn the water to a very warm temperature and blast your butt, hip, leg (as I am about to do in 2 minutes!). All the best for a natural recovery. If you can avoid surgery, you'll be doing yourself a tremendous favor.

Linda

3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.

gwennie17
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Welcome to the board, Seaniboy ~

If you are starting to feel somewhat better, you might want to do what you can to maximize healing and try to avoid any surgery. You don't mention having taken oral steroids or having a steroid injection. This are often given in an attempt to assist with healing and to reduce any inflammation you may be having around a spinal nerve root.

It is possible to heal a disc but it does take a lot of patience and perseverance. My husband ruptured L5 many years ago. It took about six months before he was back to feeling reasonably "normal" and to this day, he does his "back" exercises faithfully, every morning. He takes reasonable care to pace himself with activities that he knows result in strain -- things like raking leaves, shoveling snow, etc. He has not had a major flare in 16 years...so I know it is possible.

One thing I would suggest to you is to spend some quality floor time. If you can possibly take five minutes and do this at work, better yet. Lie on your back on the floor, knees bent, feet flat on floor, arms close to your sides, palms facing up. Be sure the pelvis is in a neutral position (not tilting up or down.) Also, you want your head in line with your spine. Do not tilt the chin up toward the ceiling. Once you are in position, just lie there and relax. Breathe from the belly, slowly and deeply. You only have to stay like this for several minutes at a time -- it is a natural form of decompression and the position will unload the discs. Another way to do this is to lie the same way but snuggle your hips up next to a couch or chair. (Body will be perpendicular to the couch, head pointed out away from couch). Place your lower legs and feet on the seat of the couch or chair, arms by your sides, palms facing up. Again breathe slowly and just relax.

When I was really having a flare I would do this for five or ten minutes each hour. I have also been known to find a quiet corner in an airport concourse and do this. Please give it a try and see what you think.

Regarding work, try to take a mini break as often as possible, like once each hour. You don't have to stand or walk long, but do get up and stretch. Also, be sure your work station is set up well for your body. Good postural alignment is extremely important once you have disc problems.

It is very important to avoid any activity that involves bending, and especially, twisting, reaching up overhead and to the side, lifting anything heavier than about a gallon of milk. Avoid long car rides, anything that jostles your spine, like very bumpy roads. For the next several months, the best and safest activity for you is walking. And drink tons of water.

If you find your leg pain and numbness does not improve by the first of the year, you may have to proceed with surgery.

There is no way to answer your question pertaining to numbness. Anything involving nerves is a big unknown. If a doctor is honest with you, he will tell you statistical outcomes. He has no reliable way to predict when the waiting becomes "too long" or the compression is too much. Some people have nerve damage after a week or two, and others are OK after years of living with nerve pain. I can't really tell you how the nerve pain recedes. Some people wake up from a discectomy and all pain and numbness is gone. Others have pain that very very slowly gets better. I personally believe that if something is truly numb, it may get better but I don't believe it ever goes away entirely -- but that is just my opinion. I don't know how it is for others. Sometimes people are left with little patches where there is numbness.

Most doctors will tell you it can take at least a year for nerve damage to go away. Some say up to two years. But I never give up because I think it is possible for nerves to continue to heal and regenerate. My toes have been numb since the end of 2001 and just fairly recently I have started to have new sensations in them. They are far from "normal" but there is feeling and it keeps changing.

There are only two situations where you must seek medical attention right away. When there is involvement with the bladder and/or bowel, it is considered an emergency. And if a patient develops foot drop he should also call his doctor ASAP. Otherwise, it is a matter of how much pain can you live with, how does it impact your life, etc. There are always trade-offs and it is a very personal decision.

Did you read through all the articles on this website pertaining to sciatica? Here's a link to one I like:

http://www.spine-health.com/conditions/sciatica/what-you-need-know-about-sciatica

Good luck to you. Please post with your questions and comments.

Gwennie

seaniboy
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Dear Gwennie, Thanks for

Dear Gwennie,

Thanks for your explanation: I'm interested in what you say about the pririformis muscle because the start of all my trouble was when i fell down very heavily on a (hard) tennis court. WhenI got home that evening i had a very stiff back getting out of the car - but I was still able to play tennis (twice!!) the following week. (Madness!!!)

But by the end of that week I had pain from the buttock down to the knee (which I think is a classic piriformis type problem). For that reason my physiotherapist said she thought that my problem might be SI Joint pain. It was only two weeks after my original fall that the pain spread to my ankle/foot (and became excruciating).

However when I had my MRI Scan about 4-5 weeks after the fall it showed no (visible) problem with the SI Joint. All very strange.

