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Sciatica advice

  1. #26
    Angry Gumball RandyO's Avatar
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    Re: Sciatica advice


    Quote Originally Posted by Stromper View Post

    I assume she does not keep something in her back pocket but if yes stop
    been so long, but now reminded, my orthopedic doctor had me get my wallet out of my back pocket, and take my belt off and start using suspenders

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  2. #27
    Lifer tsorfas's Avatar
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    Re: Sciatica advice

    Sciatica advice-37b11f0c-00d8-4ad4-9827-5f1775c59d43
    We were instructed to schedule an appointment with a Dr about an injection. In the mean time can anyone help me understand what I’m reading because honestly I don’t get a thing from this.

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  3. #28
    Changes come butcher bergs's Avatar
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    Re: Sciatica advice

    Seems there's alot going on around the L5 disc.

    I will speak with a nurse I know to see if she can translate.


    EDIT: Text sent. Will post up when I have a translation.

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    Last edited by butcher bergs; 01-31-19 at 03:03 PM.

  4. #29
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    Re: Sciatica advice

    Quote Originally Posted by tsorfas View Post
    Sciatica advice-37b11f0c-00d8-4ad4-9827-5f1775c59d43
    We were instructed to schedule an appointment with a Dr about an injection. In the mean time can anyone help me understand what I’m reading because honestly I don’t get a thing from this.
    My interpretation of most of that is that it's all normal - with the exceptions of L4-L5 and L5-S1, if that is of any use.

    If I understand correctly, they're not seeing any direct nerve contact in L4-L5, but in L5-S1 there is a bulge 'abutting' the S1 nerve, which I suppose implies it can make contact with the nerve pretty easily through normal daily activity, but at the moment the picture was taken, it was not in contact. The Doc you'll be scheduling an apt with should know precisely what is being conveyed.

    The gist is that the doc will likely recommend a lumbar epidural where they inject a couple substances in the region between the disc and the nerve which can sometimes help reduce or remove the pain for some period of time. This lets you get full range of motion and exercise without the pain. Strength and flexibility can help prevent future contact. The epidural is just a quick procedure, no big deal.

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  5. #30
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    Re: Sciatica advice

    Word for word:

    Moderate, perhaps expected for the age of the patient, bone degeneration in lower back.

    Just above that, one of the discs between the vertebrae is breaking down, not as "cushy" as it's supposed to be. It is squished.

    Mid/ low back bulging disc with no nerve pinching (ie "ouch" but no neurological effects). Mid back, good.

    Lower back disc sticking out with some impingement of the nerves exiting the spine but not the spinal canal itself...possible neurologic symptoms such as numbness/ tingling likely in buttocks or lower extremities. Low back bone and disc disease with narrowing of "exit" holes for nerves that are branching from the spinal cord, but no obvious nerve impingement yet.



    Let me know if you have other questions based off these descriptions.

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  6. #31

    Re: Sciatica advice

    Your mom sounds like a good candidate for physical therapy. If the doctor doesn't suggest it try to make sure she pursues some

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  7. #32
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    Re: Sciatica advice

    Quote Originally Posted by butcher bergs View Post
    Word for word:

    Moderate, perhaps expected for the age of the patient, bone degeneration in lower back.

    Just above that, one of the discs between the vertebrae is breaking down, not as "cushy" as it's supposed to be. It is squished.

    Mid/ low back bulging disc with no nerve pinching (ie "ouch" but no neurological effects). Mid back, good.

    Lower back disc sticking out with some impingement of the nerves exiting the spine but not the spinal canal itself...possible neurologic symptoms such as numbness/ tingling likely in buttocks or lower extremities. Low back bone and disc disease with narrowing of "exit" holes for nerves that are branching from the spinal cord, but no obvious nerve impingement yet.



    Let me know if you have other questions based off these descriptions.
    Much appreciated Butcher!!!

    - - - Updated - - -

    Quote Originally Posted by joshk1025 View Post
    Your mom sounds like a good candidate for physical therapy. If the doctor doesn't suggest it try to make sure she pursues some
    Doctor did. Mom is against it because of the cost. $60/visit after insurance...

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  8. #33

    Re: Sciatica advice

    Quote Originally Posted by tsorfas View Post
    Much appreciated Butcher!!!

    - - - Updated - - -



    Doctor did. Mom is against it because of the cost. $60/visit after insurance...
    $60 a visit isn't so bad compared to the cost of surgery. She is still at the point where she could probably save her back and eliminate the pain

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  9. #34
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    Re: Sciatica advice

    Quote Originally Posted by butcher bergs View Post

    Let me know if you have other questions based off these descriptions.
    Pics of said nurse....

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    hmmmm......

