Sciatica Questions and Answers Archive 2009

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A: Hi Anindita, What as the diagnosed reason for the pain and what type of testing was used to make this diagnosis? Best, Sensei Adam Rostocki

Q: First I would like to thank you for this web-site.After reading book Healing Back Pain by Dr. Sarno, I understood most of the facts regarding back pain from sciatica, but one question I can not answer for myself. When we talk about structural diagnosis (herniated disk which pinches/pressures on the nerve/root), the logical way of thinking tells me that if you relieve the pressure (by surgical decompression, for example) you have to get permanent cure for the structural cause??? And again according to Dr. Sarno's theory of ischemia, this exact ischemia might have been caused by the same pressure ( read structural cause)?Please, explain it in more details?Sincerely, Sergey

A: Hi Sergey, For structural causes, sometimes, surgery is the right cure. The point is that 99% of structural causes are misdiagnosed and coincidental to the symptoms. In essence, they are not the cause of anything. Ischemia is a psychologically driven process, not structural in the case of TMS. Hope this clarifies the issue for you. Best, Sensei Adam Rostocki

Q: hello there. i am only 24 years old and i was diagnosed with sciatica over a year and a half ago. sometimes the pain is bilateral and other times just one leg is affected. i have been under the care of my pcp and neurosurgeon, who have two different views of the diagnosis. pcp said from day one it was sciatica, we tried every type of NSAID there is practically with no luck. i went to neurosurgeon, and was ordered an MRI, which showed no apparent "cause" of the pain. frustrated and almost in tears i sat in his office and felt like a liar. i asked him what he thought it was and he said "just general nerve pain." so needless to say with no definitive diagnosis, and "no leg to stand on," i feel hopeless. i currently take ultracet, bc i have refused narcotics being in the medical field, and so far it has seemed to take the edge off. i cannot continue to have sleepless nights, and i do have a 6 year old to keep up with, we plan on having more children but im terrified of not being able to take anything but tylenol for the duration of my pregnancy. i just feel like i was misdiagnosed with sciatica, but don't know what else it may be. so my question is do these following symptoms fit, and what are my options? my symptoms are as follows: deep bone pain not just on the back of legs but front as well, sometimes bilaterally, pain starting from buttocks down to feet constantly, sitting, driving, and trying to lay down only intensify it. bilateral tingling occasionally, and burning sensations. PLEASE HELP!!!! Cassandra

A: Hi Cassandra, First of all, sciatica is NEVER a diagnosis. It is a symptom. Next, sure you have it and bad. However, in my experience, yours is a classic case of ischemia and is completely illogical to blame on any other causation. I advise knowledge therapy and feel you will do very well with this treatment. Best, Sensei Adam Rostocki

Q: At the end of May I started having pain in varying parts of my right leg; this went on for a few weeks. Then one morning I got up out of bed and had a sharp, knife-like pain in my lower back. This lasted for a few weeks, and my leg pain, as I remember, pretty much went away. For weeks now, however, I have had a numb right foot (mainly in my toes and ball of my foot) with tingling and sometimes shooting sharp pains (not too bad, however), mainly when my leg is at rest. My foot goes cold often and seems to have very little circulation. At other times, in certain standing positions, my foot will be flushed.

I have gone to a good chiropractor nearby and he has helped, and I have no pain in my back now (although from time to time it feels a little sore, not bad). I have pain in the back of my leg, the calf, when I walk very far. Last week I visited my local GP and he said I have very little pulse in my right calf area. He made an appointment for me at a vascular clinic. I only have Medicare A & B and am afraid, if it is a sciatic problem, I will be given all sorts of tests that aren't necessary and, of course, are costly. My GP doctor said I may have to have an angiogram, and maybe a stint in my leg.

The foot numbness has gone on for about three months, as I remember anyway, and my calf pain upon walking is intermittent.I just don't want to take a chance if my problem is vascular and not from my back. By the way, I "pulled" my lower back when I was helping a friend pull a small cabinet out of the trunk of her car. I didn't feel it for a while however. Help. And thank you for your advice. Barbara

A: Hi Barbara, The pain could be sciatica or vascular. There is no way to be sure without testing. Make sure to consider ischemia as a possible source as well, as this is the main reason for symptoms like yours and would explain much of your diverse symptomology. Best, Sensei Adam Rostocki

