First off thank you for taking the time to read this. I have read these boards for sometime now and they have been helpful.
I am a 22 y/o male and I have had severe sciatic pain for almost a year now. I have tried physical therapy, transforaminal epidural steroid injection (TFESI), piriformis trigger point injection, and conservative treatments such as yoga, ice, rest, and moderate exercise. So far, nothing has helped.
I have a long history with sciatica. In August of 2010 I had to undergo a micodiscectomy/hemilaminotomy on my L5-S1 area because I was having similar sciatic pain. I was very overweight as a teenager but also very athletic - I played every sport, got into fights, wrestled, and did stunts and such with my friends. One thing led to another and my weight probably caught up to me. After my operation I lost weight and started taking my fitness more seriously and I was fine up until last summer.
Some time between May and June 2014, my sciatic pain came back with a vengeance. In the months before May and June, I don't remember feeling symptoms. I could sit and stand just fine. But then the pain just came out of nowhere. I don't remember falling or lifting anything particularly wrong to trigger it.
Since then, I have had severe sciatic pain and cannot sit or stand for any amount of time without it hurting badly. Laying down relieves it but only somewhat. It's still there when I'm supine just not as much.
I got an MRI of my lumbar spine in January 2015 that doesn't show anything significant. The doctors' only explanation is that scar tissue from the old operation is causing my pain. I don't believe this explanation because scar tissue wouldn't form so suddenly 5 years later. From my understanding scar tissue forms only a few months after the operation, and if it didn't cause pain then (which it didn't), then it shouldn't cause pain now.
I fail both the straight leg raise (SLR) and the crossed straight leg raise (XSLR) tests miserably (meaning both tests produce a lot of pain). One doctor thought I had piriformis syndrome but after several sessions of myofascial massage therapy and stretching/strengthening I had shown zero progress so I gave that up.
I don't know what to do. I'm very depressed and frustrated. I wish I could do the things that people my age are doing but I cannot. I've been housebound for nearly the past year. Is it worth it getting a second MRI? What about a CT scan? I've also heard that standing MRI's can reveal things that a standard supine MRI cannot.
I would appreciate any feedback.
L5-S1:Right hemilaminotomy and microdiscetomy post surgical change noted. There is T2 hypointense enhancing soft tissue signal abnormality within the right ventral and dorsolateral epidural spaces with encasement of the descending right S1 nerve root, consistent with peridural fibrosis.No definite residual/recurrent disc herniation. There is disc degeneration with loss of T2 signal and height. There is a mild diffuse eccentric to the right and mild ligamentum flavum and facet degenerative hypertrophy. No significant spinal canal stenosis. Mild right neurofroaminal stenosis.
Right L5-S1 microdiscectomy postsurgical changes, with peridural fibrosis encasing the descending right S1 nerve root. No definite residual/recurrent disc herniation.
There is nobody on the forum qualified to advise on an MRI finding all responses will be based on personal experiences only