source of leg pain

[sliv]

I have been dealing with left buttock, leg and calf pain for 4 months following an intense period of work (70 hours with 2 hours sleep) which followed a possible strain somewhere in the left buttock/hamstring region several days prior to the work marathon - has anyone ever developed sciatica and discovered a source in the buttock causing the pain as opposed to the spine? I have an MRI which shows a small bulge at L5/S1, doctor thinks that's the source and wants to send me for epidural, just want to see if people have experienced sciatica from sources other than spine (we discussed piriformis syndrome, he doesn't think that's it either).....thanks  a lot

[Tuckamore]

I am not Mollyrae. But there is not a way to send a group message. It must be done individually. MedHelp is working on possibilities.

I am glad that you have decided to take the advice of your physician. Mine were wrong, which is not the norm. I will hope that yours are not.

Best of luck to you.

[Tuckamore]

The DX was done through an injection under fluoroscopy into the SIJ. A numbing agent was instilled followed by a steroid. If I had less or no pain after the agent was injected I had SIJ Dysfunction/Syndrome.

I remember that day so very well as I too was a bit skeptic. How could a D.O. be do right when MD's and multiple specialist were at a loss??? As the IV Sedation wore off and I was asked to stand up from the post-procedure bed.

I gingerly placed my feet on the floor and than my weight. No pain. So I took a step, No pain. I reached outward, No pain. I learned forward, No pain. I squatted, No pain. I began to laugh and with my laughter came tears and as I began to dance right there in that little 6x10 room. I cried with tears of you, I laughed, "No Pain, No Pain!!!!!"

It was one of the most joyful experiences in my life since this journey through pain began. I had a diagnosis. I had hope. I later discovered that unfortunately my SIJ is too far damaged to respond to treatment. It was the numbing agent at work. But what a glorious few hours.

On x-ray my SIJ also looks "funny."  I forget the exact reading. It is not usual or normal that an x-ray will reveal any SIJ problems. Mine is just so severe that it does. An MRI or CT scan will not reveal SIJ issues. Only the SIJ injection will provide a definitive DX.

[sliv]

thanks so much for your reply, I am going ahead with the doc's recommendations, continuing to work with the PT and hoping for the best down the road...by the way, I've had a lot of replies to my post, is it possible to send a message to everyone at once? If not, thank you all and a good New Year!

[seano]

Epidurals are silly to me because they only temporarily help, if they help at all. I have had so many that they can't even inject the necessary medicatons due to scar tissue that developed over time. They did help my pain, but only somewhat and albeit temporarily. I think it's wiser to fix the problem once and for all, rather than masking it every few months, possibly causing more problems. Just my opinion! ( One of my old pain doctors "required" patients on narcotic therapy to have epidurals. I think it was a real money maker for him. Other patients of his that I spoke with were enduring epidurals, knowing that they didn't help them at all. Sounds silly of me to have a procedure done repeatedly that does not even help the patien! He was a jerk of a doctor anyway!)

[seano]

I had a pinched nerve somewhere, AND a herniated disc on my lower spine. It caused the same symtoms you desribed. No amount of pain killers even touched this type of pain. I recommend getting the ball rolling-, meaning see your primary care doctor. He/she will probably get an mri, which should show whats wrong with you. I tried everything (rest, hot/cold, physical therapy, acupuncture, etc.), but surgery was the only thing that actually helped me with this type of pain. I wish you luck with this!

[opus88]

goodmorning Tuck...was the original DX of SIJ dysfunction done with an MRI?...or how?

[Tuckamore]

Hello Sliv,

Welcome to the Pain Mangement Forum. I am glad that you found us and posted.

Your pain could be coming from your spine. You should not dismiss your physicians diagnosis. I cannot tell you if his diagnosis is correct or not.

That said I will tell you that I have severe sciatica and it is not related to my spine. I also have pain in my hip, lower back, lateral leg, foot and groin. This pain is all related to my diagnosis. Can you generally point to the exact location (one spot) of pain in your buttocks?  

The sacroiliac joint (SIJ) is located in your buttocks or gluteal region. The sacroiliac joint lies next to the spine and connects the sacrum (the triangular bone at the bottom of the spine) with the pelvis (iliac crest). I have SIJ Dysfunction. This is an often over-looked and undiagnosised condition. I had in for years before it was diagnosed (DX). Unfortunately because it went so long untreated it is now disabling and untreatable.

I am not suggesting that you have SIJ Dysfunction instead of a bulging disc. You asked for other possibilities and that is one. After my PCP DX my condition she sent me to a nurologist to see of he could offer any treatment suggestions. The neurologist refused to believe my DX. He said it was rare and I didn't have it. It took an SIJ injection to confirm my DX before the neurologist would even consider it. So it's a tough sell.

Good luck to you. If you have any additonal questions please feel free to ask me. I will look forward to your updates with interest.

Take Care,
Tuck

[Mollyrae]

Hi sliv:

The source of your pain is coming from your lower back. Even a small bulge can cause you pain. I have heard both good and bad things about epidurals. Some work and some don't. It's generally up to the patient. Listen to your Doctor...he's on the right path.
Please take care,
Mollyrae