Sean

seaniboy
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Thanks for the tip

Hi Linda,
Thanks for your tip - I'll look into i a Back joy (although I think in the UK - where I am - it must be called something else). I've heard good things about the TENS machine too - so that's another avenue I'm going to investigate.

Certainly agree about the shower massage: at the moment I am trying to go swimming as much as possible and a whirlpool massage afterwards is always very comforting.

Sean

seaniboy
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Update and dealing with the NHS in the UK

Hi Gwennie,

Thanks for your tips - and sorry not to respond before.

I haven't had any injections - or indeed been offered any. I have been taking Tramadol pain-killers plus fairly large quantities of Ibruprofen and Paracetamol.

I've also been doing my exercises. My PT recommends lying flat on the floor with one knee bent and lifting my hips up off the floor. When things were at their worst I couldn't cope with that. But now I can do that fairly easily. I'm also doing a lot of swimming.

I'm pleased to report that 11 weeks since crashing over, things have eased quite a bit. I now take 2 Tramadol at night and two in the morning. But although I can do loads more than 4 weeks ago, I still have some residual numbness in my foot. Also, I still have quite a of stiffness in my leg - it's like a bad hamstring/muscle pull. I would describe that as permanent background discomfort rather than pain. But if I kicked a football and followed right through with the leg, the result would be agony. And I still have a bad limp which is particularly pronounced after a period of sitting.

My big dilemma will be whether or not to opt for surgery in the New Year if these symptoms don't go away. I can't believe that I can have made so much progress only to be held up on the home straight!! This week I'm going back to the PT for some more demanding exercises in the hope of freeing up that compressed nerve.

Anyone have a suggestion as to the point at which someone like me - who seems to have a relatively straightforward problem - should accept that surgery is inevitable?

I should also say that, having read many of the posts, it seems that there are some people who are really suffering in a big way out there. So I feel very humble reporting on my symptoms which - in comparison to everyone else's - seem rather trivial.

I also know that some people from the UK contribute to the forum, so I thought for those Brits suffering like me I would say something about the way I managed my health care using the NHS.

When I first hurt myself playing tennis I went to a private Tennis Club Physiotherapist as I get a member's discount. Half an hour of PT costs £30. She was very good - but can't prescribe medicines. So I had to go to my GP for that. 3 weeks worth of prescribed pain killers cost just over £7 on the NHS. The GP too was very helpful and would have organised (free) PT on the NHS if I had wanted it. But I preferred to keep going with my Tennis Club PT as that was more convenient for me.

However, after 5 weeks of pain, I decided something more radical was required and my PT offered to refer me for a scan and - if I wanted - to a specialist. In the UK you can't just go and see a specialist or have a scan - you have to be referred either by a GP or a private health practitioner like my PT.

The problem in the UK is that it can take quite a while to get a scan on the NHS and to see a specialist (I'm not quite sure how long). But if you are willing to pay and go privately, then you can usually get something done within a week.

I had to pay £195 for an MRI scan - which was interpreted by both the radiologist and the PT as showing a L5 S1 disc herniation. I thought that was money well spent because I then knew exactly what was wrong with me and could make a plan about what to do. Just knowing what was wrong - rather than floundering in ignorance - was a big help psychologically.

But it also meant that I could take my scans to the specialist that same week who I saw as a private - rather than NHS - patient. (Most specialists in the UK work partly for the NHS and partly as private consultants).

So for another £200 within four days I got a 50-minute with the specialist who outlined my options: basically an extended period of conservative care with surgery as a possible option if things didn't heal up on their own. Again, I thought this was money well spent as I then felt that I had actually done everything within my power to address my condition.

But - and this is the trick with the NHS system - having seen me as a private patient, the specialist is entitled to treat me as an NHS patient should I need surgery - and so he placed me on his NHS waiting list. Under NHS rules, once you are on the list you have to be treated within 18 weeks; according to the published statistics, the actual waiting time for (non-emergency) cases like mine would be nearer 12-13 weeks.

I could have asked to have the operation done privately within the next two weeks; but he didn't recommend that - and it would have cost £7000 pounds. On the NHS the surgery and post-operative care is, of course, free.

So I spent just under £400 getting an MRI scan and a specialist consultation - and I appreciate that not everyone can afford that - but my advice to fellow Brits is, if you can, it is well worth the money, because even if if you go privately for the scans and specialist consultation, you can still opt to be operated on under the NHS scheme if it turns out to be necessary. (If you were in an acute state with incontinence etc. they would do the operation immediately - no waiting for 18 weeks). Moreover, even if you pay to go privately, although the operation would be done sooner, it would still be done by the same surgeon and in the same hospital.

OMG I 've gone on for so long! Sorry! Time to sign off.

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