  10. #35
    Senior Member Tas's Avatar
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    Re: Sciatica advice

    Quote Originally Posted by butcher bergs View Post
    Word for word:

    Moderate, perhaps expected for the age of the patient, bone degeneration in lower back.

    Just above that, one of the discs between the vertebrae is breaking down, not as "cushy" as it's supposed to be. It is squished.

    Mid/ low back bulging disc with no nerve pinching (ie "ouch" but no neurological effects). Mid back, good.

    Lower back disc sticking out with some impingement of the nerves exiting the spine but not the spinal canal itself...possible neurologic symptoms such as numbness/ tingling likely in buttocks or lower extremities. Low back bone and disc disease with narrowing of "exit" holes for nerves that are branching from the spinal cord, but no obvious nerve impingement yet.



    Let me know if you have other questions based off these descriptions.
    yep....mild progressing to moderate disc bulging at 2 levels not yet encroaching on the spinal nerves. Regardless of imaging you still have to take the patients symptoms into account and treat accordingly. pictures don’t always tell the whole story.

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  11. #36
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    Re: Sciatica advice

    Quote Originally Posted by tsorfas View Post
    Much appreciated Butcher!!!

    - - - Updated - - -



    Doctor did. Mom is against it because of the cost. $60/visit after insurance...
    going to a physical therapist more that once is a rip off, when I had sciatica, I never even went to one once, as I posted earlier, the doc gave me a booklet and circled the ones he wanted me to do

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  12. #37
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    Re: Sciatica advice

    Quote Originally Posted by tsorfas View Post
    Doctor did. Mom is against it because of the cost. $60/visit after insurance...
    While it can add up, doctors appointments, imaging, copays on epidurals and MRI's etc aren't cheap. I hope this doesn't come off as insensitive but that might also help characterize how much it's affecting daily life. Sciatica can vary in it's severity from minor annoyance to new levels of pain. It can be bad enough that you'll pay every dollar you have to make it stop.

    I believe any outcome is going to include an expectation that she begin regular core exercises. With proper form. That's how you prevent future additional injury, and how you keep stress off the spinal column. There's also a chance the doc you're going to consult with about an injection is going to recommend PT first.
    Quote Originally Posted by RandyO View Post
    going to a physical therapist more that once is a rip off, when I had sciatica, I never even went to one once, as I posted earlier, the doc gave me a booklet and circled the ones he wanted me to do
    I think that's a bit over the top, but I kind of agree in that they encourage you to go several times a week for a month or more when it's probably fine to go just a couple times. However, I think that depends on the person, how much coaching they need/want, and how much progress they're seeing own their own. If you're afraid to do the exercise properly because you know how much it can hurt, a PT can help. They can also spot dangerous habits.

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  13. #38
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    Re: Sciatica advice

    Quote Originally Posted by black View Post
    Pics of said nurse....
    Google "nurse" images. She's the 3rd row down, 3rd image from the left.

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  14. #39
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    Re: Sciatica advice

    Quote Originally Posted by Tas View Post
    yep....mild progressing to moderate disc bulging at 2 levels not yet encroaching on the spinal nerves. Regardless of imaging you still have to take the patients symptoms into account and treat accordingly. pictures don’t always tell the whole story.
    any advice that hasnt been mentioned?

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  15. #40
    Lifer tsorfas's Avatar
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    Re: Sciatica advice

    Meeting with neuro-specialist on the 14th or earlier if they have cancelations.
    No PT until then. We are expected to be told she should do an injection. Reading online about those seems like they do more damage than good and they certainly don’t last. But I don’t want to make a judgement call before actually talking to the doc.
    Chiropractor said he has been treating her for exactly that and she will get better in time, he gave her an additional 10 visits at no cost because he is confident that he is delivering the right method. We shall see I guess.

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  16. #41
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    Re: Sciatica advice

    Not the news we were hoping for. She met with dr Kumar from Pain Clinic of the St Vincent’s Hospital.
    He said that she has hernia on the left from the gel of the spine and arthritis on the right side.
    He said that injection won’t fix anything. It will just give “some” pain management. It depends on each person but it can be as little as 20 days and as much as 6 months.
    He said that PT / Chriro / Yoga don’t fix anything and they are only teaching you to ease the pain temporary.
    Last, the ONLY solution according to this doctor is surgery which has a 50-50 chance and again depends on the person.
    Needless to say this was not what we were hoping for at all

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  17. #42
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    Re: Sciatica advice

    Try a teeter hang up, should be able to find an old one

    Back surgery etc. is serious sh*t and should be last resort, your guts go on a table next to you

    Many times simple movement will stop further progression and usually pain will be ignored by brain eventually

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  18. #43
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    Re: Sciatica advice

