Sciatica Problems - looking at fusion

[hobbes50]

Hi, this is my first post here. I just had an EMG (after 2 MRIs) and the doctor doing it said the results were much worse than he expected. The L4 and L5 vertebrae have degenerative disk disease and are severely pinching the sciatic nerve. I've had terrible low back pain extending into my buttocks, primarily the left one and down the left leg to the point of making it practically unusable for months. The pain actually started some 20 years ago after a work accident of just lifting a box of books from my desk to the floor and ending up with a diagnosis of sciatica. Since then the pain has been off and on. In the last 6 months, though, it has gotten significantly worse and now my days are spent mostly in bed or on the couch because of the hideous pain. My pain doc has tried epidurals, muscle relaxants, various pain medications, and nothing works except to make me sleepy. In the morning when I get up, my feet hurt to walk on. If I stand more than five minutes, I start crying from the pain in my left leg. I can't sit for more than ten minutes. It's just horrible. And no way to live. There have been times if I had a pistol, I'd end it all. My partner insists we see a neurologist and look into fusion. I have one more appt to see the pain doctor to go over the EMG and get on more injection into the sacroiliac joint.....I could just really use some shares from people who might have been in my position. Also, I have had some incontinence problems of almost not making it to the bathroom in time and this is fairly new in the last six months........thanks for listening....

 

[tetonteri66]

Welcome to the board. I can assure you that there are many merabers who share or have shared your issues with sciatic pain. Perhaps I am mistaken, but your post leaves me with the impression that you are not under the care of a spinal specialist? If not, I would suggest you see either an orthopedic spine surgeon or a neurosurgeon who devotes the majority of the practice to issues of the back and neck. Many people do not realize that orthopedics is a large field with sub specialties, so you want to be sure to find one that specializes in spine care, and does not also do things like joint replacements, etc. A neurologist is useful in some cases, but this specialty can tell you about the nerves but not about the mechanical structure of the spine. They frequently do testing for spine patients that has been ordered by a neurosurgeon or ortho spine surgeon.

Regarding your specific problem, it sounRAB like what you are experiencing, if you have DDD at one segment, is that the disc is wearing away, which allows the two vertebrae to come close to touching. This issue, along with other issues that go along with DDD result in the nerve root being compressed as it exits the spine at the level of the L4-L5 vertebrae. These spinal nerve roots run in predictable patterns out from the spine to innervate various parts of the body. With the lower lurabar nerves, they run down to the "cauda equina" where they co-mingle and connect to the sciatic nerves as they branch into each leg. When the nerve is compressed in the lower back, it causes the symptoms that you feel in your legs, buttocks, ankles and feet. Sometimes pain is also felt in the "hip" area and groin.

Fusion is the most drastic way of dealing with a nerve compression, but there are other, less invasion treatments as well. I encourage you to get a copy of your MRI if you do not already have one, and take it to a spinal specialist. He/she will be able to examine you and put together the information gleaned for the physical exam, your description of your symptoms, and the imaging to make an informed diagnosis. Treatment may or may not include surgery...but do not assume that fusion is the only option. It would be the LAST option you would be offered.

Have you mentioned the incontinence problem to your doctor. When you already have a known issues with the L4-5 segment, signs of bladder or bowel involvement are a possible symptom of "cauda equina syndrome." Not to scare you, but, this should be brought to the attention of your doctor as soon as possible. CES has the potential to cause permanent nerve damage, but can be treated if caught early.

 

[maltluver]

Tetonteri, is as always, right on target. I wouldn't put off seeing a spinal specialist as soon as you can. Keep a close eye on that "bathroom" issue and report it to your doctor . Cauda equina is nothing to fool with and you need to get an MRI.

If you should have a sudden loss of ability to hold your bladder or bowels, I urge you to go the the Emergency Room.

Please do stay in touch with us and let us know how you are doing.

Carol

 

[MrBurton]

Welcome! I am a male so I can't talk about incontinence issues. I can say this. Let surgery be your last option... the pain.. yes I have had sciatic pain where I cry when I walk... fixed with a chiropractic adjustment... emergency room pain.... I had a spinal tap done and PDHP or Post Dural Puncture Headache is nothing to laugh at.....

So do find a spinal specialist. A chiropractor that has a decompression machine and one that has a 'family' practice is the best to go to. I say family practice because they usually offer a cheap ROF/initial consult (sometimes free!) And then a regimen to decompress your vertebrae. And yes do tell him/her about your other issues... I do have some light to shine on your other issue with an analogy...

There was a study of people who died from kidney failure...(sorry don't know the source) 90% of the cadavers had a thin or disconnected nerve from their kidneys. Tracing the nerve back to the spine it was found that the vertebrae had pinched the nerve so much that the nerve atrophied.... further study revealed that all of the people, during life, where diabetics....

I would research or ask the chiropractor if the sciatic nerve provides some 'feed' to the uterus, bowels or bladder... worth a look at least.

The chiropractor will also (at least the good ones) will support or at least pro-long the need for surgery while keeping you out of pain.... Your doctor may also know a good chiropractor... never hurts to ask.....