Sciatica - My story and a question: How do YOU manage it? - Cycling Mob: Road Cycling, Mountain Biking and More

06-26-2004, 04:51 AM

Greetings! Long, semi-sad story is next, question at bottom.

I had been experiencing one of my infrequent flare-ups of a mild to
moderate sciatic condition when I took a header off my bike at
somewhere between 25 and 30 mph. I was on a group ride coming down a
hill. We had had a large amount of rainfall recently and there were
occasional sand washes running out into the road. Sadly for me, a
deep sand wash (4 - 6") became visible as we entered a shaded region
from an area of bright sunlight at the bottom of a hill.

Cyclists to my left, can't go that way. Deeper sand to the right, not
a good choice either. I tried to make it through but being a roadie
only, I wasn't aware that I should get my weight back on the bike to
get through it. Got launched onto my left hip (the side with the
sciatica) and hit there first, luckily in the sand rather than on the
pavement. So the road rash was minimal, although I did slide for a
distance on my elbow before I rolled into a nice older couple's lawn.

Got bandaged up, straightened out my handlebars and shifters, and
finished the ride (27 more miles). I finished fairly well, averaging
about 17 mph. As I felt fairly sore I didn't ride until the following
Sunday. Got out about 4 miles that day and felt terrible. My
sciatica hadn't gotten too bad and I was SORE with a giant bruise on
my hip but all in all, I felt as if I could ride. Not. Struggled
back up the hill to our house but was able to walk, move and bend
reasonably well. Monday morning (Memorial Day), however, was another
story. Woke at 5 a.m. due to a level of pain in my left leg that had
tears dripping from my eyes. Trip to ER, shot of dilaudid and muscle
relaxer and script for vicodin.

Ever since, I have been struggling with the managed care system to get
the treatment I need and the docs all agree I need in a bad way.
Oooops, sorry, we forgot to submit for your pre-authorization for a
spinal cortisone shot. Ooooops, we're so sorry, we didn't read the
insurance company's info, you need an MRI for the pre-auth submission.
Ooops, sorry, we can't get you an MRI until the first week of July.
Ooooops, sorry, we can't get you in for your spinal til mid July. The
bastards are more than happy to throw opiates at me but give me actual
treatment? They think not.

I have received significant relief from a chiropracter but I believe
in the spinal (my father has sciatica too and he has been pain free
for five years after just one shot) and am hopeful that the
chiropractic care I have received won't cause my MRI to show that the
shot is unnecessary (in their estimation).

On to my real question: what do you do to manage your chronic pain
and keep on the bike?

TIA

App, who kinda likes the opiate pain relief but understands the
inherent problems therewith.

06-26-2004, 09:33 AM

"Appkiller" <[Only registered and activated users can see links. ]> wrote

<snip>

>
> On to my real question: what do you do to manage your chronic pain
> and keep on the bike?
>

My most recent bout of sciatica was caused by riding, early in this training
season. I stayed off the bike for 10 weeks, and am just now getting back
into training. I tried to ride some, but found it just made things worse.

My leg pain is usually caused by a bulging lumbar disc, but this time I
suspect it was related to the piriformis muscle. (Unfortunately, I did not
get a confirmatory diagnosis prior to pain cessation.)

For weeks I was able to manage my pain with ibuprphen. Then I started taking
synthetic morphine in addition. I finally ended up getting an epidural shot
of corticosteriods, which took more than a week to kick in. I'm sure my pain
doctor would credit the epidural, but for 36 hours prior to complete release
of the sciatica, I was in great pain.

At any rate, my treatment was based on the long-standing diagnosis of
bulging disc. If it happens again, I'm going to ask for a new MRI and PT.

FWIW, my advice to you is try to get a definite diagnosis! I would have felt
better knowing whether my recent problems were due to a muscle injury or
progressive disc degeneration. Now that I'm pain-free, the doctors don't
seemt to care.

Horace

06-26-2004, 09:33 AM

"Appkiller" <[Only registered and activated users can see links. ]> wrote

<snip>

>
> On to my real question: what do you do to manage your chronic pain
> and keep on the bike?
>

My most recent bout of sciatica was caused by riding, early in this training
season. I stayed off the bike for 10 weeks, and am just now getting back
into training. I tried to ride some, but found it just made things worse.

My leg pain is usually caused by a bulging lumbar disc, but this time I
suspect it was related to the piriformis muscle. (Unfortunately, I did not
get a confirmatory diagnosis prior to pain cessation.)

For weeks I was able to manage my pain with ibuprphen. Then I started taking
synthetic morphine in addition. I finally ended up getting an epidural shot
of corticosteriods, which took more than a week to kick in. I'm sure my pain
doctor would credit the epidural, but for 36 hours prior to complete release
of the sciatica, I was in great pain.