    Quote Originally Posted by tsorfas View Post
    He said that injection won’t fix anything. It will just give “some” pain management. It depends on each person but it can be as little as 20 days and as much as 6 months.
    He said that PT / Chriro / Yoga don’t fix anything and they are only teaching you to ease the pain temporary.
    Last, the ONLY solution according to this doctor is surgery which has a 50-50 chance and again depends on the person.
    Needless to say this was not what we were hoping for at all
    I would absolutely get another surgical opinion - IMO back pain is typically managed by finding the right combination of treatments, including everything he just brushed away (to say injections don't work for more that 6 months is simply false - as they say, "while results will vary" my best friend had them two years ago and is still generally pain free). But, even if she got 6 months of relief from a 10 minute procedure, isn't that preferable to opening her up? The two surgeons I saw, both back specialists, said surgery is the last resort and should only be tried if everything else fails. They both recommended going to the hospital's pain management center (Tufts in my case) before considering surgery. Just my $.02. Good luck with it.

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  19. #44
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    Re: Sciatica advice

    Worth noting, surgeons tend to recommend surgery. Make sure you have copies of the MRI and look for a DPT who is able to read/analyze them and structure a therapy program which will strengthen the area around the injury.

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  20. #45
    Lifer
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    Re: Sciatica advice

    Quote Originally Posted by tsorfas View Post
    Not the news we were hoping for. She met with dr Kumar from Pain Clinic of the St Vincent’s Hospital.
    He said that she has hernia on the left from the gel of the spine and arthritis on the right side.
    He said that injection won’t fix anything. It will just give “some” pain management. It depends on each person but it can be as little as 20 days and as much as 6 months.
    He said that PT / Chriro / Yoga don’t fix anything and they are only teaching you to ease the pain temporary.
    Last, the ONLY solution according to this doctor is surgery which has a 50-50 chance and again depends on the person.
    Needless to say this was not what we were hoping for at all
    I've unfortunately met with several doctors over the years in this field. Every single one has cautioned against surgery, saying it should be avoided at all costs. Although I guess that's with the assumption it isn't meeting certain criteria like imminent severe nerve damage. The healing process is also likely to worsen her atrophy and make it harder to recover. At least one warned me that 'surgeons like surgery. they have a hammer, and everything is a nail'.

    The injection is quick and pretty easy. Kinda surprised he'd recommend surgery before at least trying it once. The rule of thumb seemed to be about 6 months but results vary.

    My perception of this field is that circa maybe 1980 to 1990, the primary recommendations where bed rest and rather crude surgeries. The more current view seems to feel that was dangerously wrong. But it's possible there are still some professionals preferring what might be a dated view. At the very least, get a second opinion. And with back surgery, I'd be seeking a third opinion. I'd ask if any doctors would like the idea of trying an injection asap while options are being considered.

    If I can make some assumptions about what the doctor may have been trying to convey - there is a bunch of feel-good quackery out there that I wouldn't waste even 5 seconds on. I think most of those people genuinely believe in their stuff, and want to help. It's just misguided. You aren't gonna fix a ruptured disc rubbing on a nerve with some mind-body-soul realignments.

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  21. #46
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    Re: Sciatica advice

    Shots are limited in what they will treat I think. In my case, the joints had been inflamed for so long that the shots were used to break that cycle. I don't know that they would do anything for disc or nerve damage?

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  22. #47
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    Re: Sciatica advice

    Quote Originally Posted by Bonk! View Post
    Shots are limited in what they will treat I think. In my case, the joints had been inflamed for so long that the shots were used to break that cycle. I don't know that they would do anything for disc or nerve damage?
    I don't think they'll do anything for nerve damage. Just relief from the pain. Which allows the patient to increase their activity levels. Otherwise you feel trapped because moving and bending causes the sciatic pain to increase.

    The goal of a lumbar epidural is really to buy time. If I remember right, the herniation will typically dry out and naturally recede over a couple years. But there is lingering problems from atrophy/inactivity/learned pain-avoidance habits that can occur if not remedied soon. Which may be a factor in the surgeon's recommendation to skip it and just get on with what they felt was inevitable.

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  23. #48
    Angry Gumball RandyO's Avatar
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    Re: Sciatica advice

    she may be a candidate for a stimulator Spinal Cord Stimulation Systems | Medtronic

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  24. #49
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    Re: Sciatica advice

    Also, if her injury is due to years of lifting packages, what about an inversion table? I have a similar injury and I am going to give one a shot - they're all over Craigslist so it wouldn't cost much.

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  25. #50
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    Re: Sciatica advice

    Quote Originally Posted by Bonk! View Post
    Also, if her injury is due to years of lifting packages, what about an inversion table? I have a similar injury and I am going to give one a shot - they're all over Craigslist so it wouldn't cost much.
    I actually have one. I’m about to give it to her to try out.

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