6 moths of Sciatica - doctors not helping?!

Brain and nerves
1

Hi guys!

I was wondering if anybody could offer some advice when it comes to getting a referral for an MRI scan?

To give some background, I'm 26 years old & have been relatively fit & healthy all my life. Around October last year, I started to experience frequent pins & needles in my right foot & soon after, a dull ache on the outside of my calf. About a month later, the pain in my calf had worsened & I developed lower back pain - this then very quickly descended into the worst pain I've ever experienced. My entire leg from hip/bum, right down to the foot felt as though it was burning on the inside & I lost most of the feeling in my toes. Sitting down was impossible & the only thing that eased the pain was continually walking around, non stop.

Over the course of about 2 months, I visited the walk in centre twice, my gp 3 times, along with 4 phone consultations. I paid for 3 sessions with a private osteopath & was off work for a total of 11 weeks, meaning I was extremely low on funds over the festive period!

To start I was prescribed Naproxen & Amytriptiline, followed by the addition of codeine & paracetamol. None of these touched the pain. I was then given Gabapentin & referred to a physio - this was prescribed over the phone, by a doctor that hadn't seen me, which I found quite worrying. Throughout this experience I have also tried heat & freeze products, along with ibuprofen gels.

The Gabapentin actually worked & this combined with physio meant that most of the pain subsided to just a discomfort & tingly foot. I returned to work 4 weeks ago & was weened off the gabapentin & discharged from physio. I have continued the exercises 3 times a day & have been taking classes such as aquacise, yoga & pilates.

Since stopping the gabapentin, I have felt the pain slowly creeping back in, a little more each day, with the pins & needles becoming more constant. I returned to my physio who just recommended more physio - even though I'm keeping up with the exercises meticulously.

I have asked for a scan, an actual diagnosis so many times now. I have tried being polite, getting angry & also getting teary, nothing is working. Everything they have done has been based on guesswork & I'm worried & frustrated that I'm not getting the care that I need. I'm terrified that I'm the going backwards, towards the same condition that I was in before Christmas & really can't afford to be off work again.

I'm considering using my savings to pay private for an MRI, but I pay my tax & national insurance so I'm therefore angry that I'm even having to consider this! Does anybody have any advice to offer? It would be greatly appreciated.

Thanks in advance,

Mellisa

2

Hi Mellisa, I'm astonished. They have absolutely no right not to offer you a scan.

As it happens I'm in the exact same position, for past three weeks I've had intense pain, like someone has switched on a food mixer inside my right lower back, all down right leg encompassing thigh and whole area, back of knee, lower calf and foof, the pain emerges after the slightest domestic chore or ANY exercise. I am taking up a yoga class but don't relish the extra pain I'm likely to be in.

On Tuesday I see my doctor and if he says i cannot have a scan i think i'll consider taking legal advice/action. My sciatic pain makes me both tearful and nauseous and i will NOT put up with it not being thoroughly looked into.

I'm sorry i can't actually advise, only empathise and say keep pressing to get a scan and ask to see a chiropractic /physiotherapist as I will be doing so on Tuesday. They have absolutely no right.

Very best wishes , Fiona

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Hi Mellisa, I'm astonished. They have absolutely no right not to offer you a scan.

As it happens I'm in the exact same position, for past three weeks I've had intense pain, like someone has switched on a food mixer inside my right lower back, all down right leg encompassing thigh and whole area, back of knee, lower calf and foof, the pain emerges after the slightest domestic chore or ANY exercise. I am taking up a yoga class but don't relish the extra pain I'm likely to be in.

On Tuesday I see my doctor and if he says i cannot have a scan i think i'll consider taking legal advice/action. My sciatic pain makes me both tearful and nauseous and i will NOT put up with it not being thoroughly looked into.

I'm sorry i can't actually advise, only empathise and say keep pressing to get a scan and ask to see a chiropractic /physiotherapist as I will be doing so on Tuesday. They have absolutely no right.