Q: Hi,I was diagnosed by physio/doctor no xrays with a disc bulge 17 months ago. I had sciatica down my left leg etc.Now 17 months on I am left with pain in my left buttock the pain is located at eh site of the Ishial Tuberosity and goes across there. The pain is worse when sitting, driving and horse riding. It eases when stood up or lying down on my right side or having a warm/hot bath. It is aggravated when massaged and when I do certain exercises. The pain does not really move is it always at this spot and is constant, it is just the intensity of the pain that changes. Do you think that there could be something else causing this pain now?. Thank you. Anne

A: Hi Anne, How were you diagnosed? It is completely impossible to diagnose a herniated disc with an exam alone and still impossible with x-rays. It requires specialized imaging, such as MRI or CT scan. There are many other explanations for your pain and I am inclined to agree with ANY of them, except a herniated disc, since the symptoms are not consistent with that diagnosis at all. Best, Sensei Adam Rostocki

Q: I experienced Sciatica pain about 3 months ago. I did an MRI and there is L5-S1 herniation in disc. I have done physical therapy, chiropractor and all the recommended stretches on a daily basis. I even did swimming straight for one full month. My problem is extreme burning sensation and numbness in my right foot. After 10 to 15 minutes of walk, it starts to develop and it makes impossible to continue walking. I had one round of ESI injection. Any suggestion or help is appreciated. Thanks, Abbas

A: Hi Abbas, Herniations at L5/S1 are extremely common and not generally the source of any pain. To me, the fact that the symptoms come on only after walking for a time make the disc an unlikely culprit. If you would like to type your MRI report for me, I will be happy to advise you further. Best, Sensei Adam Rostocki

Q: Hi,my name is faye I am 47 nearly 2 years ago I was attacked by a dementia resident at my work place thrown to the floor landing square on my butt with alot of force which has resulted in me having surgery which was Right L5-S1 Transforaminal lumbar interbody fusion and L4-5 interspinous distractor insertion. I had this surgery 11/11/08 and still have 3-4 months recovery period left. The pain from butt to foot pins and needles. I am never pain free, its like mental torture. I am very depressed, I feel inadequate a failure @ witts end any advice? Faye

A: Hi Faye, I would like to take a look at your pre-op MRI before advising you. You can type me the relevant parts of the report, Best, Sensei Adam Rostocki

Q: My name is Kevin and i was medically discharged from the British Army. I underwent surgery on my lower back twice and i had my 3rd operation to fuse nerve endings i think. I now suffer severe sciatica down my right leg and my lower back. I receive a pension from the army but i would give them every penny back if they let me be pain free for a month.I have no quality of life and would greatly appreciate some advice. I tried for the first time an osteopath and in two visits my pain has doubled. The osteopath assures me that this is normal but i am not convinced. I have never heard of osteopaths being helpful to back problems. He is expensive and repeats the same painful 10 minute session on each visit. The annoying thing is that i could wake up tomorrow and my sciatic torture may be gone. I am taking tylex6,gabapentin6,diazepam2,amitriptylie2. The osteopath has told me to apply an ice gel pack every hour for ten minutes but i feel better when i apply a hot water bottle. I am 42years old but i feel 72 years old. Anyone who can give me advice on the use of an osteopath would be greatly appreciated as i am losing my mind. Kevin

A: Hi Kevin, I do not think this path of treatment will do anything to cure you. I would love to be wrong, but highly doubt it, given your history of unsuccessful treatment already. Best, Sensei Adam Rostocki

Q: Hello, I stumbled on your website and have to give you credit in the literature you provided. You're the only that I have found that is recommending "knowledge therapy". I never heard of such treatment but I am willing to do give it a go since I have tried several things to heal my sciatica. I have been suffering on and off for almost a year, and I am hating it. My question to you is: Will this be the real thing? will this truly help me? Thanks, Joe

A: Hi Joe, I certainly hope so, for your sake. It worked wonders for me and millions of others with a wide range of chronic pain syndromes. Best, Sensei Adam Rostocki

Q: Your book suggests I stop my physo treatment which is stretching exercises. Does this mean that I should never stretch? I usually stretch before and after karate training. Liam

A: Hi Liam, No, the book does not suggest that at all. The book suggests you stop treating psychosomatic pain with physical modalities. Stretching is important, just as exercise is vital. However, these modalities should be done to insure good health, not as a form of back pain treatment. The difference in ideology is crucial. Putting faith in these modalities as a curative approach to back pain will simply perpetuate symptoms. Using them as a means to good health will create good health. I hope this clarifies the point for you. I send you my very best! Sensei Adam Rostocki

