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Sciatica caused by L5/S1 herniation, doctor wary on surgery.

hamlin4thhhamlin4th Posts: 6
Hello Spine-Health. I am a 21 y/o active male college student. I've had sciatica for eight months now in my left leg, and I feel like it is slowly getting worse by the month. These last two in particular suck.

I got my MRI a week and a half ago where my parents live, showing that I have a herniated disc at L5/S1. I recently had to change doctors to the area where I attend school, and I had an appointment with my new doctor earlier.

He was very understanding, but still against getting surgery done. He referred me to a physical therapist, but I refuted that since I saw one two months ago when my sciatic pain skyrocketed. He also referred me to a neurosurgeon who I will call as soon as I can (forgot the documents with the number earlier today ugh), but he strongly hinted that they won't go through with the surgery.

The idea is that I have a "moderate" case of sciatica, but even this level of sciatica is very painful. It's "moderate" in the sense that I don't have symptoms such as numbness in the toes, weakness in the leg, lower back pain is absent, and I have control of my bowel movements. However, I don't want to have to wait to this level where a rush to the ER would be required. At the same time, my sciatica can still be very painful. I'm a student so I can't avoid sitting for lectures, midterms, and studying -- sometimes hours at a time.

From looking through past topics on spine-health, it's true that my case of sciatica isn't as bad as most people's, but it still hurts a lot! Yes, I actually feel better if I'm standing and walking as much as possible. Yes, I can sit for hours of a time, but it becomes uncomfortable but doable, usually by shifting my weight to my right buttock. Yes, I still have 100% strength in my left leg, meaning that I can exercise properly.

But at the same time, I'm in constant pain and have to take 800mg Ibuprofen three times a day. This is not how I want to live at 21. Without the Ibuprofen, I reach daily 4 in pain, with it, a 2, but it's still there. But even the Ibuprofen doesn't prevent the extreme pain when I get up from sitting. Even just after 30 minutes of sitting, if I don't have two armrests I press with my hands to get up with, I experience an 8 in pain when I get up. That lingers for a fifteen seconds that involve limping, hunching over, and sometimes lightheadedness.

And because I've been on Ibuprofen for so long, I'm afraid to touch any alcohol. Didn't even drink on my 21st birthday that passed a few weeks ago. I also fear that long-term effects of being on Ibuprofen, but as of now I really have no choice if I want to function with a tolerable amount of pain.

So I feel like I'm at a crossroads. My doctors say I'm not bad enough to get surgery, but the conservative treatment that recommend has not worked in the past. The stretches my former PT recommended do not relieve my pain, and some of them don't even work anymore because it hurts too much to do them.

When I see this surgeon, am I supposed to lie and exaggerate (say that my pain increased since I last saw my doctor) my sciatica to a level that a surgeon would go for surgery? I'd hate to do this, but I'm surprised that with eight months of sciatica that they're still prescribing me with a conservative treatment. Its frustrating to be told to see a PT again and just to take my meds daily when neither has improved my condition.

The only thing I haven't tried are the steroid injections, but I'm very against those. I've known two people who got those (they suffered from separate cases) and it either helped them for a short time, or didn't work at all. I want a permanent fix, not something temporary.

And it's not that I WANT surgery. No way. Having to get back surgery at 21 is disheartening. Who have you heard that has gotten just one back surgery? This sets a terrible precedent. But at the same time, I feel like I have no other options. I don't want to be in pain anymore. I also used to be an athlete, and I was planning to return to crew in the fall, but there's no way I could do it with sciatica.

I really wish a microdiscectomy would just be something you could walk into a clinic and tell them to just get it over with.
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1

Comments

  • LizLiz Posts: 9,745

    Liz, 

    Veritas-Health Forum Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • What is your pain level at on a scale of 1-10? That should be an indicator and help you and the neurosurgeon decide what's best for you. I am pretty sure that the neurosurgeon will go along with the surgery if that is what you want. I just had my microdiscectomy done last month and I feel a lot better than before my operation. Iif you go with the surgery, I hope you have good results.
    L5/S1 Disc Herniation. Microdiscectomy 12/12/14
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  • Hello Chris. At my best with pain medication involved, I am a constant 3. Without, I am a 5. However, when I get a really bad flare-up, I turn into a varying 6-8 regardless of medication. I'm actually in the last category right now and it is very painful. What's worse is only at the higher numbers does my sciatic pain not just affect my buttock to my knee, but it also goes all the way down to my foot. It would be very discouraging to have to repeat PT. I feel like I need this surgery.

