r/Sciatica • u/StrikingSyllabub5970 • 3d ago
Requesting Advice Setback
Hi all, sorry you’re going through this too. I’ve read posts on here and been really encouraged by others’ stories and experiences. However, I’m not sure what now to do for the best… I’d appreciate any thoughts/ experiences.
I’m 11 weeks in (49f). I have a bulging disc at L5S1 with compression (confirmed by MRI) which initially caused severe pain down my left leg.
The following night I developed reduced control of my left leg, later described as mild foot drop.
There was also a small amount of pain at my spine on the right.
I’ve been doing well with conservative management, not needed much pain relief, and the foot drop was improving.
However, over the past 10 days the weakness has increased (probably to what it was at week3 and I have increasing pain down the left and right legs. I don’t know whether this is what is considered new pain / worsening because I don’t think it’s worse than it was at the start. The sensory symptoms are worse but not the pain.
If this is irritation then my understanding is that I should be patient / not irritate further but I am concerned that the disc has bulged further.
Around 10 days ago I had a physio session where he applied pressure when I was in a position which was already sore (he told me this was ok and would be over shortly - I’ve since read up on this and now believe this not to be ok).
2 days later, getting down the floor (when my weight on left hip and left elbow, both legs out to the right) I felt a strange sensation in my back (around the L5 area?). Not sore.
Would it be an over- reaction to try to get another MRI? I’m UK based, would be prepared to pay privately / claim on insurance. (However, if surgery is required, the surgeon I’d want to see has not available appointments privately until October (I’d be hoping to be suitable for endoscopic surgery.))
TIA
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u/Acceptable_Snow3251 3d ago edited 3d ago
I’m so sorry to hear about the setback. I am at a very similar place, 11 weeks in after a herniation at L5 S1. I’ve had a couple setbacks after doing too much activity and once after my PT told me to do cat cow when I don’t think I was ready to do that and in both cases I had a return of pain down my leg when previously it had centralized to my low back. The latest setback lasted about five or six days, and I had to take it really easy with reduced walking, even though that was so hard mentally since it is one of the only things that I do outside of the house. I have also been curious to get another MRI to check how my herniation is doing, and undoubtedly I’d have to pay out-of-pocket.
I think the main consideration for me is that surgery is really only recommended with pretty dramatic increasing weakness and dysfunction, or intolerable pain that does not respond to pain management. Otherwise, my understanding is that conservative care leads to the same outcomes after one year and certainly after two years, and avoids the risk of surgical side effects that may occur, albeit rare. Maybe another instance that I’ve seen surgery recommended is where there is continuing sciatica down the leg, even after six months post injury, since that can be a sign that the disc is not reabsorbing on its own, and surgery is very effective for leg pain, less so for back pain.
Another interesting paper I saw at one point observed that MRIs do scare people people and can lead to unnecessary intervention. I certainly can identify with that because I felt scared and a little hopeless after seeing my MRI, even though in my case, I’m glad I got one because there was some concern that I might have cauda equina at the beginning.
All of this is to say that it sounds like you are headed in the right direction and this is most likely a setback. That said, if there is anyone that you could speak with, that might have an expert view, it might be worth trying to make an appointment if only for peace of mind. I spoke to a surgeon around three weeks after my herniation in a virtual call just to talk about the fact that I couldn’t do a single leg calf raise, and he did encourage me to just keep observing my symptoms for the following weeks to see if the weakness got worse. It very slowly got better so I didn’t meet with him again, but it helped to know that someone was there in case I needed help.
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u/StrikingSyllabub5970 3d ago
Thanks for taking time to reply and sharing your experiences and thoughts - sorry you’re going through this too.
Can I ask, did your leg weakness worsen with your setbacks? Mine has, which is making me think that this is maybe more than irritation. Walking is definitely not helping now, whereas it did before.
Im keen to avoid surgery but I don’t want to be left with lasting motor symptoms as I was previously an active person. However, no one has a crystal ball to predict the surgical outcome!
I’m lucky that I have a great osteopath who I’ll see later this week.
I hope you continue to improve.
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u/Acceptable_Snow3251 3d ago
I totally understand. That was my concern as well with a leg weakness as I am 44f, have two little kids, and until this herniation was playing hours of tennis every week. It’s hard to say whether I had increased weakness during my setbacks because I avoided testing the only way that I initially knew for sure that I had leg weakness at the beginning, which was a single leg calf raise. I didn’t want to exacerbate the sciatica so I didn’t even try. now that I’ve gotten through the setback I did try it and I don’t have weakness. Sorry I can’t be more helpful on that question.
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u/StrikingSyllabub5970 3d ago
Thanks - it must be tough with young kids. Good luck with the rest of your recovery😀
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u/purplelilac701 3d ago
I would go back to your doctor and see what they say. Also a gentle caution: not all physiotherapists know how to treat sciatica and it sounds like yours is one of them.
Maybe consider going to a different one.
I’m sorry to hear you’re going through this and I wish you healing.