Q: I have had two injections for the sciatic (bulging disc) back and butt pain gone, but foot is still numb?? also i feel i can play golf again, is golf known to cause flare ups? thank you so much!!! Stephen

A: Hi Stephen, Golf can aggravate back pain, but it is not inherently damaging. Most of the injuries are due to psychological conditioning and suggestion rather than actual structural damage. I do not have a copy of your MRI report, so I am not sure what type of condition you are dealing with. This makes it difficult to comment on the foot numbness. If you would like to type or send your report, I will be happy to look at it for you. Best, Sensei Adam Rostocki

Q: Will sciatica cause you to not be able to stand straight? I have severe pain in my buttock made worse when I try to stand erect. The only way I can get around is by staying really bent over. The pain goes down my legs too and has gone from the left,then both and now the right side. Ramona

A: Hi Ramona, Sciatica is generally affective of the legs and buttocks. Most conditions which cause bent over postures affect the lower back muscles, as well as those in the buttocks. This is very common for many forms of muscular back pain and often happens in combination with sciatica. It is unlikely that the symptoms have a structural cause if they are moving so drastically. I would suspect ischemia. Best, Sensei Adam Rostocki

Q: Hello- For the past year and a half I have been experiencing back pain. In my case it was the straw that broke the camel's back, meaning I cannot pinpoint an event that caused the injury. Started with anti-inflamatory a few months later I realized this pain is still there. Wen to a back Dr. his rx was PT, that was no good. Had an MRI Sept 08, revealed mild disc bulge (2mm) between L4/L5 along with an annular tear at the same level. Then around December 08 I started experience what I know so well now to be nerve pain had another MRI revealed the same L4/L5 issue w/ L5/S1 having a paracentral/left paracentral protrusion (4mm) with slight impingement upon the left neural foramina. I cannot imagine what a severe impingement feels like! The back pain /spasms are very minimal now but I am very careful with my body mechanics, my issue is the nerve irritation that drives me insane! Thankfully it is not constant but lately its been more than not. My symptoms are bilateral nerve issues in both legs not so much tingling anymore its more of a burning feeling. Sometimes when its real bad I feel like it travels every where like I know this sounds crazy but I feel it my eyes, nose, ears like it just bothers me. When I told the Dr. this in Dec. he decided to do an MRI of my brain and it came back great, I think they were ruling out MS. In Late may of this year, 09 I had four epidural injections (two on each side) I feel like I had some relief but now its worn off. My issue now is here I am -I've tried PT,epidural, chiro, even decompression, and I am 34 years old, is this it for me? is this how my life is going to be?? I've spent a lot of money because my insurance is not the best. I am willing to do what it takes to get better but nothing seems to help. The bilateral thing is something else! Susie

A: Hi Susie, Your symptoms are not consistent with your diagnosis, which your doctors should have pointed out to you. I do not think the herniated disc has anything at all to do with your pain. The symptoms are most likely ischemic. I recommend knowledge therapy for you, as this is the only hope you have to cure the condition. The medical system is a waste for this particular syndrome... Best, Sensei Adam Rostocki

Q: had a herniation at L1-2 HAD surgery last year and never once even b4 surgery had sciatica. Just groin pain . Surgery rid me of the groin pain and i just had the best year of my life however I decided to do my first roadtrip and still i felt fine even after i got back. When i came back i broke out into shingles along the s1 dermatome path leg and foot. Could shingles be the cause of bilateral sciatica or could it have been the 4 hour roadtrip. I mean I have been in the car even longer and never had a problem. Jan

A: Hi Jan, It is impossible to say. Shingles, just like sciatica, is often psychosomatic. The trip may be caused it physically (unlikely) or set off something in your mind (more likely). Either way, I recommend thinking long and hard about what may be an alternative cause, since the surgery obviously acted as a placebo, not a cure. I send you my best, Sensei Adam Rostocki

Q: I have sciatica on my right side, it came on all of a sudden. I have had this before on my left side. I am using ice packs, every two hours, 20 mins. The pain at times is very severe, I have to walk bent over, have a problem with reaching for things up high. I have no insurance. Was wondering if swimming in the pool would help. I also have been using muscle relaxers, my husbands, don't seem to help and either does pain pills. Have a trip planned in Oct. need to get better by then. Thank you, Jeanne