Very best wishes , Fiona

4

PS. One thing worth considering is emailing or phoning PALS or any similar organisation online ( the precise names apart from PALS escapes me for the moment but google "medical nhs complaints organisation" and set out the details of what's been happening and don't be afraid to name names. Good luck!

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It's "NHS Complaints INdependent Advocacy Service" or PALS may also be able to help.

6

First, you need to know that it is definitely sciatica (sounds like it) and then discover what's the ROOT CAUSE of the pain...there can be many.  Check this...

https://patient.info/forums/discuss/sciatic-nerve-pain-from-the-perspective-of-many-decades-629096

See if any of that makes sense to you...

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Or there is an organisation called healthwatch whos email address can be found online

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Or Healthwatch may be able to help.

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Hi melissa91000, I to am suffering from that pain. When my pain first started I went to see a general medicine doctor, who prescribed me a oral steroid to help with the swelling. After about a month the pain got to be the absolute worst. So I went back to my general medicine doctor who referred me over to a spine specialist who orderd a cat scan which showed I have a herniated disc that is causing the sciatica pain. I did two rounds of physical thearpy and continue regular check up between general medical and spine specialist. You need to find 1 doctor that u can afford to treat you for this pain. The first thing should be an MRI or ct scan to see what the possible cause is. Good luck to you. I have also began seeing a chiropractor who also practices differnt acupuncture and energy flows to help my body heal this disc and give me pain relief. I pay out of pocket 45.00 every session. As I can afford. It's been 9 months since my Sciatica pain begun. Best of wishes and be strong. Don't let this pain. Get the best of you. Stay active. I have lost my activity and endurance to even walk out to the car...so stay active.

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Click my link in the post above.  I think you found your cause; now you need the op to fix it once and for all...just like I did.  You should NOT have to live with that pain.

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Hi Melissa 

I’m in the same boat gp wouldn’t refer in the end I went private for a scan and to see a spinal specialist if you can just pay as it will take weeks for an nhs referral anyway. Sadly I now can’t be treated as I discovered o was pregnant so I have to just manage it until baby born x I don’t rate physio but just started seeing a chiro and Swimming and Pilates morning making me pain free as yet I’m 6 months in it’s hideous 

Keep us updated 

12

I have the same issue sciatic pain down left buttock,calf and ankle. Numbness in big toe and palm of foot and also some numbness on top of foot.

I’m sure most GP’s have little empathy for sciatic pain unless they have experienced it themselves.

I think this is how, from experience I think the NHS doctors guidelines work.

If the pain follows an event such as lifting, twisting etc then it is probably a bulging disc interfering with a nerve. As long as the nerve pain is only on one side and not interfering with bladder or anal function then the disc injury will likely recover within 6-8 weeks or less. During this time pain medication should be prescribed. A combination of nerve relaxant, pain killer and anti inflammatory. For me it was Amitriptyline, Neproxin and over the counter co-cocodamol. It seems that most doctors will just tell you to take ibuprofen and paracetamol. 

During this period they advise physio exercise. This where the NHS mentality kicks in as the doctor will not usually refer you to a specialist and the physio therapist would normally do the referral if there has been no improvement following physio. The timeline for referral is at about 12 weeks from first episode. 

Referral is normally to an orthopaedic spine surgeon. In the UK surgery is a last resort as it should be.

If the injury is in recovery then the Dr will probably suggest MRI and then if disc bulge suggest pain treatment that might include nerve block injection, 70% effective for leg pain sciatica and can last up to 3 months if the correct nerve root is located. If the MRI doesn’t show any obvious nerve compression then they may use it as a diagnosis tool to identify the problem nerve first before injecting the steroid.

