I've had sciatica for a while but this is new and terrible
March 1, 2020 9:17 AM   Subscribe

I've had a herniated disk for decades and have had sciatica related to this, mostly years ago until I learned new movements and core strength and got mostly rid of it. I did something a week ago that reactivated it, and it's mostly okay and manageable except I get these moments of excruciating, screaming (literally) pain that last for usually under 10 minutes. They come on without any evident stressors that I can tell and they are really debilitating but then they let go and I'm back to just having my sciatica acting up, which is a pain I'm familiar with. Anyone know what is going on with me?

Also, any suggestions on how to live through these pain attacks with a bit more grace than I've displayed during the last few would be welcome. Writing on my bed shrieking obscenities is not good form, truly.
posted by hippybear to Health & Fitness (16 answers total) 5 users marked this as a favorite
Two personal experiences only:
1. Any new belt has to be test-driven before I make an appearance in it, because they always cross your back at a different point and it might be "the" nerve jangler.
2. I carry the thinnest billfold - ID and two cards max, because even three folded bills in there can set it off.
I also live where the temperature never goes below fifty degrees, because any chillier means a week of agony. Heating pad does give site specific relief. My doctor pointed out magnesium deficiency may aggrevate it, so find a good online source for Centrum Silver for men.
I literally feel your pain.
posted by halfbuckaroo at 9:35 AM on March 1, 2020

I wish I had something immediately useful for the pain attacks. I don't. But as someone a few years further down the line than you (I just turned 60), one of the hardest, most fundamental realities I've had to accept in the past decade is yes, I'm getting older. I'm aging. I can eat well, stretch more, exercise more, take my vitamins or whatever ... but the age thing is not going away.

So what have I done that's worked to address the symptoms that were pretty much driving me to despair seven or so years ago? It took a while but I finally accepted the fact that I had to stop aggravating things, to slow down. In general. But also in particular. I literally do not walk as fast as I used to. Which was an incredibly hard thing to train myself to do. Because I could keep achieving my old pace -- it's just that later, that night, the next day. That's when I'd get the pain.

A good friend who's a little older than me warned me way back when, "Watch out for your fifties. You can still fool yourself that you're maybe going to live forever while you're in your forties. But nobody gets through their fifties without something going wrong."

And finally -- far from filling me with despair, accepting the reality of aging has actually freed me from it. Some of it anyway. Insofar as it's forced a sort of stoic maturity I didn't have before, and this has its own rewards.

Hope some of this helpful.
posted by philip-random at 9:59 AM on March 1, 2020 [4 favorites]

It could be your piriformis or your psoas. The only suggestion I have for either is physical therapy.
posted by Medieval Maven at 10:12 AM on March 1, 2020

Back Mechanic is a must.
posted by cotton dress sock at 11:02 AM on March 1, 2020 [2 favorites]

The video in this previously might help you.
posted by MexicanYenta at 11:15 AM on March 1, 2020

I too have back/disc issues for decades (sportsball of all kinds) and had my first sciatica attack last May, a few days after returning from weekend trip which included 1000+ miles of driving. I was in constant/chronic pain for any movements I made. I could lay in the fetal position on the couch, but that was it. I saw my GP a few days after the first symptoms, and she put me on Gabapentin and OTC pain relievers (Tylenol, etc). I got NO relief from any of these, and found myself rather depressed, especially as I continued to lose sleep. I was in the way for 7 days.

I decided to see a local chiropractor who works in our hospital system's sports medicine facility, and fit me in the same day I called. The treatment was very slow stretches consisting of my being on my stomach, and the table being tipped while my chiropractor used his hand as a fulcrum — around the sacrum in my case. I felt significantly better after the first treatment and went back to work 2 days later. I followed up with the chiro one more time a week later, had another of the same treatment and was released to do PT exercises at home and lots of walking. I did have to use a cane for about a week to steady myself in case of sudden flair-ups.

Unfortunately, I can't do many exercises for the core due to an injury that is exasperated by such things. Pisses me off, because I was getting a lot out of light yoga prior to that, and recommend it.

* Ice on/off every 15 minutes.
* I do #1 & #2 of the poses/stretches here as long as there is no pain (IAMNYY).
* Consider a chiropractor if there are licensed practitioners near you. Should only be stretching and not adjustment.

Good luck!
posted by terrapin at 12:01 PM on March 1, 2020 [2 favorites]

I'm sorry you're experiencing this. My wife has experienced a period of brutally painful sciatica from a disk herniation (L5-S1). At its worst, there was a period of a few months when she could hardly move, couldn't work, couldn't sleep, and she got very depressed.

Here's some advice for living through the pain attacks. My wife's physiotherapist recommended that, in addition to the limited physio she could perform with such a keyed-up nervous system (and in addition to the Lyrica she was being prescribed), she should do this series of workbooks and videos about understanding pain and differentiating it from active danger.

If you've gone through major pain episodes before, this might be basic to you, but for us, it was revolutionary. Her worst sciatica episodes were sending both of us into sheer horror and panic on top of her pain itself, and the videos really helped us reconceptualize the pain.

This was over two years ago now, and we still think of it as the turning point, where she started to come back from rock bottom.

Good luck, and again, I'm sorry.
posted by Beardman at 1:34 PM on March 1, 2020 [3 favorites]

I have trigeminal neuralgia, so I feel you on the pain attacks. I'm sure you're familiar with all the recommendations for reducing chronic pain (getting enough sleep, controlling stress, etc) so I won't go into that. When I'm having attacks what helps is closing my eyes and focusing on my breathing. I try to think of the pain as something that's just there, it's just passing through, and it's OK. This is extremely hard when it feels like lightning is attacking my face, but when I can reach that state of stillness it does help. Basically it's mindfulness work and focusing on staying in the moment and existing in your body rather than focusing on the pain and how much it hurts. I'm sorry you're going through this!
posted by schroedinger at 1:56 PM on March 1, 2020 [1 favorite]

It might not be sciatica- I had sciatica like symptoms that actually came from a gut infection. I guess the irritation in my intestines somehow inflamed or pressed on the nerve in my pelvis? It went away when the stomach problems did.