A: Hi Jeanne, Forget the pills. You can try the pool. It can't hurt. Obviously, I recommend going to a doctor for evaluation when possible. Best, Sensei Adam Rostocki

Comment: In Jan 2009 I broke my left foot and after months of physio, I've got some rather nasty pains in my left buttock, down my leg and into my foot. I am still having phyiso but the pain is very sore. It can come and go, but when it's back.....my god....I cry and wish I could take the nerve away! I am glad I am not alone with this pain! Becky

A: Hi Becky, No, you are certainly not alone. I thank you for sending in your story and hope you can find some relief soon! Best, Sensei Adam Rostocki

Q: Hi there, I am 33 and dealing with my 2nd bout of sciatica. Had it 2 yrs ago in my right leg, very intense leg pain, back muscle spasms, but lasted for 4 weeks. Now in my left leg, pain in lower back, and ankle, and calf for almost 6 months. I don't have an hour in the day with no pain.I have looked at my back in the mirror, i am completely crooked! the lower spine veers off completely to the left, and the muscle on that left side and protruding and rock hard.

I am in Canada and an mri is a 3month wait.still waiting....I have had 15 chiro visits, with only temp relief..next day i am back to acute pain.Recently, a fellow flight attendant recommended an osteopath. I found one who is also a physiotherapist... i have booked my first appointment, which is coming up...Do you think this might be a helpful route... I clearly need to have my spine realigned somehow... due to the severity of the misalignment i think the pain could very well be pinched nerves....It is obviously very depressing, living with chronic pain, especially being someone who by nature is very happy and enjoys an active lifestyle... thanks for your time, Sandy :)

A: Hi Sandy, If the condition you are describing is indeed scoliosis, it is highly unlikely that it can be "re-aligned" as you put it. This is a myth perpetuated by some care providers and I know for a fact, since my chiropractor promised to straighten out my curve and was obviously unsuccessful. I do not subscribe to the idea that a curve is usually able to be worked out through traditional body work. However, it is also rare for a curve to cause pain. I think you can pursue whatever treatment you are comfortable with, sans surgery, but I would hold out for the MRI and at least get some x-rays to determine if the curvature is in the bone or simply muscular. There are many other possible reasons for your pain. Let me know what you find out... Best, Sensei Adam Rostocki

Q: I am 29 and having some rather nasty pains in my left buttock, sometimes in the back, down the leg and foot. I've just overcome a broken left foot and limp while walking, could this have started what my doctor claims is Sciatica? Any help would be great :) Becky

A: Hi Becky, If you have been nursing an injury, it could cause some short term pain throughout the leg as you get used to full functionality again. This pain should be transitory. If it lasts, consider diagnostic testing. Best, Sensei Adam Rostocki

Q: I suffer from sciatica with symptoms of numbness in both feet and extreme burning sensation in my feet. I have tried stretching but it just aggravated my pain. Any advice that you can give, Philip

A: Hi Philip, Have you been to a doctor about the condition? If so, what was the diagnosis? This will help me to advise you. Best, Sensei Adam Rostocki

Q: herniated L5/S1 in 12/06 picking up someone during a mma class. chronic pain and sciatica for next year and a half. kept me from doing what i truly love to do ie; running weight lifting. decided to have an endoscopic discectomy in 4/08 and continued to have symptoms for a few months afterward. eventually butt pain went away entirely. started getting back to running and what not. now it the sciatica only in left thigh , calf, and little toe has resurfaced. an m.r.i. taken in 11/08 showed some formation of scar tissue. also having lateral hip pain. a cat scan showed some minor degenerative change in s.i. joint. can this be causing my new symptoms? even riding a bicycle is bringing them on. Bob

A: Hi Bob, I do not have your MRI reports handy, but given your history and taking several months to enjoy relief from the procedure, I doubt that the surgery did anything at all, since the disc was likely not to be the source of pain. Now, the scars might be causing some, but this too is a usual scapegoat used to explain failed surgical procedures (which are epidemic). If you want to type up your MRI reports, I will be happy to give a detailed opinion. Best, Sensei Adam Rostocki

Q: lord, my butt is killing me, know is my sciatica...going to a chiro, that's helping me sleep but when I get up in the morning, it just brings me to my knees, takes 20 minutes to get the pain to go away, almost makes me sick, is there something I can do the night before so I can at least get out of bed without this horrible pain...its just in my butt, when I massage it and put ice on, 20 minutes and its somewhat gone but lord its painfully, what can I do pleasssssssssssssssse help... Lynn

