Sciatica-- now it's surgery.....

[grgreer]

I thought I would post this question on the Training forum. The plyometric exercises that I did this off season finally caught up with me. I have been dealing with sciatic pain from my belt line to below my knee on my left side for a little over a month now. I went to the Neurologist, who wants to cortisone inject into the disc space (of course). I have an MRI upcoming on the 1st. I have also gone to a local Chiro, who recommended extension exercises to move the disc back in place, and treated the pain with trigger point electric stimulation and accupuncture. I was able to get some from relief at the Chiro. He feels that I do not need the injection, and that I can heal up with stretching and other non invasive techniques.
I have not been to the gym to work out for over a month. That is the longest lay off that I have had in over 8 years. At this point, I don't know when I will get to throwing. I was looking forward to more events this year, but I don't think that is going to happen.
Has anyone had Sciatic pain? What did you do to fix it? What do you recommend, what do you not recommend. How long did it keep you from throwing/ working out?
Thanks for any input.
Gordon

[FrankH]

I have had this problem; unfortunately it usually requires lots of rest. It's frequently the result of inflammation, where you have an injured/swollen muscle compressing a nerve. So Ibuprophen/Motrin for a few days should help, but don't overdo it. The Dr might prescribe prednisone, a stronger anti-inflammatory. Hot bath/heating pad too, and light stretching.

if that doesn't do it, time to let a doctor do his thing. JMHO.

[Rich McClain]

I use to have this issue on a regular basis. As Frank said, "It's frequently the result of inflammation..." I had a really bad back injury years ago. Since then if my hamstrings get too tight, the pull will cause sciatic pain. When the pain returns, which is rare these days, I focus on holding my abs in for about 15 minutes. This usually allows my lower back muscles relax and my bones shift back into place. To the best of my knowledge cortisone is not a fix ever. My experience is similar to the direction your Chiro is giving you. Stretching and electro-stimulation helped me out during the first months of my injury. I make sure I do core work every workout and stretch regularly.

Hope you get it sorted out.

[robert monroe]

make sure that you get the right diagnosis.i am a 13yr massage therapist and have been working with a chiropractor for 11yrs.we see a lot of people who exiibit symptoms of sciatica but more often than not it is piriformis syndrome.the sciatic nerve runs through or under the piriformis and if that muscle is tight/inflammed it can give rise to similar pains associated with sciatica.aggressive stretching/ice are miracles.a foam roller would be your best bet along with ice.frequency is key concerning recovery...i cannot recommend any anti-inflammatories but i use advil/tylenol on a rotating schedule.you also might want to focus on hip flexors too,if you have pain in one are then you usually will have an imbalance in another'opposing/opposite' muscle....cotisone works well but its not a fix and it might not take.,i had 2 shots in my shoulder for a partial thickness tear in august of last year and am still in pain today.less die to my rehab but zero effects with the shot.try massage and get yourself a foam roller.it will work wonders.

[Mike Wills]

Thorough warm ups and stretching - especially hamstrings and hip flexors
Foam roller, emphasizing IT bands, hamstrings, and whatever is at the top of the hip ledge on the back
Press ups
Inversion table and inversion table crunches
Most important - and the only thing that I know that will really help in a short period of time: Reverse hypers...the lower back miracle movement!!!!

[grgreer]

Thanks for all of the recommendations. I plan on staying away from the cortisone injection. I hope that the MRI shows something of the piriformis, but in talking with the chiro (72 year old who has seen alot of people) It is probably a disc bulge that the extension stretching is going to help. I have some pretty tight hams, which does not help. A reference book that he brought out that showed the areas of pain in relation to certain muscles indicated Glute medius and Glute minimus involvement. I am going to wait until pain free to start throwing. The hardest thing is not doing something that bothers it. It starts to feel OK and I do something to tweek it. I gotta get smarter.
Gordon

[grgreer]

Rich,
did you have bulging discs with your injury? My MRI shows a pretty good bulge at the L4-L5 area.

[grgreer]

Just to update in case anyone was wondering. The radiating pain ended up in a chronically tingling left foot. Pain in the left side of the buttocks and posterior of left leg is still there. I decided to get the cortisone injections (MRI shows foraminal stenosis at L4-L5, increased disc bulge at L5-S1, so two injections). The shots ignited some pain down the left leg, said to be due to the inflammation of the nerves. I laid around all day to let the shot work. I should know if I get some relief in a few days.
I have pretty much written off the 2011 highland games season. I will be on the boards and still have faith for a recovery. Being away from the gym for two months is killing me. I have not had this kind of layoff for more than ten years. I do have the name of a practice in Towson-the Towson Orthopaedic Asociates -- Scoliosis and Spine Center. I have a personal friend that went there 10 years ago, had a disc replacement, and feels great. I plan on making an appointment and having a consult, just in case I need to go to the next step.
Everyone have a great season. I hope to see that Gerry gets his first caber turn this year.

Stay Healthy, my friends.

[robert monroe]

hope you have a speedy and effective recovery.ice & stretching seem to be very effective with anyone i have worked with in that capacity.go slow and listen to your body.good luck

[grgreer]

Just thought I would give everyone an update. I did Electronic stim, stretching, Chiropractic, accupuncture, cortisone injections (2- one at L5-S1 and L4-L5), PT (which in combo with the injection gave pain relief and my flexibility back), and nothing got rid of the tingling, numbness and pins and needle sensation. SO, I went to Towson Spine and Scoliosis center. I have Lumbar stenosis and a ruptured disc.
I am to have surgery on July 25th and be home on the 26th. I am having a discectomy to remove the ruptured portion of the disc (they are leaving the disc in place) and a Laminectomy to relieve the pressure from the stenosis (decompression). I am told that I will not need a fusion or rods. The Surgeon feels that I should be able to get back into the games next year. I was told not to throw for at least 6 months. I feel comfortable with this surgeon since he works on NFL linemen who are still playing.
I hope to be back out next year. Hope everyone PR's this year.

Gordon

[FrankH]

I had a lumbar laminectomy (L4-5) in 1989. With all the new technology and minimally-invasive techniques, I'm sure you will have good results and I hope you're doing well.

Unfortunately in my case, I delayed my recovery by trying to rush it. I was back in the office, with the wound still oozing, a week or so after being released from the hospital when I had been put on 6-8 weeks bed rest. I had complications for several years afterward because of it. Not having learned anything from that experience, I tried to rush my recovery from my brain hemorrhage in September, too-- and finally backed off. Hopefully before I did any damage.

So my advice, for what it's worth, would be to make sure you take your doctor's advice. If he says 6 months, take 6 months-- even if you feel OK. You will return faster in the long run, and healthier. You'll be glad you took the time to do it right.

Good luck; take your time and heal up nice and slow. Hope to see you on the field next year.

--Frank

[grgreer]

Great to hear from you Frank. I am sorry to hear that your laminectomy did not go so well. I have a 3 inch scar (staples). The biggest thing right now is pain control. I have no oozing or anything. I am able to do stairs and everything. I definitely plan on taking it slow. My plan is to get back to the games next year, even if it is only one or two events. They are addictive.
I hope that your recovery continues. even if it takes you longer than you would want. i can't wait to see everyone on the field next year. I am waiting till about February to figure out a games to target for a return. I also am going to try to drop about 40 pounds and take some stress off of my body. This episode was my wake up call to get off of the heavy weights and quit walking around at 300.
See you on the boards my friend.

Gordon