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Newbee w/Siatica

PostPosted: Thu Mar 15, 2007 10:10 pm
by Butch
Hello all. I love these online forums. So much info at your fingertips.

My situation is similar to many others. Herniated disc is pinching my siatic nerve. It all started Jan7/8. Had some pretty strong pain down the back of my leg, wasn't sure what happened, took a hot bath and the pain went away, then my foot started going numb. I lost strength in my right calf. The pain hasn't come back since. I could barely walk. Did some PT. That helped. I can now walk ok , but with a limp. I'm really afraid of permanent damage. Now that it's mid March I'm working on 9 weeks. My Sergeon said I don't have alot of options. I feel he's pushing towards surgery as a quick way out, and a mortgage payment. Sorry I don't mean to offend anyone by that statement, but that's what I'm afraid of. I'm sure there are many very good doctors that would rather not operate.

My question is this , I know if I let it go too long there is a chance of permenant damage, but how long is TOO long? I believe my nerve is still pinched cause the doctor checks my Achile's reflex in the bad leg and gets nothing. ALL other reflexes work fine. Is this a big deal?

Thanks for any info...
Butch

PostPosted: Fri Mar 16, 2007 8:02 am
by Guest
Hi Butch,

Your sciatica sounds similar to mine...I too had pain (severe, for nine weeks) that finally subsided. I also had muscle atrophy in my left leg: calf, thigh and buttock. A physiatrist measured my calf and found that it was 1 cm smaller than the good leg. I had numbness and pins n' needles in my foot as well.

I was scheduled for surgery, but four days before that the pain stopped. I decided to wait and see before going to surgery.

This month has been a time to watch my leg weakness and numbness and see if it improved, got worse, or stayed the same. I was told that if it got worse, I would need surgery. If not, surgery was 50% indicated, whatever that means.

I've been walking daily, and doing stretching and strengthening exercises specifically to get the strength back in my leg. I'm starting to see some improvement in muscle strength.

I don't know how long before nerve damage becomes permanent. I think doctors, surgeons in particular, always warn of the risk of permanent damage because they want you to be aware of the risks.

The way I see it, I'm taking a gamble whether I have surgery or not. Each choice has different risks. So far, I'm happy with my choice not to have surgery.

I've met several people who recovered from muscle weakness and atrophy from a pinched nerve without surgery, but again, there are no guarantees...

Leigh

PostPosted: Fri Mar 16, 2007 8:04 am
by cygnet
BTW - that was me posting above. I didn't realize I wasn't logged in!

PostPosted: Fri Mar 16, 2007 12:18 pm
by Butch
thanks for the reply.
I talked to my surgeon today. He suggested surgery, but said let's give it another 4-8 weeks and see if there is any improvment. He said I certainly could try other treatments.

Over the last 4 weeks I haven't really gotten any better. My walking has gotten better, but the weakness is still just as bad.

As a I stated before what really worries me is my nerve is still pinched. This is proven by no reflex in my Achiles tendon. Anyone have a nerve pinched this long?

PostPosted: Fri Mar 16, 2007 2:39 pm
by cygnet
I have no reflex in my left achilles tendon either. It's been gone since early on. Physiatrist said that was probably permanent.

I can move my foot normally, so I don't know what having no achilles reflex means in terms of functionality. It doesn't seem to matter for doing things you want to do. Does anyone know more about this?

My injury began on November 30th, 2006. It has been 14 weeks now. I am assuming that since the pain subsided and the weakness in my leg has improved, that the herniation has begun to be reabsorbed and is not pressing on the nerve to the same extent as earlier. This is just a guess though.

I had a massive left paracentral herniation that broke through the ligament and impinged on the thecal sac. I read that very large herniations that leak into the spinal canal are reabsorbed more quickly than smaller ones, possibly because the immune response is greater (found studies by doing a Google search on the terms spontaneous resorption herniated disc). Hoping that is the case with me.

PostPosted: Mon Mar 26, 2007 5:00 am
by randolph
Hi Butch

Be sure to read the NYTimes articles that Leigh recommended and linked us to a few months back. Apparently the rush to surgery that your surgeon feels, is not based on a factual, real need for surgery ... it's just the popular opinion. I got the same "prediction of doom" from an orthopaedic surgeon regarding my sciatica symptoms, muscle weakness, and nerve damage, and have recovered without surgery. I'm pretty sure the surgeon who recommended surgery for me was motivated by more than making another payment on his beemer (you do wonder though sometimes ...), but his training was in surgery, not physical therapy. You know the old saying: give a man a hammer and everything looks like a nail.

As long as you make steady improvement with the exercises, even if slow (as mine was) and even if you haven't regained full function by the 8 week window your surgeon gave you, I'd continue with the PT.

Randolph

PostPosted: Mon Mar 26, 2007 11:21 am
by cygnet
Hi Butch,

I'm not checking in much lately because my computer died. It's in the shop. I'm at the public library at the moment.

Anyway, I just wanted to add that you might want to check the Resources page of this website. Dean posted a link there to the Physicians Neck and Back Clinic. I found an essay on that site very helpful.

It's listed under the Research and Information section. The title is, "The Herinated Disc: New Concepts and Treatments".

The article specifically addresses neurological symptoms caused by herniated discs. What was interesting to me was that they stated that (I'm paraphrasing here) neurological and motor deficits are common, but progressive deficits are uncommon. Based on their research, only progressive deficits - where weakness or numbness is getting worse over time - require surgical intervention.

Good luck and I hope you're feeling better.

I wasn't able to improve muscle strength until after the nerve pain in my leg subsided. I waited 9 1/2 weeks before the pain went away, then another couple of weeks before I felt ready to do more than gentle stretching and walking.

I've seen major improvements in strength and numbness in the past several weeks. I can now walk at a normal pace again, without a limp.

When I was in pain, I didn't think it would ever end. Hang in there!

Leigh

PostPosted: Mon Apr 02, 2007 8:50 am
by Butch
thanks for the info I will check out the link for sure.

I have seen a very small improvment. I can flex my calf muscle a little bit. So I can feel that there is a muscle there. My walking has improved. I still walk with a slight limp, but not as much. I think one place I differ from most cases is I have no pain at all. I only had pain the very first day. That was it. Pain went away and numbness and weaknes set in the first day. I'm working on 10 weeks of no pain. This is what worries me. I understand and most cases see improvment after the pain subsides.

I downloaded Dean's book. Very informative. It turns out I've been doing the Cobra all along.

One thing that may be a hinderance is I've had a cold for the last 2 weeks with a bad cough. When I get a coughing fit I can feel it in my lower back. This can't help things.
Thanks for the replys, guys
Butch