A: Hi Lynn, What is the diagnosed cause of the pain? What I was hoping for was an MRI report or a diagnostic conclusion from a physician. Have you been to one? Did you get an MRI? If not, this is my recommendation for a place to begin.Best, Sensei Adam Rostocki

Q: I have been diagnosed with a slipped disc between L4 and L5 which has resulted in EXTREME sciatica. It has taken years to identify this problem. Since my diagnosis I have been on various meds and the only thing that has given me any relief is Hydrocodine (vicadin). But the relief is starting to dwindle and I end up taking more which is making me even more wakeful and causing stomach issues. I have had PT as well as spinal injections. Neither one has helped. Pain management has given me the Vicadin and pain patches, but nothing is really helping. I am 32 years old and have been having this pain get progressively worse since I was 19 years old. I refuse to have surgery because I have heard such horror stories of it now working. Not to mention I react very poorly to anesthesia. My pain starts in the left buttocks down to the knee. It is greatly limiting my physical activity and is starting to control my life. My life is the true definition of chronic pain. Do you have any recommendations? Any advise you could give me would be greatly appreciated. Jenn

A: Hi Jenn, I would like to see the MRI report before making any recommendations. This way, I know exactly what you are dealing with. If you can type it up and send it to me, that would help lots. Best, Sensei Adam Rostocki

Q: Will your treatment help me I have spinal stenosis caused by a fusion I had in my back 16 years ago,I have tried everything, chiro, inversion table,had one injection(epidural)now have swelling,a messy period,and I am in menopause, canceled second shot, help. Korina

A: Hi Korina, It might. I can not tell for sure. If you do not want to take the risk, just get to your local library and take out all of Dr. John Sarno's books. This way you can get some idea about knowledge therapy and see if the approach is logical for you. Best, Sensei Adam Rostocki

Q: My mom is having burning pain in her buttocks, sciatica and its joint. She feels almost like the pain was emanating from her bone. She applied a joint pain balm, but she didn't get relief. So can you please suggest what she has to do??? Sonam

A: Hi Sonam, She has to get to a doctor for accurate diagnosis. There is no way of knowing the best treatment if you do not know the cause of the symptoms. Let me know what the doctor says. Best, Sensei Adam Rostocki

Q: I have an osteophyte impinging on the L5/S1 area nerve causing sciatic pain. I had one epidural and the bone spur initially blocked the needle insertion. I take Vicoprofin and Neurontin. I go back for another epidural next week. How would you rate the cheap TENS units and the inversion (hanging from feet) for pain relief. I have had surgery for left side sciatica and don't want to have it again for the right side and the surgeon was an a--hole to deal with and talk to. Jim

A: Hi Jim, I do not recommend either modality. I also do not recommend surgery and hope you can avoid it. Your opinion of their surgeon seems to be quite common among patients ... Best, Sensei Adam Rostocki

Q: I have ongoing pain in my lower back (right), buttock and down the inside of my thigh right the way down to my heel for about 6 months now. I did not hurt my back or anything,it started as occasional pain but is now there all the time, especially when sitting down, driving and standing still. I get relief when lying down.I went to a chiro first who said I had a twisted pelvis, he treated me about 6 times with no improvement.Went to the doctor then, said I have Sciatica, without examining me at all. He prescribed Dislofenic an Co-codamol. This gave me no relief at all. Went back to doc and he perscribed Arcoxia 90mg, have only been on these for a few days, but they may have helped slightly.I would like to hear your views on this case please? Would a scan show up the problem? Aidan

A: Hi Aiden, I can guarantee that the treatment you have received will do nothing to cure the condition, since drugs are simply symptomatic therapy, by nature. An MRI might show a structural reason for the pain, but most of these spinal abnormalities are merely scapegoats and not the underlying source of pain. The pattern you describe is atypical (the inside of the thigh, in a line to the heel) and takes into account several spinal nerve roots. To me, this almost immediately rules out a singular structural source. To begin, I advise losing the drugs and getting an MRI if at all possible. Best, Sensei Adam Rostocki

