gapcheryl,
I am sorry to hear you are having problems that bring you to meet us here.
Unfortunately, sciatica and disc problems can sometimes be very difficult to diagnose. Often an MRI will clearly show the problem and the options for a fix are laid out, but sometimes the answers aren't clear at all and can be very frustrating to work through. I had one of the tough to diagnose cases. My sciatic pain was along the S1 dermatome, but the only problem that showed up on my MRI was a broad-based disc bulge at L4/L5 which usually doesn't cause S1 sciatica (L5/S1 usually does). Furthermore, I had an unsuccessful decompression surgery at L4/L5. After many second and third opinions and tests, a discogram and upright MRI finally showed a huge tear in my L4/L5 disc along with it bulging out severely to the back when I would sit. I recently had an L4/L5 fusion and while I still have a long road to recovery, I finally feel like my problem has been mostly fixed. I am still having sciatic pain when I sit, but it is not as bad as it was before.
In your case, an L1/L2 disc herniation is not nearly as common as the two bottom levels and doesn't explain why you would have sciatic pain into your ankle. Many disc herniations are asymptomatic and your L1/L2 herniation likely is that. I would suggest looking up dermatome charts on the Internet to see which disc level matches up with your sciatic pain. It may be a level off like mine was, but should get you closer to where the problem likely is. I'm no doctor, but I have a strong suspicion you may have a tear or herniation at L4/L5 or L5/S1 that didn't show up on your MRI. I once heard that MRI's only catch something like 85% of all disc herniations. Whatever the statistic, MRI's are less than perfect to show disc problems. Sciatica is almost always caused by a lurabar disc problem.
Do you find that your problem is worst with certain positions or activities (i.e., sitting, standing, walking, laying down, lifting, bending, etc.)? If your condition is worse with load bearing or sitting activities that place more pressure on the lurabar discs, I would suggest really pushing the doctors for an upright MRI. However, they often reserve this expensive test as well as many other tests for people more advanced than where you are at.
When dealing with a condition that has the potential to take you out of work for a period of time or that was possibly caused by your work, it is extremely important to get at least one or two doctors that are firmly on your side, and that will support you for LTD claims or worker's comp paperwork. Chiropractors and physiatrists are often helpful to consult with for this in addition to a spine surgeon.
EMG's don't always show a problem - they only show it if it is severe enough, so a negative EMG doesn't necessarily mean you don't have a problem.
Also, if you are not able to return to work really soon, it might be worth consulting a disability/worker's comp attorney for advice. It shouldn't cost you anything, and could be extremely valuable in case your problem requires future surgery or extensive rehabilitation. Sometimes they can present a case that your heavy lifting at work was the cause as you don't do heavy lifting in your personal life, even if there isn't solid proof that your job was the cause. Also, if you don't get relief soon and your doctor doesn't have answers, you may need to go for multiple additional opinions and tests and may need to be very assertive to get them. If your insurance allows it, a consultation with a fellowship-trained spinal surgeon would be helpful at this point also.
Now that I've covered some of the worst-case scenario issues, I want you to know that most cases of sciatica are corrected with time (lots of it!)
and conservative treatments, so don't think that you will necessarily need surgery or be out of work.
Best of luck to you and ask any questions you want here, and keep us updated with your progress! I ended up losing my job and having to go out on disability, and I understand how frustrating it is to be facing the decisions of what steps to take to protect your health and yourself financially.
