Unbearable sciatic pain, help!

In My Humble Opinion
1

[a note to mods: I am seeing and am under the “care” of my primary care physician and a pain specialist. So this is mere a plea for anecdotal things dopers have found that relieves the pain - not seeking medical advise, per se]

[note to dopers: I’ve searched the other threads. The best one looks like it’s from ‘06. So I’m hoping for a bit newer help]

TLDR VERSION: I have severe sciatica pain. Seeking anecdotal remedies.

I have debilitating sciatica. I can only lay in bed. I can’t walk, sit or stand. It is absolutely excruciating. There is no position that will relive the pain.

Background of sorts… I know pain. I’ve broken bones (most notably my collarbone), I’ve fractured my pelvis and it became infected, I had a skull fracture from a bike/car incident also got infected. I’ve been in major car accidents (car totaled - I wasn’t driving). And so on. I say these things so you don’t assume I’m just being a wuss.

I’ve had sciatica twice. One about 8 years ago and another time about 4 years before that. Both extremely painful but I was able to get around, even worked at my job as a handyman.

But this… this another whole level. I can only walk about 20 feet until the pain drops me. I can’t sit for more than a few seconds.

The pain doc gave me norco. It doesn’t help that much. Just makes me woozy. In desperation I doubled the dose. It didn’t help the pain that much but I did spend the next 1/2 day throwing up. I’m alternating heat and ice and doing prone stretching when I can.

My primary gave me gabapentin. It helps a little - mostly sleeping but when I wake up the pain is always back.

I need to be up because I know laying around will make it worse but with this pain there is just no way.

Seeking advise on anything that has helped any of you. Thanks for reading.

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I wish you the best!

Look into acupuncture (I have no personal experience):

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Thank you.

4

FWIW, I also immediately thought of acupuncture (also no personal experience).

Do you have access to a swimming pool? Perhaps floating/water aerobics will take some pressure off the afflicted area, plus some possible upper body exercise as a bonus. I know, getting there is half the fun.

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When I had horrible disc pain/radiculopathy in my neck, my doctor’s pain meds knocked me out but did not improve my situation. A physical therapist saw me three times a week for a couple of weeks and made the pain go away with a combination of heat, massage, and traction.

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I’ve had this issue off and on over the years; I noticed it’s been particularly worse since working from home during covid times, as opposed to daily commutes to the city with lots of walking.

I know you don’t want to hear this, as I (literally) feel your pain, but in my experience, you gotta get up and move. You just have to. With my worst episodes I’ve been in so much pain in the morning that I would involuntarily yelp out loud and almost fall to the floor when trying to take a normal step, forget about even TRYING to walk up or down stairs. In these instances I would spend an hour or so walking around the house in tiny baby steps while focusing keeping my posture correct. After an hour of this the pain would gradually dull to the point where it was still there but no longer debilitating. Then I would make sure to take several small breaks for little walks throughout the day. Usually if I do this routine the worst episodes clear up and I feel better in a week or two.

Podcasts are a great way I found to pass the time when baby-stepping around trying to not focus on pain :blush:. This is a podcast episode I found which was helpful to explain sciatica and posture: 068 What is Sciatica and How to Fix It - The Body Nerd Show | iHeart.

I purchased an adjustable sit/ stand desk and try to spend at least 50% of my workday standing, which also seems to help. I have noticed if I am not vigilant about this, or if I spend too much time laying around in bed over a long holiday weekend or whatnot, that is when the bad episodes occur.

Just my anecdotal experience. I’m a 40yo fit, active female and exercise regularly (biking, running, surfing, etc) if that makes any difference.

I’m also curious to hear if anyone has anecdotal experience with acupuncture for this, I’ve been considering trying it but haven’t found a lot of conclusive info one way or another.

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The first time that I had a bad flare up, I went to my doctor. He gave me vicodin. It took the edge off, but didn’t do much about the actual problem, and I was terrified of getting hooked on them. It took weeks before it cleared up, the whole time in quite a bit of pain and slowly becoming an opioid addict.

The next time it flared up, someone recommended their chiropractor to me. That had far more effect than drugs did. I think that chiros are pretty full of themselves, and think that they can fix things that they cannot, but for the specific issue of things being out of alignment, fixing that alignement can help. I got on the table at a self described “7-8” on the pain scale, and got off at a 4-5. Still hurt, but no longer overwhelming me. I didn’t even realize how badly the pain was affecting me until I felt as though a fog was lifting from my head. He also recommended Advil, and I ended up having far less pain than I was in while on the Vicodin, and it cleared up in not much over a week. I did visit him 4 times that week, and continued to visit once or twice a week for the next couple of months.

If I had access to a hot tub, that probably would have been useful, but just drawing a pretty hot bath, and laying with my feet on the wall helped out with the pain.

I feel ya, I’ve not had a bad flare up in over a decade now, but I certainly remember them. It didn’t matter what position I was in, I hurt. Sitting was the most painful thing, standing wasn’t very pleasant, and even laying down didn’t do much. Strangely, the “position” that I found that reduced the pain the most was walking slowly with a crutch or a cane on my right (the side that had the pain) side. I would just walk in circles around my house for hours, as anything else hurt more.

Now I recognize flare-ups, and try to catch them early. I feel that familiar twinge in my hip, note the weakness in my leg. If muscle relaxers are available, they help, but I’ve found that a beer or two does almost the same thing. Hot bath with me on my back, but with my legs in a sitting position and my feet flat on the wall. Usually by the next day, things will have calmed down.

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Doc prescribed stretches and stuff for me the one time I had something sciatica related, but it wasn’t anywhere nears as bad as what you have. It was stuff about building up muscles so it wouldn’t push on that nerve.