    Also, if I get this surgery, does anyone know how many days of school I might miss? I'd prefer to keel this in the low side. I'm on a quarter system so any time lost is significant. I live on-campus so maybe I could use my school's disability services for transportation plus asking my professors if I can just stand during the lecture (luckily this quarter my classes are only 50 minutes each).

    I'd also consider purchasing a standing desk for my studies.
  • ClarinetgirlCClarinetgirl Posts: 188
    edited 01/07/2015 - 4:33 PM
    I am 20 years old. I just had a Discectomy at L5-S1 on October 30th. I went to my second post op appointment today. Sadly my neurosurgeon did not clear me to go this semester. I go to a small college so we do not have disability services for transportation. I also live on campus. I saw 2 different surgeons. The first was a Orthopaedic spine surgeon. He did not want to do surgery at all. Regardless of the fact I lost control of my bladder. I then went to a neurosurgeon who was the one who did the surgery. I pray you feel better soon!!
    L5-S1 Emergency PLIF Revision May 26th 2015
    L5-S1 PLIF May 22nd 2015.
    L5-S1 Discectomy Feb 27th 2015.
    L5-S1 Discectomy Oct 30th 2014.
    Ashley
  • PlumbTuckeredOutPlumbTuckeredOut Philadelphia, PAPosts: 325
    Since I injured my back when I was 8 years old I was in near constant pain by the time I reached college. I'd get everything I needed in the morning and bring it to campus because there was no chance I could make that walk back to my dorms for things between classes. Many days I was in tears because the pain was so bad but doctors wouldn't go near my back. I was 32 years old before the doctors went ahead for my first surgery. I wasn't laid up for more than a few days BUT, within a year everything returned to how it had been before surgery. Ten years later I needed to go back for more surgery and now I'm doing whatever I can before I have "more surgery".

    I know I sound like a broken record but surgery doesn't always work because once they open up an incision the area is the best it's ever going to be again. Once you have surgery scar tissue creates new pain, disks slip back to where they want to be, and, even when you think everything that can be done, was done, the nerve decides it's still going to be just as painful as it was before surgery. Nerve pain follows its own set of rules.

    What the docs are trying to say is, surgery may make the pain and injury even worse. Unless there is a clear indication that they can change things for the better doctors won't suggest surgery. If your choice for surgery is because of pain, surgery isn't a good idea. Try going to a pain clinic and try aquatherapy or more physical therapy.

    I'm considering having a zipper tattooed down my spine.
    Sheila

    Two roads diverged in a wood, and I took the one less traveled by...... (Robert Frost)
    I still don't know if I should have taken the one that said, "Caution! Dead End" (Me)
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  • PlumbTuckeredOut said:
    Since I injured my back when I was 8 years old I was in near constant pain by the time I reached college. I'd get everything I needed in the morning and bring it to campus because there was no chance I could make that walk back to my dorms for things between classes. Many days I was in tears because the pain was so bad but doctors wouldn't go near my back. I was 32 years old before the doctors went ahead for my first surgery. I wasn't laid up for more than a few days BUT, within a year everything returned to how it had been before surgery. Ten years later I needed to go back for more surgery and now I'm doing whatever I can before I have "more surgery".

    I know I sound like a broken record but surgery doesn't always work because once they open up an incision the area is the best it's ever going to be again. Once you have surgery scar tissue creates new pain, disks slip back to where they want to be, and, even when you think everything that can be done, was done, the nerve decides it's still going to be just as painful as it was before surgery. Nerve pain follows its own set of rules.

    What the docs are trying to say is, surgery may make the pain and injury even worse. Unless there is a clear indication that they can change things for the better doctors won't suggest surgery. If your choice for surgery is because of pain, surgery isn't a good idea. Try going to a pain clinic and try aquatherapy or more physical therapy.

    I'm considering having a zipper tattooed down my spine.
    Sheila
    I understand that, but 8 months with this thing, I don't know what I have left. I'm willing to take the risk, and believe me, I've though it over. I've read many topics here on spine-health that both tell stories of successful recoveries and nightmarish aftermaths.