At any rate, my treatment was based on the long-standing diagnosis of
bulging disc. If it happens again, I'm going to ask for a new MRI and PT.

FWIW, my advice to you is try to get a definite diagnosis! I would have felt
better knowing whether my recent problems were due to a muscle injury or
progressive disc degeneration. Now that I'm pain-free, the doctors don't
seemt to care.

Horace

06-26-2004, 09:33 AM

"Appkiller" <[Only registered and activated users can see links. ]> wrote

<snip>

>
> On to my real question: what do you do to manage your chronic pain
> and keep on the bike?
>

My most recent bout of sciatica was caused by riding, early in this training
season. I stayed off the bike for 10 weeks, and am just now getting back
into training. I tried to ride some, but found it just made things worse.

My leg pain is usually caused by a bulging lumbar disc, but this time I
suspect it was related to the piriformis muscle. (Unfortunately, I did not
get a confirmatory diagnosis prior to pain cessation.)

For weeks I was able to manage my pain with ibuprphen. Then I started taking
synthetic morphine in addition. I finally ended up getting an epidural shot
of corticosteriods, which took more than a week to kick in. I'm sure my pain
doctor would credit the epidural, but for 36 hours prior to complete release
of the sciatica, I was in great pain.

At any rate, my treatment was based on the long-standing diagnosis of
bulging disc. If it happens again, I'm going to ask for a new MRI and PT.

FWIW, my advice to you is try to get a definite diagnosis! I would have felt
better knowing whether my recent problems were due to a muscle injury or
progressive disc degeneration. Now that I'm pain-free, the doctors don't
seemt to care.

Horace

06-26-2004, 09:33 AM

"Appkiller" <[Only registered and activated users can see links. ]> wrote

<snip>

>
> On to my real question: what do you do to manage your chronic pain
> and keep on the bike?
>

My most recent bout of sciatica was caused by riding, early in this training
season. I stayed off the bike for 10 weeks, and am just now getting back
into training. I tried to ride some, but found it just made things worse.

My leg pain is usually caused by a bulging lumbar disc, but this time I
suspect it was related to the piriformis muscle. (Unfortunately, I did not
get a confirmatory diagnosis prior to pain cessation.)

For weeks I was able to manage my pain with ibuprphen. Then I started taking
synthetic morphine in addition. I finally ended up getting an epidural shot
of corticosteriods, which took more than a week to kick in. I'm sure my pain
doctor would credit the epidural, but for 36 hours prior to complete release
of the sciatica, I was in great pain.

At any rate, my treatment was based on the long-standing diagnosis of
bulging disc. If it happens again, I'm going to ask for a new MRI and PT.

FWIW, my advice to you is try to get a definite diagnosis! I would have felt
better knowing whether my recent problems were due to a muscle injury or
progressive disc degeneration. Now that I'm pain-free, the doctors don't
seemt to care.

Horace

06-26-2004, 09:33 AM

"Appkiller" <[Only registered and activated users can see links. ]> wrote

<snip>

>
> On to my real question: what do you do to manage your chronic pain
> and keep on the bike?
>

My most recent bout of sciatica was caused by riding, early in this training
season. I stayed off the bike for 10 weeks, and am just now getting back
into training. I tried to ride some, but found it just made things worse.

My leg pain is usually caused by a bulging lumbar disc, but this time I
suspect it was related to the piriformis muscle. (Unfortunately, I did not
get a confirmatory diagnosis prior to pain cessation.)

For weeks I was able to manage my pain with ibuprphen. Then I started taking
synthetic morphine in addition. I finally ended up getting an epidural shot
of corticosteriods, which took more than a week to kick in. I'm sure my pain
doctor would credit the epidural, but for 36 hours prior to complete release
of the sciatica, I was in great pain.

At any rate, my treatment was based on the long-standing diagnosis of
bulging disc. If it happens again, I'm going to ask for a new MRI and PT.

FWIW, my advice to you is try to get a definite diagnosis! I would have felt
better knowing whether my recent problems were due to a muscle injury or
progressive disc degeneration. Now that I'm pain-free, the doctors don't
seemt to care.

Horace

06-26-2004, 01:41 PM

"Appkiller" <[Only registered and activated users can see links. ]> wrote in message
news:ac4af1d8.0406260451.446a616f@posting.google.c om...
>
> On to my real question: what do you do to manage your chronic pain
> and keep on the bike?
>
After two years of steadily worsening sciatica and visits to just about
every kind of health care practitioner that deals with such, I finally
underwent disc surgery. That was over two decades ago and I have been fine
ever since except when I do types of lifting that I shouldn't - then I have
a couple of days of mild sciatica which I guess is my body's way of
reminding me of what I should and should not do. It actually wasn't until
after my surgery that I became more a more serious recreational rider and
still do the occasional century. I doubt your managed care will opt for
surgery unless you become totally incapacitated. It may be that your
sciatica will subside to a point where you can begin a daily regimen of
lower back and abdominal exercises to alleviate recurrences. However, it is
also possible that your accident caused an actual disc rupture in which case
you may eventually have to undergo the knife. If so, a word of advice: go
with a surgeon who does nothing else but disc surgery of the lower back.
Mine was a neurosurgeon who did nothing else. Orthopedic surgeons also do
the surgery. BTW, the worst part of the surgery was the preliminary
myelogram - where dye is injected into the spinal column to identify on an
Xray precisely where the disc rupture is - done 6 weeks before the surgery.
I suspect that less invasive diagnostics are used today. Good luck!