Q: My fiancee got injured on the job as a truck driver 8/2008. He got the common sciatic nerve pain and had to get immediate medical care. The doctor said it was a herniated disk, L4 & L5 after he was given an MRI. Then gave series of 3 steroid shots to the spine. Then he had a laminectomy & diskectomy. Got a bit better, then the bad cramping leg pain, buttock pain, back pain came back. So they gave a 2nd MRI and a 2nd diskectomy. He never felt much better, and so they gave 3 more steroid shots those didn't help either. Now the doctor has him scheduled to see him on 8/28/09 and will probably talk about doing a fusion because he mentioned that as being the last resort. He already had a myelogram before the 2nd round of steroid shots. I think it is a bad idea and I hate to tell him to just deal with the pain, but I really don't think its a good idea after reading your experience along with others. Do you think rehab would be a better idea? I just wanted your thoughts. Kim

A: Hi Kim, I would have welcomed the chance to advise him prior to that first surgery, for that is when things most likely went awry. At that time, the fix could have been easy... Now, it is far more complicated. Real damage has been done from the procedure. Unfortunately, I usually hear from patients AFTER their surgeries fail, instead of prior to the actual procedure. It is a shame. I almost never recognize fusion as a solution for back pain, since it is barbaric, contrary to natural spinal function and a degenerative accelerant. If you would like to type the MRI reports for me, original and latest, I will be happy to take a look and give you my opinion. Best, Sensei Adam Rostocki

Q: I have occasional (average once a week), sometimes sharp and usually constant pains, mostly centered in my right hip. It usually spreads a bit down my leg, more severe in the back of it, but extremely rarely below my knee. It does affect my standing up and walking when it happens, and I usually can't find a comfortable position to relieve it. Sometimes it's just a few hours, sometimes it's almost 2 days. I've just started reading about sciatica, suggested by my massage therapist (who commented that my hip definitely "does not feel right"). We are thinking it may possibly be a condition related to a motorbike accident I had a few years ago, that's just starting to flare up now. I was hit by a car, flew off my bike, and landed on my right hip. No issues with it until now, though, and I cannot recall anything else major enough that it should be causing so much pain. Everything I read about sciatica indicates that "real" sciatica is usually caused by disc issues in the spine. But I don't have any pain until right at the ball-and-socket joint of the hip (nothing at all in the back), and I can tell it's that nerve just by the way it feels. Are there other possible conditions and terms I might consider using in my research, on the possibility this is *not* sciatica? Heather

A: Hi Heather, Does not sound anything like sciatica to me. I recommend looking under hip pain, hip joint pain, hip injury, sacroiliac joint pain. Best, Sensei Adam Rostocki

Q: I have been off work for two weeks with sciatica, been having osteopathic treatment and getting fed up not exercising - used to go to the gym. What exercise can I do in terms of recovery - is swimming ok? any other? thanks, Alex

A: Hi Alex, I do not know the cause of your symptoms, so it is difficult to advise you. I think you should discuss this with your physician. Generally, most sciatica patients can do any form of sensible exercise and swimming is one of the best. Sincerely, Sensei Adam Rostocki

Q: Hi, I have been dealing with a right side lower back/sciatic nerve/SI joint/pelvic torsion issue for 7 months. The pain came on suddenly after a regular run/walk but I had been playing and practicing alot of golf which has aggravated my back before. I am an avid runner/swimmer and workout daily. I'm 53 years old.I went to PT and felt better, but after certain prescribed exercises, I would relapse. Doctor, PT and chiropractor all thought I had SI joint dysfunction. I begged for MRI and after 4 months doctor relented. MRI showed L3-L-$ disc osteophyte complex and broad based disc bulging centrally. There is mild to moderate neural foraminal narrowing on the right due to disc bulge with minimal neural foraminal narrowing on the left due to disc bulge. Doctor wanted me to have epidural injections, but I was feeling better so I postponed. I went to a chiropractor for about 8 treatments and again, I'd feel fine for a week or so and then I'd have some sciatic symptoms which affected my sleep.

I am currently being treated by a PT who also specializes in pilates. She has helped me alot with postural corrections and the pelvic rotation. However, everytime she gives me anytime of lower body exercise, the sciatica returns (this is typical). I do feel better with McKenzie type extension but no of the therapists believe in this, although I do. I had some very tight muscles on the right and self treated with a foam roller for trigger points (I have alot). I ended up in excruciating pain for 4 days. There is alot of research on the trigger point approach but this type of massage just aggravates my problem.I have only taken Ibprofen. I'm not a drug taker and won't take anything stronger. Not sure what you think. I've downloaded and paid alot for different "systems" and nothing has helped. I hate to invest in another program with no results. Not sure what you think. Thank you! Lisa

