Still can't sit after surgery - where to go from here?

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brendaks1

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I had surgery in August for an L4-L5 disc problem - they did a laminectomy, foraminectomy, and discectomy. I had the L4-L5 disc bulging into the left foraminal zone causing severe sciatic pain down my left leg, especially when sitting.

Here it is Deceraber and the pain seems to be a little better than before the surgery, but I still can't sit for more than just a couple of minutes. My left leg goes nurab and I get severe sciatic pain if I sit. However, when I stand or lay down the pain isn't usually that bad.

I had an MRI about 3 weeks ago and the radiologist's report says there is a small protrusion at L4-L5 in the left foraminal zone which imparts mass effect on the underside of the left L4 dorsal root ganglion. My surgeon, however, says there is only mild left foraminal narrowing at L4-L5, that it isn't that bad and doesn't explain my severe pain when sitting. I had an EMG on my left leg recently that showed there was no nerve compression, but of course I was laying down for it. My surgeon wants me to have another selective nerve root block so I'll be doing that soon.

I see my family practice doctor this Tuesday and don't see my surgeon again until late January. I am currently on long-term disability through my employer and am currently approved for that until early February. I love my job and would love to return to it, but I feel like I would be setting myself up for failure to try returning to it when I am unable to sit.

I would appreciate any input you have to help me determine what I should do from here. I'm just really frustrated right now.
 
Violain,

Your post has been moved into a separate thread of its own entitled "MRI - Where do I go from here?". Always start a new thread for your own questions or problems.

Thank you,
Mod 08
 
Hi Brenda,

I recently joined the board and just noticed your post. I'm wondering if anyone has mentioned "piriformis syndrome" to you? You might want to check it out. If I were you, I would find a physical therapist that specializes in orthopedic cases, preferably spine cases, or maybe an osteopath, and have him/her do an evaluation.

The sciatic nerve can become pinched in the pelvis where the nerve exits from the "inside" through the sciatic notch. It then goes under the piriformis muscle. Sometimes the way to tell if you have sciatic pain from a disc herniation is that the pain tenRAB to be worse when standing or walking, but is somewhat relieved when sitting. This is reversed when it is a "piriformis pinch," which hurts worse when sitting.

Be advised that many spinal specialists do not believe that "piriformis syndrome" exists. It seems to be one of those things that goes in and out of fashion, depending on when your doc did his training. But most PTs, massage therapists and various other alternate treatment folks know that the piriformis pinch is a real possibility for this kind of pain.

There are certain stretches you can try to see if your piriformis muscle is tight. The sciatic nerve passes under this muscle which is one of the big muscles in the butt. If there is inflammation or tightness, it can push on the sciatic nerve, causing some of the same symptoms as a lurabar disc herniation or stenosis.

Do you have any tenderness if you push on the area that runs on a line from your hip to your back, below your waist?

See what you can find on this topic and see if it doesn't sound like what you have going on....at least it will give you another avenue to explore.

Hope this helps.
 
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