06-26-2004, 01:41 PM

"Appkiller" <[Only registered and activated users can see links. ]> wrote in message
news:ac4af1d8.0406260451.446a616f@posting.google.c om...
>
> On to my real question: what do you do to manage your chronic pain
> and keep on the bike?
>
After two years of steadily worsening sciatica and visits to just about
every kind of health care practitioner that deals with such, I finally
underwent disc surgery. That was over two decades ago and I have been fine
ever since except when I do types of lifting that I shouldn't - then I have
a couple of days of mild sciatica which I guess is my body's way of
reminding me of what I should and should not do. It actually wasn't until
after my surgery that I became more a more serious recreational rider and
still do the occasional century. I doubt your managed care will opt for
surgery unless you become totally incapacitated. It may be that your
sciatica will subside to a point where you can begin a daily regimen of
lower back and abdominal exercises to alleviate recurrences. However, it is
also possible that your accident caused an actual disc rupture in which case
you may eventually have to undergo the knife. If so, a word of advice: go
with a surgeon who does nothing else but disc surgery of the lower back.
Mine was a neurosurgeon who did nothing else. Orthopedic surgeons also do
the surgery. BTW, the worst part of the surgery was the preliminary
myelogram - where dye is injected into the spinal column to identify on an
Xray precisely where the disc rupture is - done 6 weeks before the surgery.
I suspect that less invasive diagnostics are used today. Good luck!

06-26-2004, 01:41 PM

"Appkiller" <[Only registered and activated users can see links. ]> wrote in message
news:ac4af1d8.0406260451.446a616f@posting.google.c om...
>
> On to my real question: what do you do to manage your chronic pain
> and keep on the bike?
>
After two years of steadily worsening sciatica and visits to just about
every kind of health care practitioner that deals with such, I finally
underwent disc surgery. That was over two decades ago and I have been fine
ever since except when I do types of lifting that I shouldn't - then I have
a couple of days of mild sciatica which I guess is my body's way of
reminding me of what I should and should not do. It actually wasn't until
after my surgery that I became more a more serious recreational rider and
still do the occasional century. I doubt your managed care will opt for
surgery unless you become totally incapacitated. It may be that your
sciatica will subside to a point where you can begin a daily regimen of
lower back and abdominal exercises to alleviate recurrences. However, it is
also possible that your accident caused an actual disc rupture in which case
you may eventually have to undergo the knife. If so, a word of advice: go
with a surgeon who does nothing else but disc surgery of the lower back.
Mine was a neurosurgeon who did nothing else. Orthopedic surgeons also do
the surgery. BTW, the worst part of the surgery was the preliminary
myelogram - where dye is injected into the spinal column to identify on an
Xray precisely where the disc rupture is - done 6 weeks before the surgery.
I suspect that less invasive diagnostics are used today. Good luck!

06-26-2004, 01:41 PM

"Appkiller" <[Only registered and activated users can see links. ]> wrote in message
news:ac4af1d8.0406260451.446a616f@posting.google.c om...
>
> On to my real question: what do you do to manage your chronic pain
> and keep on the bike?
>
After two years of steadily worsening sciatica and visits to just about
every kind of health care practitioner that deals with such, I finally
underwent disc surgery. That was over two decades ago and I have been fine
ever since except when I do types of lifting that I shouldn't - then I have
a couple of days of mild sciatica which I guess is my body's way of
reminding me of what I should and should not do. It actually wasn't until
after my surgery that I became more a more serious recreational rider and
still do the occasional century. I doubt your managed care will opt for
surgery unless you become totally incapacitated. It may be that your
sciatica will subside to a point where you can begin a daily regimen of
lower back and abdominal exercises to alleviate recurrences. However, it is
also possible that your accident caused an actual disc rupture in which case
you may eventually have to undergo the knife. If so, a word of advice: go
with a surgeon who does nothing else but disc surgery of the lower back.
Mine was a neurosurgeon who did nothing else. Orthopedic surgeons also do
the surgery. BTW, the worst part of the surgery was the preliminary
myelogram - where dye is injected into the spinal column to identify on an
Xray precisely where the disc rupture is - done 6 weeks before the surgery.
I suspect that less invasive diagnostics are used today. Good luck!