Sciatica with no insurance. Help!

March 19, 2009 1:04 PM

I have numbness in my leg but no longer have the means to get it monitored. Is there any risk of long-term damage or atrophy if it goes on too long?

About ten months ago I experienced intense pain in one leg, followed by numbness in the front of my calf. (I've always had back problems, and I was in grad school and spent a lot of time sitting.) There was recently a question about this from someone with the same problem who hadn't yet seen a doctor. I did, and they gave me steroids and said go to physical therapy and strengthen my core and back. I had X-Rays and everything. But my insurance expired, and with it went physical therapy and any way to have it monitored. I think the numbness might be receding, but it's really hard to tell, and the leg is definitely still numb. I exercise regularly and have all but solved my back problems. My question: If my leg is still numb, can there be long-term damage or atrophy after a while? And does anybody have any experience with treatments that have solved the problem? One guy wanted to give me a cortisone shot back when it first happened. Many thanks!

posted by JamesWilson123 to health & fitness (10 comments total)

I know a friend who had a similar problem and it was due to his sciatic nerve. He went in for a cortisone shot - only to find out that the shot was directly into the nerve. He vows never to return for another.
posted by The Light Fantastic at 1:14 PM on March 19

I always thought that the numbness was caused by the nerve, rather than the tissue, so it seems unlikely there will be damage or atrophy.

The only way to cure this sort of thing is by exercising your core. Swimming works really really well for back injuries.
posted by KokuRyu at 1:25 PM on March 19

It sounds like you have nerve damage somewhere (could be anywhere, back, leg, hip...)

You should take a look at your daily routines, even your sleeping habits to see if there is some position you're putting yourself into that is causing the damage.

My experience was like this: I noticed a numbness in my left hand. Went in for tests and found that I had nerve damage in my elbow. The doctor said I needed to stop doing whatever I was doing that caused the damage or I'd eventually need surgery.

Turns out I had been resting my arm on my new desk in a way that put pressure on my elbow for a few hours a day. I switched my seating around and changed my posture. It took weeks but eventually the numbness went away.

Not sure if this is exactly the case with you, but that's my experience. YMMV.
posted by wfrgms at 1:32 PM on March 19

The front of your calf? Your calf muscle is behind the fibula and tibia. If by chance you mean the thigh, then you might consider the lateral cutaneous nerve of the thigh. If that is the case, I can tell you from personal experience that it very well may be permanent
posted by Neiltupper at 1:44 PM on March 19

First, a disclaimer: I am a medical student, not a doctor, and especially not your doctor.

That said, I'd like to chase this rabbit so that I might learn a bit and possibly help you out in the process.

Like Neiltupper, I'm confused by the "front of your calf" thing. Do you mean the front part of your lower leg, near your shin? And a few more questions...

1. Do you have muscle weakness too, or just numbness?
Reason for asking (RFA): Sensation and muscle impulses are carried by different nerve fibers. Figuring out if it is just one or both could help localize the lesion.

2. How would you describe the numbness? Is it constant or intermittent? Does it tingle? Is there anything you can do to make it better or worse?
RFA: Knowing this can help determine what's causing the problem.

3. If you were to draw a line around where the numbness started/stopped, would it match up with any of these colored areas?
RFA: This could help you narrow it down to a specific cutaneous nerve

4. Can you describe the pain from 10 months ago? Was it a pinpoint, a radiating pain, dull or sharp, etc? How long did it last?
RFA: Trying to figure out what types of nerve fibers were involved.

5. Can you reproduce the pain that you experienced 10 months ago? Possibly by doing something like this?
RFA: This is testing for "piriformis syndrome" which is fairly common. Some of your symptoms are close, but others don't match up - just don't want to miss something obvious.

Again, I'm no doctor, but I look forward to following this thread. I should also say that if you can figure out a way to see a doctor you should probably do just that. If there's a free clinic in your area, they should be equipped to teach you some exercises instead of sending you to physical therapy (b/c most of their patients can't afford it).

Hope this helps.
posted by stuboo at 2:36 PM on March 19

This helps immensely and I appreciate your interest.

1. No muscle weakness.
2. It's constant and nothing helps. I have had pins stuck in the leg and wasn't able to feel it. This is weird, but it tingles sometimes during sex.
3. It would not match a colored area in that chart. The numb area starts an inch or so below my knee for about six inches and is about three inches wide.
4 and 5. The pain was exactly like when you stretch your hamstrings in a door jamb by lying on your back with one leg straight out on the floor and the other at a 90 degree angle. You know that pain that comes with the stretch? Only I wasn't stretching and couldn't slacken my leg to make it go away. It started gradually and lasted a couple of days until I got the steroids in my system, but that's when the numbness started.

Additionally, I think it was brought on by vertebrae (L4 and L5, I think) constricting the nerve while running, which I haven't done since and never will again, sadly. And, I was on the road for three days before seeing a doctor, so all day in the car didn't help.

Also, to clarify, I was talking about my shin, or the front of my leg. "Front of my calf" - that was pretty smart. Sorry for the confusion.

Thanks again!
posted by JamesWilson123 at 4:59 PM on March 19

i dont need to know the answer... but is it any specific type of movement during sex that makes it tingle? meaning can you reproduce the movement NOT having sex? the reason i ask is that it could be a clue as to where the location of the irritated nerve is, and not as a physician but a medical professional i would be worried that if you can alter the sensation that it is possible that it can be changed, worsened or become permanent or may be reversible. until you can get physician relief take some anti inflammatories as long as your stomach and liver is ok! and keep up the exercise that strengthens your back and core.
posted by kgreerRN at 5:47 PM on March 19

does anybody have any experience with treatments that have solved the problem?

Sometimes, not keeping anything in your pockets will help with this. Cheap to try out at any rate.
posted by yohko at 9:17 PM on March 19

What you are describing sounds to me like a herniated disc (maybe b/w L4-L5) pressing on your sciatic nerve. The numbness you are experiencing could be from permanent damage to the nerve- meaning the nerve is no longer pinched, the disc and/ or surrounding inflamed muscle are no longer pressing on it b/c of time and phys therapy and meds.

The numbness could also be from ongoing and continual pinching of the nerve- which, overtime, can cause permanent damage. You would really need an MRI to diagnose what's happening. However, it does sound like the pinching has been resolved b/c your pain has disappeared. It can take many, many months for a nerve to recover after significant compression.

Exercising your core may or may not help you. Sometimes strengthening the abdominal muscles can support the spine in such a way that it helps to move a herniated disc ever so slightly back into place/ off the nerve.

This blog may answer a lot of your questions.
posted by hellboundforcheddar at 9:42 AM on March 20

Cortisone shots really help a lot of people by the way- but since your pain has receded significantly I would discuss w/ a neurosurgeon or orthopedist what the next step for you should be to address the numbness. I realize not having insurance is going to be an impediment...
posted by hellboundforcheddar at 9:44 AM on March 20