A: Hi Lisa, I would like to see the MRI report if possible. Judging by your partial and temporary relief from treatments, which do nothing at all to correct the supposed source of your pain, I highly doubt that the disc/osteophyte situation is the actual causation. If you can send the MRI report and detail the exact location of your symptoms (as specificly as possible) I will be happy to give you my thoughts. Best, Sensei Adam Rostocki

Follow up: Hi Lisa, Ok, I have a definite opinion based on your past history of symptoms, treatments and relief enjoyed...I do not think the discs or osteophytes are responsible for any pain you have. Additionally, I do not think there is anything at all wrong with your SI joint and I barely believe piriformis syndrome to be anything more than another name for chronic TMS of that given muscle. I believe that your problems are all ischemic and linked to psychological conditioning. The relief you have enjoyed is illogical for the diagnoses made and treatments received. It is very logical for an ischemic pain syndrome. I advise knowledge therapy for you and feel you will recover 100% with this treatment. In your case, I am very confident in this opinion. Best, S.A.R.

Q: I had both my sacroiliac joints injected many years ago as my body was twisted. After having it twisted back and injected I had many years without pain. I now over the past year have started to have low back ache. This has always been rectified by anti inflammatory pills from my gp. I am now experiencing pain in my right buttock and down my right leg. This is manageable throughout the day, and is more frustrating than extremely painful. Night time though is a very different story. I sleep at night for a couple of hours to be woken by very severe pain. This radiates down my right leg and foot feeling like a burning almost numbing type pain. I find I have to sit and stand for most of the time and the pain then settles slightly.I have been given amitriptyline which I believe is a relaxant of some sort. I have only been taking for a few days but as yet it has had no affect. Prior to this I was given tramacet pain killers which also had no affect at all. Any advice would be welcome as I just need to get more than two hours a night sleep so I can return to work. Ann

A: Hi Ann, Sciatica which comes on while trying to sleep is generally anatomically illogical and caused by ischemia. Have you ever had an MRI performed to diagnose your condition? If so, what was the result? If not, this is a good place to begin. Best, Sensei Adam Rostocki

Q: i have pain below the knee for a couple of month now sometime impossible to walk on my right leg. start 1 year ago paint in my calf (like a charlie horse)all summer was still able to run and exercise. then it disappear now the pain reappear the front of my leg below the knee. i am in hospital right now to find out what is the cause. i had a rupture of the disc 9 yearsago. i had a surgery and everything was fine. is it the same problem. i try anti inflammation,muscle relaxer, physical therapy, acupuncture and chiro. a matter of fact this begin a the chiro. i had pain in my back since the surgery every week. i was going there to crack my back. suddenly my pain end up in my calf. for 1 year like i said the pain disappear and now it back in my right leg.my symptoms are: difficult to walk,steady pain below my knee (the front of my leg.\, shin not the back or the calf) tingling,numbness, sometime sharp pain.

could you help? i have an appointment with the spine specialist on the 30 of june. i have the mri done which showbulge of the disc. may be sciatica. i know some new treatments are available like micro endoscopic or micro discectomy. could you help? thank you, pierre

A: Hi Pierre, If you could provide your MRI report, it would help me to advise you. Right now, I am not sure what you are dealing with exactly. Best, Sensei Adam Rostocki

Q: My symptoms match yours. I have had bi-lateral sciatica for almost a year. It started w/in 2 weeks after arthroscopic knee injury. My orthopedic surgeon immediately referred me to a back partner in the same practice. After reviewing my MRI he stated that I had chemical radiculitis- he acknowledged that it was only a theory--but he presented it like a death sentence of life long pain as he stated there was little he could do from a surgical standpoint. Since then I have had numerous epidural and trigger point injections which only provide short term relief, have taken Neurontin which provides some relief, had done chiropractic (VAX-D) to try to heal the annular tear, and am currently finding that acupressure massage helps some. My research is similar to yours i.e., bilateral sciatica is rare. It is unlikely to be caused by the annular tear--if I even have one. And, in my case, it seems most likely have been caused by surgical positioning and poor surgical padding. Nonetheless, my pain seems to start at the sacroiliac joint (right next to and above my coccyx which is tender to the touch), and my worst pain is in my feet and then my lower legs and hips. I really do not have any back pain, as it is from my hips down that hurts. Mark

A: Ok, Mark, Thanks for sending in your story. Did you have a question as well? Best, Sensei Adam Rostocki