    On a somewhat related note, anyone know how I should treat alcohol having been on NSAIDs for months? Do I have to continue as a full-on teetotaler, or can I have a drink or two at night if eight hours have passed since taking a dose of Ibuprofen (in this case, 800mg).
  • shez1325sshez1325 Posts: 49
    edited 01/08/2015 - 12:24 AM
    Hey I'm 28 and recently had a microdiscectomy. If my surgeon or health care providers said they wouldn't do surgery I definitely wouldn't be signing myself up for it. I understand you are in pain and when it gets to its worst you just want it gone and to be back to normal. However I don't think there is a quick fix. I think as you are so young doctors will try everything first before surgery, which is logical. If your pain is only at a 5 there is still hope for improvement. ( sorry to say only!) If you are prepared for surgery why not try a injection first. My physio had a guy who had Terrible sciatic pain and injections worked for him and it give him the opportunity to continue with physio and resolve his sciatic pain.

    Have you made an appointment for the Neurosurgeon? It is an elective surgery and I would believe someone would do it for you even if you were not presenting in a way that its your only option left. I wouldn't be giving up on physio as you will only need to do physio anyway after surgery! May as well give it a crack and if you are seeing one they would be able to see if your making improvement or not and reccomened surgery if need be.

    As far as NSAIDs I have never heard of not being able to drink? what is your reason for not thinking you could drink? I wouldn't think one or two standard drinks would interfere with that medication?

    Let us know how you go!
  • vvv03vvvv03 Posts: 11
    edited 01/09/2015 - 11:17 AM
    You have the same problem I have for the same reason. I'm going in for surgery on Thursday. The only differences are that I am 46 and have had it for over 2 years. I exhausted all options (acupuncture, chiropractor, phys therapy, pain management/injections) and even though I, too, have a good range of motion and only marginal weakness in my left side as a result, I couldn't live with the pain anymore. I have a desk job and my days are spent flopping from side to side, standing up and leaning over my desk, sticking my butt out in an effort to ease the pain. The last pain management doctor I went to had me bend over, walk around, etc. and proclaimed, "You don't need surgery." I didn't know whether to burst into tears or punch him in the face. Who made the rule that you only need surgery if you are immobilized by your pain? Radicular nerve pain HURTS and I have it for about 7 or 8 hours a day, at least 5 days a week. It's no way to live. I would say do your best to get the surgery, though I think it will be harder for you, as you are young and possibly haven't exhausted every option. I wish you the best and can only tell you that you are not alone. It sucks. I really understand what you are going through.
    Valerie
  • I've been dealing with the same issue for 18 months (sciatica due to L5-S1 herniation), so I know the frustration and the helpless feeling. I was 37 when I herniated it mountain biking and I'm now at the point where I spent most of the day in bed. I did have a microdissectomy at 11 months, but not until trying multiple forms of non surgical treatment. There are other medications you can take in addition to ibuprofen, specifically the ones that block nerve pain. I take gabapentin. The epidural injections can work great and they work to target inflammation of the nerve, just in a more localized and concentrated for than the ibuprofen. PT will give you core strengthening and traction exercises, and they might give you a TENS machine. Also, try chiropractic and acupuncture. I'm betting that they are hesitant about the surgery only because you haven't tried all of the non invasive options first.

    As for the surgery, it was actually very easy. I was of all needs and feeling good within a week. My problem is that it reherniated, which apparently happens in 15-30% of cases. So while it may seem like a great answer, it isn't perfect and could make things worse.

    I'm not a doctor (just an anatomy and physiology instructor trained in neuroscience), but I would urge you to try other meds and the epidural before having surgery.

    Good luck!

    Oh yeah, you can drink and take ibuprofen. Since both can irritate your stomach, make sure to eat and chew some antacids. No drinking with Tylenol.
  • ReismanRReisman Posts: 7
    edited 01/15/2015 - 5:56 AM
    I've had sciatica again for 6 months. In March 2013 I had a microdisectomy and was cured immediately. I also had 2 herniated discs. Now I have horrible sciatica and had 3 epidurals and wasted my money . They did absolutely zero. The doctor ( neurosurgeon ) feels he can go in and clean up scar tissue, open my spinal canal and help me with another microdisectomy. I trust him 100%. I am scheduled for Feb. 2 nd. I take 2-3 percocets a day for pain. This is no life. This is my last option. Tried pt too never worked.
    Roselyn Reisman
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