But in general you should stretch your hamstrings, hip flexors, including psoas, quads etc and your piriformis daily twice. Gently. Then walk for at least 10-20 minutes afterwards if you can. It'll make a huge difference. You can find lots of youtube videos online about how to do so.
posted by fshgrl at 2:04 PM on March 1, 2020

Magnesium cream for nerve pain (and other pain) management.

However, surgery is another option to permanently take the pressure off the nerve (e.g., microdiscectomy).
posted by heyjude at 2:30 PM on March 1, 2020

If it doesn't resolve in a couple weeks and you have good health insurance, go get an MRI. I know there's an argument to be made that with back issues we do too much scanning. I have made that argument myself. But sometimes scans are really helpful. About five years ago I had an onset of terrible sciatica. I'd had it before on the other side, so I waited for it to go away. I saw a massage therapist, an acupuncturist, and a physical therapist. But it just got worse. It got to the point that I'd be in tears walking down the street. Truly one of the worst things I've ever gone through. After 3+ months I finally went to the doc who assumed it was a herniated disc, and I was going to get a steroid injection. But they did an MRI to confirm, and it turned out I had a spinal cyst, pressing on my sciatic nerve. Yowch! The doc went in and POPPED the cyst, and voila! No more pain. This is probably not what's going on with you, but if it persists and it's unbearable, find out what's going on. Nerve pain is no joke.
posted by swheatie at 2:33 PM on March 1, 2020 [2 favorites]

My husband suffered from sciatica and back problems for years. Every year or so he would have a pretty severe flare up. He was able to manage the pain with ibuprofen, or Doans, icing frequently, and periodic physical therapy. Last October he had a flare up, it subsided, then started again in November. He said the pain was the worse ever, around an 8 on a 1-10 scale. Added to this, he developed foot drop on the pain side. The doctor prescribed Medrol, an MRI and x-rays and recommended surgery.

So, two days before Thanksgiving my husband had an L5-S1 microdiscectomy. He said he realized in the recovery room that he didn't hurt. Lying on his back didn't aggravate his sciatica. After years of having constant, nagging pain, he just didn't hurt anymore.

The doctor says the recovery from the actual surgery has been textbook. Getting full use of his left foot back has been slower, at about 90% function right now, but progressing well. Surgery helped my husband tremendously.
posted by socrateaser at 6:30 PM on March 1, 2020

I also agree with considering scanning or other tests if it persists. For one, abdominal and pelvic pain can be really hard to distinguish from back pain, especially if you're already tending to think that it's back pain. Something like a hernia or who knows what could be at fault. Also, it could be a back thing that is identifiable and easier to avoid irritating once you know what it is. I have back pain from a benign hemangioma and it's super easy to avoid bugging it now that I know what I need to do (no running or jumping, not too much pushing heavy stuff).
posted by internet fraud detective squad, station number 9 at 9:09 PM on March 1, 2020

Response by poster: So, this isn't back pain, this is sciatic pain. It runs down my leg to my ankle and lower when it gets really bad. I've seen the MRIs of my herniated L5-S1. I walked with a cane for 5 years while I was learning now to live with this.

This flare-up is unexpected and was (is not as I type this) severe. I've never had pain like that during my short periods of excruciation. I don't know why they happened, or why they went away, or why I'm doing fine now. It's all a mystery to me.

There is nothing in any of my back pockets ever. Hasn't been for decades.

I agree that new scans are probably a good idea. After years of being basically benign (with low-level flares that don't matter overall), this suddenly got truly bad in a new way. Thank you for suggesting that. And for this conversation overall. I hope it continues.

It's going to be a while before I can get work and doctor to coincide for a new scan, but when I do I'll let you all know what is found. In the meantime, I'd welcome more observations or suggestions about any of this situation for me. This whole "flare-up" thing seems to be quite uncommon.
posted by hippybear at 11:05 PM on March 2, 2020 [1 favorite]

I had this (or something like it) and the horrible debilitating pain eventually went away. I had MRIs and all that and nothing ever showed up. It's been fine for a long time.

But every now and then, just to remind me it can, SOMETHING twinges (maybe I lean over a certain way, or twist in my chair... or maybe just do nothing).... and it feels like my leg is being stabbed by little burning knives. IT'S INSANE.

I can only believe it's a something hitting a nerve, and the result is this "pain" that travels down that nerve. To me it's not "real" pain. Real pain would be if a real knife was stabbing me in the leg.

But this nerve-induced flare-up pain that feels real, but is not actually tied to any true pain causation that can be identified absolutely- WTF is that?? All the responses above seem to indicate there is nothing common to point to. I wish you luck and hope you can find an answer.
posted by I_Love_Bananas at 8:09 AM on March 3, 2020

Response by poster: So, just a quick update. I've managed to get the sciatica tamed back down, just a bit of residual pain at the moment and it's getting better every day. Haven't had any of those utterly consuming pain flare-ups for over a week.

I'm still looking into getting new scans done. We're short-handed at work (and I work in a warehouse where missing someone leaves a big hole), and so after we get back to full staff I can start to look into getting time off for that. I'll keep you all posted.

Thanks for your suggestions of things to look into. I'll be mentioning many of them when I do finally start the process.
posted by hippybear at 8:47 AM on March 14, 2020

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