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[Mamie]

Hi everyone - I've had sciatica on and off for about two years, but in the last 6 months or so it has worsened.  I was prescribed Nortriptyline for the pain, numbness and pins and needles and also because these symptoms were waking me up.  This didn't work out as it is supposed to be one of the less sedating TCAs it kept me awake most of the night. 

Also to complicate the issue my anxiety is quite bad at the moment - lack of sleep isn't helping.   Some days I feel I just can't cope anymore.  I am having physio for the sciatica and have been told that there are quite a few medications that can help and not to give up. 

What I am wondering is if I can perhaps kill two birds with one stone.  I have been reading that Pregabalin is used for sciatica and is also used for anxiety and I am wondering if there is anyone here who can share their experiences of this medication or any other which has helped.

Many thanks.     

[CLKD]

I found that swallowing two 'nurofen' B4 a brisk walk would ease sciatica.  Occasionally I can feel the nerve in both buttocks, sometimes they will itch.  Also, making sure that I kneel rather than bend when doing 'stuff', i.e. putting on dogs' leads/collars, sweeping up ......... as well as sitting correctly.

I saw a physiotherapist earlier this year who explained that my sciatica is actually bursitis, she suggested exercises 

[Mamie]

Thank you CLKD.  Unfortunately the ibuprofen type meds are not recommended for me due to having had ulcer in the past.  Also have some current stomach issues.  About six weeks ago I thought I had fractured a hip, the pain was so severe.  I couldn't sit or lie down comfortably and GP said that the sciatic nerve can cause excrutiating hip pain.  I needed to take a high dose of co-codamol for a couple of days to cope .. horrible nauseating drug. 

Yes I can feel the nerve in both buttocks also .. not very nice is it?  I also try to kneel rather than bend, also squat a lot .. knees are a bit worn out as a result   

Physios are very hit and miss, difficult to get a good one in my opinion.  I also wonder how come you never seem to come across a middle aged one, they are all either in their twenties or thirties with limited experience.   

[Flossieteacake]

I sympathise as I have sciatica too. I remember when it first happened I could not walk at all. It is interesting you say it could be linked to anxiety. I would not be surprised as anxiety plays havoc with our bodies.

You are so right about NHS physios all being young! I wonder why that is.

I would give pregabalin a go. Anything is worth a try when you are in so much pain.

[CLKD]

What did the GP suggest : GP said that the sciatic nerve can cause excrutiating hip pain : unlikely. Hip pain is found deep in the groin.  Back pain is over the hip - the sciatic nerve root emerges from the buttock.  R U able to tolerate Paracetamol?

What's causing the gut upset?  Could be hormones, I had problems for years.

Physios don't usually have 'limited experience'.  Those I worked with were in their 30s/40s.  Training takes several years.  They cover all aspects of medical conditions , some even specialise in womens health.  In recent years 1 has been able to self refer, my GP recommended that I seek advice.

Let us know how you get on.  Which exercises do you think would help?  Swimming is non weight bearing, so good for overall health: however, I HATE public changing rooms  . 

[Marchlove]

Hi Mamie

Sorry to hear of your sciatica which from experience can be excruciating.

If I were you I’d push for a referral with a spinal surgeon or neurosurgeon (not an orthopaedic surgeon) who will do a MRI.

This may seem a bit daunting but it will give you useful information as to the actual cause of your pain with better options on how to proceed.

As you have been doing physio for awhile the Gp should not be able to withhold this referral.

It is over ten years since I had an operation for this and haven’t looked back since. I’m not saying that is what you need but I think having the facts will be helpful.

I can’t really remember all the pain killers I was taking but I remember the surgeon was most insistent that I take paracetamol 4 times a day which was topped up with various other things, whilst I was waiting for the op.

Best of luck with it all.

M xxx

[Mamie]

Flossie - thank you for responding.  The anxiety is really a separate issue, but is certainly worsened by lack of decent sleep and pain.  I take paracetamol which only takes the edge off but is better than nothing.  When I wake up with that burning backs of legs feeling I need to take something in order to get back to sleep.  I only ever take the co-codamol if the pain becomes unbearable.  I'll see how things go and what sort of medication they think might be most appropriate. They will probably offer a different TCA - but I am wary of them in general because of the link with dementia.
Interesting that you have the same experience re physios -  here in London they are really young and the one I've been seeing is fairly hopeless to be honest.     

Marchlove -  Thank you for that very helpful information.  I have been given exercises to do for the last two months and physio is now referring me to a gym.  You know how it works - they wont make any further referral until you've jumped through all their hoops. 

The NHS is extremely reluctant to do MRIs due to cost -  they will tell you that the treatment will be the same regardless (i.e exercise).  I will probably end up funding it myself. 

That's interesting information about pushing for a spinal or neurosurgeon and not an orthopaedic one.  I will certainly push for a referral if there is no real sign of improvement.  That's really great and encouraging to know that you are now pain free.  Long may it continue.

[Flossieteacake]

Flossie - thank you for responding.  The anxiety is really a separate issue, but is certainly worsened by lack of decent sleep and pain.  I take paracetamol which only takes the edge off but is better than nothing.  When I wake up with that burning backs of legs feeling I need to take something in order to get back to sleep.  I only ever take the co-codamol if the pain becomes unbearable.  I'll see how things go and what sort of medication they think might be most appropriate. They will probably offer a different TCA - but I am wary of them in general because of the link with dementia.
Interesting that you have the same experience re physios -  here in London they are really young and the one I've been seeing is fairly hopeless to be honest.     

Marchlove -  Thank you for that very helpful information.  I have been given exercises to do for the last two months and physio is now referring me to a gym.  You know how it works - they wont make any further referral until you've jumped through all their hoops. 

The NHS is extremely reluctant to do MRIs due to cost -  they will tell you that the treatment will be the same regardless (i.e exercise).  I will probably end up funding it myself. 

That's interesting information about pushing for a spinal or neurosurgeon and not an orthopaedic one.  I will certainly push for a referral if there is no real sign of improvement.  That's really great and encouraging to know that you are now pain free.  Long may it continue.

I am also in London. I have had a lot of physio in the past for pain back and none of it helped at all. They were all in their twenties too.

I wish you luck.

[Marchlove]

Mamie, I forgot to say prior to that I had an epidural steroid injection which amazingly lasted about 8 years! That was on the nhs, albeit years ago.
Unfortunately the second one didn’t last long at all just a few months. Hence my surgery route.

Orthopaedic surgeons are fine for knees/hips etc but don’t ever consider one doing any spinal surgery.

Yes, you will have to jump through many hoops to get there but a steroid injection might be the first option to consider.

M x

[CLKD]

Many surgeons won't do extensive surgery without trying the injection route first to see if there is benefit.

Let us know how you get on.  Lack of sleep can = anxiety 

[Mamie]

Mamie, I forgot to say prior to that I had an epidural steroid injection which amazingly lasted about 8 years! That was on the nhs, albeit years ago.
Unfortunately the second one didn’t last long at all just a few months. Hence my surgery route.

Orthopaedic surgeons are fine for knees/hips etc but don’t ever consider one doing any spinal surgery.

Yes, you will have to jump through many hoops to get there but a steroid injection might be the first option to consider.

M x

That's really great to read about the epidural steriod injection lasting so long.
 
I really appreciate all the great information you have given me .. so thank you once again    

I will update from time to time.