Q: I have been surgically operated the varicocele on my left testicle, then after that I am suffering from this burning feel of my left leg what I shall do? Endeshaw

A: Hi Endeshaw , I recommend returning to the surgeon and telling them about your pain condition. If you have already done this, what did they tell you? Best, Sensei Adam Rostocki

Q: I have pain in patches in my right leg just below my knee and and sometimes on my thigh. I have no back pain only leg pain. I had an MRI and they found a small disc bulge that looks to be touching L4 nerve. I have had this condition for 9 weeks - with no constant relief the pain some times improves and then can become worse mainly be sitting in chairs and for some reason several hours after swimming. I had a cortisone injection last week - But that has mad no difference. I am interested in your feedback. Dena

A: Hi Dena, If you would like to send your MRI report, I will be happy to take a look and give you my opinion. Where is the pain below the knee and in the thigh? (front, side, back) Best, Sensei Adam Rostocki

Q: I am interested to learn more about treating long term bilateral hip and neck/shoulder pain, possibly sciatica. Have previously been diagnosed with degenerative disk disease from c2 - c7, with no evidence of nerve impingement from MRI scans or xrays. stuart

A: Hi Stuart, Cervical DDD is normal, universal and virtually always asymptomatic. Nothing to be scared of here. Additionally, despite the illogical explanation by some care providers, it will have nothing at all to do with sciatica in your lower body. Any other questions, feel free to ask! Sensei Adam Rostocki

Q: I have been diagnosed and treated by chiropractor for my left sacroiliac joint and sciatic nerve. I am improving greatly. Tried to hit tennis ball on the wall and when I went to move my quad felt weak and like it buckled. I have numbness in shin area too. Any advice as to should I try easy strengthening exercise for quad? Is sciatic nerve not firing to muscle to move? Just curious. Thanks. Karen

A: Hi Karen, There is a multitude of possible explanations for your symptoms. I highly doubt that your quad needs strengthening, so I do not think exercise is the answer. What is the diagnosis that the chiropractor has been treating? Best, Sensei Adam Rostocki

Q: I have been suffering from bilateral buttock and leg pain which radiates to both my feet for more than 15 years. Often my feet have a tingling sensation but the pain does not follow the usual sciatic pain pathway.It first started with fatigue and aching when I climbed stairs or inclines. I did not need medication. In 1999 I had C spine discectomy and fusion from C3- C7. It was about a month(?)later that I started having this pain constantly, 24/7, no matter what my activity was and even while sleeping. The pain is controlled now with Avinza, a long acting Morphine. I have had many procedures and several sessions of PT with all modalities and acupuncture. I do have OA in my thoracic and lumbar spine and also herniated discs. I cannot sit on hard surfaces or for prolonged periods. If I do it can cause severe buttock and B leg pain for 24 - 36 hours. My goal to find the cause of this pain and get of morphine. I hope that you can help me. Thank you, Sandra

A: Hi Sandra, If you would like to send the MRI reports, I will be happy to give you my opinion. Best, Sensei Adam Rostocki

Q: PLEASE HELP ME. I am 42 yrs old, have herniated L5/S1 and L4/L5 discs. I experience constant pain but i can handle this. the problem is during flare ups (like now) the pain is breath taking in it's intensity. I can only have paracetamol or valium as i have increasing allergies to ANY other pain relief. I have anaphylactic reactions to any opioid or opioid relative, local anesthetic, mobic, tramal, codeine etc. my dr's are too scared to treat me with anything during an acute flareup.i may be able to take a drug today, but tomorrow i will have an anaphylactic reaction to the same thing and end up in the ER. please help, i am in a lot of pain now. thank you, Margaret

A: Hi Margaret, I am the wrong person to ask about advice with drugs, since I do everything possible to recommend patients avoid them. You might consider acupuncture as an alternative treatment. this works well for many suffering people. Some people get relief from TENS, although I personally think it is illogical. Best, Sensei Adam Rostocki

Q: What do you do to help sciatica that my be caused by a piriformis syndrome? I agree wholeheartedly here when some say the excising can make it worse. Susan

A: Hi Susan, it depends on the cause of piriformis syndrome. In my experience, this diagnosis is almost always the result of ischemia, rather tan injury or any structural source. To cure this type of piriformis pain, I advise knowledge therapy. Piriformis pain due to injury will heal on its own 100% of the time in less than 8 weeks. Best, Sensei Adam Rostocki

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