Nov 15, 2011
(Started Nov 15, 2011)
(for Herniated Disc)
(for Degenerative Disc Disease)
(for Sciatic Neuralgia)
Not at all hard to take
Advice & Tips:
I suffered from sciatic pain due to a herniated disc in the lumbar spine (L4-L5). While the pain was bad I was really
afraid from surgery.
Here are some points that I want to raise:
1. From what I read, a very important factor in resolving sciatic pain is....TIME. Frequently the pain passes spontaneously. If the pain is bad and it does not subside, even if there is no deterioration I would consider surgery. I waited over 9 months to do surgery. Looking backwards from my experience, if you don't see any improvement over 4-6 months, you should start searching for a surgeon.
2. There are no oral medications that were shown to relieve sciatic pain. Everything that the Dr might suggest and that you might consider trying - NSAIDS, lyrica, etc., was never shown to work. Don't be surprised if it does not work for you.
3. From my experience physical therapy is not only not beneficial, it might be quite disastrous for your level of pain as you will get much worse almost instantly. For more info about my experience with physical therapists, please look at My Treatments.
4. Epidural steroid injections sometimes work (you can see my comments about them). However, if they don't work for you and you waited long enough, it's time to search for a surgeon.
5. The first issue that you need to think about when search for a surgeon is whether you are going to do it with a neurosurgeon or an orthopedic surgeon who specializes, and did fellowship, in back surgery.
I decided to go with the latter.
While I am sure that many neurosurgeons do great back surgery, it is important to remember that a herniated disc is a mechanical problem and not a neurologic problem. You might have some damage to the nerve (with me it's sensory nerves as manifested by tingling sensations that are still with me after the surgery, for other people it might be motor nerves). However, the problem with the nerve is due to a mechanical reason, a disc that is pressing on it. It's not a neurologic problem.
From my understanding neurosurgeons are mostly interested in treating neurological problems and not mechanical problems. They will surely be happy to do diskectomy as it's a very easy procedure for them, and the compensation is surely appealing for them. However, if you are interested in doing this surgery with a surgeon whose main interest is mechanical problems in the back, you should do it with an orthopedic surgeon who specializes in back surgery.
6. Diskectomy (today it's usuaslly microdiskectomy) is a relatively simple procedure for surgeons. You should probably find a surgeon who does many more complex back surgeries and will find this procedure straight forward.