I have private health care cover but doctor was reluctant to refer me to surgeon and suggested I have physio sessions paid for by insurance cover. I had 8 half hour sessions over 10 weeks at £36 a session with only slight improvement so on week 12 I was back at the GP asking for a referral.

in the space of three weeks I had first consultation (£200) where Dr said looks like L5 S1 disc bulge and sent me for MRI (£538) 

MRI showed L4 L5 disc bulge after second consultation (still to be billed) and sent me for nerve block injection at my request, which I had today.

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Hi Karl, thanks, it helped to read of your experiences as Im in such pain i dont know what to do for the best. I saw doc two days ago, he assured me unless i had numbness in water works etc then it cant be anything either twisted or crushing the nerve, but despite this past two days in late afternoons and evenings i have been literally writhing around in agony in tears sat on my sofa until applied massive amounts of gel, lavender oil and deep freeze spray as this combination in large amounts are the only thing that dulls the pain, and often im needing two applications of the lot and the strong pain killers he gave me are as yet not touching it. I cant bear to even try the exercises again as first time i tried them yesterday evening i was practically laid up in the proceeding 24 hours. My sister, who is not trained but very practical having been my late mothers carer for many years and she had spinal stenosis said wait a couple more days for the tablets to kick in before lying in what seems to me very hard carpeted floors and being, as i am, in increased pain from it. I'm not abandoning them but i just can't face it. And i only have the doctors word that i would feel this very specific numbness were it a serious case . Forgive me for sounding off at you, its just I've just struggled into bed and its mighty painful currently to negotiate the lounge on foot. This has been persistent and worsening with me for nearly seven weeks and I've never known pain quite as intense. Sorry.

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Hi Fiona

My post was a response to Mellisa's post as she seems to have similar symptoms to mine.

It sounds like your going through a very tough time and I hope you get some relief from your pain soon. It would be interesting to know what meds your GP has prescribed to treat your pain.

If it is a disk injury then the more movement you can undertake the quicker it will recover. I know that sounds ridiculous at this point in time which is why your pain needs to be controlled first.

A lot of meds can take up to a week to kick in so stick with them.

If your not happy with your doctor or have concerns regarding your diagnosis then seek a second opinion or ask for an open referral letter to go private then google a consultant in your area or ask a doctor for recommendations You will have to pay but it will give you a true diagnosis quicker and some peace of mind.

Remember though that even a private doctor will treat the pain in most cases whether it be meds or root block so that you can get more mobile and recover quicker.

The longer you are in pain the more your brain will think it's the norm and keep picking up signals from the damaged nerve area.

Exercise when the pain is relieved I would recommend cycle machine or walk on treadmill on an incline using treadmill arms as support.

Sleeping - pillow under knees if lying on back. Pillow between legs if lying on side. Flat pillows supporting neck.

Tried physio, acupuncture, healthy remedys none seem to be very effective long term. Doctors or physios will not recommend chiropractors.

I do hope you get some sort of relief soon from this awful pain.

15

Thanks everyone for your replies! Sometimes it's good to just know that you're not alone & that there is actually other people who understand how upsetting this whole experience has been.

Today I went to see a private physio/sports therapist that came highly recommended from one of my colleagues. He went way beyond the hour that I'd paid for, was very thorough & seemed to know what he was talking about.

After lots of questions & diagnostic tests, he says that I have sacroiliac joint dysfunction, on both sides. One side of my pelvis moves too much & the other not enough, plus I also have one leg shorter than other! I also have a slight curve in my spine, which all amounts to me being very misaligned...

His opinion was that this is the cause of the majority of my pain now, however maybe when it was at its worst, he wouldn't rule out a bulging disc. He thinks that now the disc has repaired as they sometimes do, but I'm still left with a wonky pelvis & a severely tight piriformis muscle.

He's given me some different styles of exercises to do, more resistance based. And has organised some follow up appointments, he's confident that he can help me to improve but has said that its not an easy ride & could involve me doing these exercises for the rest of my life.

It was a very informative appointment & I'm feeling very tender now!

Really hoping that this is the start of me getting better...