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My mother has sciatica and she uses a special chair cushion that looks kind of like an oversized bike seat. She says it’s meant to transfer the pressure of sitting to your “ass bones” as she calls them and take the pressure off the nerve.

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I’m surprised nobody has brought up anti inflammatories, since the proximate cause of nerve pain is usually inflamed tissue pressing against the nerve. A doctor will often prescribe a short course of Prednisone to alleviate the inflammation, and certainly/instead you should be taking a prescription level dose of NSAIDs while being extremely careful not to injure your stomach lining while doing so.

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Though, it’s less inflamed tissue, and more the spasming muscles clamping down on it that triggers the cascade of self perpetuating events.

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My bad, I’d missed what you said about Advil. For the OP: if you’re taking OTC NSAIDs, a very important point is to take them relentlessly, every dose never missing one, period. The anti-inflammation effect takes a couple of days to come on and must be maintained with a steady dose. If the label says every (say) eight hours, take exactly that exactly on time every time. And for god’s sake be good to your stomach while doing so.

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I’d disagree. I tell my patients (in whom I’m trying to reduce inflammation) to take it regularly for at least 2-3 weeks, THEN reduce it to regularly as needed for pain. Most pain doesn’t need constant anti-inflammatory treatment (not talking rheumatoid disease etc. here). taking stuff like ibuprofen/naproxen/mobic constantly month after month stresses the kidneys unduly and may cause chronic renal problems, along with gastric ulcers, reflux, and reduced pain relief response.

Besides, to actually reduce inflammation with ibuprofen, one needs to take 800 mg 3 x a day, or 600mg 4 x a day. Yet 200 mg of ibuprofen given as a single dose gives just as much pain relief as 800 mg of ibuprofen as a single dose.

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Things I have tried that have helped (some mentioned already).

Anti-inflammatories (if your stomach can tolerate them)
Flexaril (muscle relaxant–totally knocks me out, including grogginess for the next day, but does work and allows me to sleep).
A small TENS unit (I really thought this was quackery, but it definitely helps take the edge off to allow me to move around, and then the moving helps. They are inexpensive on Amazon, and no side effects like the medications have).
Physical therapy. I’m surprised nobody has mentioned this already, and surprised so few doctors recommend it. It definitely helps, and it is definitely NOT the same as just having exercises recommended by someone, including your doctor).

Chiropractors have made me MUCH worse, on several occasions (different chiropractors). I know different people have different experiences, and chiropractic works wonders on some, but I would stay far away.

Acupuncture had no effect on me at all.

I really am terrified of opioids, and don’t think they work well for this, and I’m slightly afraid of gabapentin, too. In my experience, most orthopedists go much too quickly to the opioids. I think that’s a bit problem.

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Radicular/sciatic/neuropathic pain responds better to meds which quiet down the nerve (anticonvulsants like gabapentin and others) or meds that make the brain pay less attention to the pain signals (tricyclics, duloxetine, other SNRIs). Stuff like prednisone can help quite a bit for acute pain due to bulging disc material. Opioids don’t tend to reduce pain, they reduce misery (moreso in some individuals, less in others). NSAIDs don’t help a lot but are better than opioids, and muscle relaxers are really just sedatives. Ketamine and buprenorphine are looking more helpful than those modalities but good luck finding a doc to prescribe those for you. TENS can help, physical therapy helps a LOT but ya gotta do it regularly, and cognitive behavior therapy can help a LOT also, as the brain itself can really reprogram to deal with pain, but needs to be taught how to do that. Epidural injections can help too, when there’s a precise anatomic cause of the pain.

And yes, I practice a fair amount of pain medicine. And just went through a 2 hour lecture today by a pain medicine specialist, updating us on these very things.

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Never mind. Question answered by our Chief Medical Ninja. :slight_smile:

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Yeah, this helps if I have access to it within a couple hours of a flare-up. It doesn’t do much once it has set in, though.

It’s rare that I can get in to see a doctor who will give me an Rx for it fast enough.

I’ve thought about getting one of these. They had it at my chiro, and I really like it. I never really thought about getting one of my own.

Physical therapy, IMHO, is more about building up the muscles to avoid having issues in the future than dealing with the attack now. When I have had a flare up, the exercises were unbearable to even think about, much less actually do.

I was pretty hesitant about it. My first couple of attacks I didn’t go, but I was in so much pain, and I knew that the doctor was just going to try to get me hooked on heroin again, that I gave it a try.

Maybe it depends on exactly what the cause is. I actually had a slight dislocation between my vertebrae. Wasn’t a whole lot, but it doesn’t take much. If the cause is due to a herniated disc, I imagine a chiro wouldn’t help, and would probably just make things worse.

Absolutely agreed. I don’t like the idea of using opioids to treat chronic conditions. There’s really no way that doesn’t turn out with addiction. As it was, I’m pretty sure that I had some withdrawal, and I was very careful about what I took. If I had gone on them again, I probably would have been hooked.

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When I was similarly inflicted, it was caused by a herniated disc, and nothing helped except the microdiscectomy, I’m afraid. I hope you have checked if it is caused by something similar? I know I was told that I was at serious risk of nerve damage or even paralysis without the surgery.

A TENS unit helped a little, but the effects wore off fast, assorted painkillers did very little except make me woozy and constipated, the chiropractor (I was sent to one by my GP) made it worse if anything. You have all my sympathy, I hope you find something to relieve it soon.

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I use a coccyx cushion to help take pressure off my spine when I sit, have you tried that to see if it helps.

I have no idea what you can do though. do they know where or how it is damaged? did you slip a disc, is your piriformis compressing it or is something else going on?

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is a nerve block an option for sciatica or would that paralyze your leg?

if it is an option, is there a difference between using heat, cold or botox to damage the nerve? does one work better than the other?