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I'm kind of stumped about what to do next. Please help!

I'm a 35 year old man suffering from sciatica, and wondering if anyone has any thoughts on my treatment so far, as everything has been going negatively for past few months.

So long story short about six months ago I broke a toe and had to wear a boot for a month. Wearing this boot has led to pain in my back. I also lifted something heavy and the pain became worse, and started feeling sciatica in my upper right leg and buttocks which wouldn't go away for several months.

The timeline since then:
  1. About 3 months ago I had an MRI that confirmed an L4/L5 bulge on the right and L5/S1 bulge on the left (although no symptoms on the left).
  2. Spent a few weeks on Naproxen, which helped a lot, but were killing my stomach.
  3. Had steroid injection in the L4/L5 bulge, after which I felt like a new man. Stopped taking the anti-inflammatory and pain medication.
  4. A few days after the injections my first son was born - life is great.
  5. ....But 3 weeks later (this is now 6 weeks ago) I woke up and couldn't get out of bed. I have a permanent hunch forward, and can't extend my back at all - can't do any Mckinsey exercises at all.
  6. A few days later I had a SPECT/CT scan that showed some irritation on my SI joint - had injections there which helped a bit but not a huge a amount.
  7. In my commitment to get better for my son, I signed up for everything, including Chiropractor, Physio, Acupuncture, Hydrotherapy, spent a small fortune on gadgets and cushions on Amazon....but sadly no real improvements over this time.
  8. I went to another Orthopaedic surgeon for a second opinion, and he basically said I should go for microdisectomy without even seeing a recent MRI.

  9. On his advice I did have a new MRI which actually showed the disc bulges are getting better though it also identified Trochanteric Bursitis (inflamed hips). Sadly the symptoms are getting worse....

  10. I was also referred to see a pain management doctor, who diagnosed me as being hypermobile and he felt that there is more than just the discs at play here. He believes my glutes, back muscles and hip muscles are "struggling" and that he felt I was overdoing things. At this stage the pain is getting worse and worse, and I feel like the more "rehab" I do the more it hurts.

  11. Yesterday I had steroid injections in my hips, which have been very helpful in that now I can sleep on my side again. I also had a Ketamine injection which was the weirdest trip in my life - it's supposed to "reset" your nervous system as after so much pain for so long you become "hyper sensitive" to pain (your body believes that everything is painful even when it isn't).
Anyways, this is where I find myself. 3 months since seeing my Orthopaedic Surgeon and not feeling much better (can't sit for too long, can't stand for too long without hunching forward and sharp pain in my right calf, lying down causes sharp pain), taking a ton of strong medication (Targinact, Diazepam, Etoricoxib, Amitriptyline).

Does anyone have any advice for me?

Thanks in advance!
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Comments

  • Good morning

    It sounds like you have gone through lot of pain from scistica. i myself have gone through it for months and seen my spinal surgeon multiple times for this excruciating pain. My suggestion would only be to ask your doctor about piriformis syndrome which is incredibly painful but this is only my opinion. please see your doctor and possibly raise that question.

    good luck


  • Wow you've been through the proverbial wringer and done everything possible to get help. I've been reading a book by one of the pain management doctors in the practice I go to and his take is similar to the PM that you saw. It's a vicious cycle, we hurt so our muscles over react to protect the spine which can cause spasms and SI joint inflammation which can cause bursitis in the hips which can lead to piriformis syndrome which can cause sciatica and the cycle goes round and round. I'm currently in the same painful cycle. I just had piriformis injections and I think it helped a little but the other issues are still really awful. 

    His approach is to do all the injections at once to get the patient out of pain so that the bracing muscles that hold up our spine can be strengthened. These muscles atrophy very quickly when we are in pain for any length of time and they take a long time and commitment to get back to doing their job. Our glutes and the muscles right along the spine are a big part of the bracing muscles. I don't know how old you are but of course it takes longer, the older you are. He believes strongly that the PM doctor should work closely with the PT to make a long term plan and not do things piece meal. 


    It's going to be a little touchy for me because he my pain management doctor's partner but I want to try his approach and I hope she will work with me. Anyway, if I were you I would try to work with the pain management doctor you saw last and just stick with him. It's awful, I know! I'm desperate for help also and I'm willing to do what I have to do, except maybe  that Ketamine stuff!  I hope this was in someway helpful  or at least encouraging to know you aren't alone. You sound like a very courageous person so I believe you'll find some help. I'll pray you do! 

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  • I just realized this is an old post so if you are still out there McLondon let me know if you found help! 

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