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Suggest treatment for sciatic nerve pain - Online Doctor Chats

Date : 25-Mar-2014
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
I'm a 57yo female, basically healthy with an old fracture at L5 and narrowing of the sciatic nerve space on the right side. I've had pain since the birth of my daughter at 40. (I should also mention my x husband is a physician) , While I had insurance I had routine MRIs and a cortisone epidural to keep the pain under control with vicodin if needed. Now divorced without health insurance and little possibility of surgical repair. It would be helpful to have some pain relief when needed. Any suggestions?
Also should mention was scheduled to have surgery for laminectomy when my husband was Dx with lymphoma therefore, didn't procede.
Doctor:Please give me a moment to read your query
Doctor:all right
Doctor:are you there?
User:yes! hello
Doctor:I have read your query
Doctor:I am sorry about your pain concern
Doctor:You seem to be in chronic pain
User:off and on
Doctor:this requires multiple approaches to keep the pain at bay
Doctor:Could you please rate your pain now on a scale of 1 to 10 based on the severity?
Doctor:there are various methods of pain management
User:for instance, I went for a long week-end, walked a lot with my daughter so it was about 9
Doctor:so sorry about that
Doctor:is it the same now?
User:I'm resting so it is about 4 currently
Doctor:that is good
Doctor:Apart from the epidural cortisone and the vicodin, have you tried any other measures of pain management?
User:A side note, I take tylenol. NSAIDs reallly upset my stomac
Doctor:Tylenol is better than any other drug for you
User:neuronton, I'm currently on an SSRI
Doctor:Good, the SSRI would help you with the pain
Doctor:Avoid NSAIDS as much as possible as it could affect your kidney
Doctor:I would suggest a few non-invasive non-pharmacological treatments for you
User:I've really tried so many other 'pain' possibilities...
Doctor:Mild physical exercises would be one option for you
Doctor:yes, it requires Behavioral modification as well
Doctor:coping with chronic pain can be troublesome at times
User:I walk as much as possible, although being on my feet bothers my back more.
Doctor:Do not strain yourself much
Doctor:a moderate walk for 20 to 30 mins would be fine
Doctor:You could try Cognitive Behavior therapy, biofeedback mechanisms
Doctor:transcutaneous electrical nerve stimulation (TENS)
Doctor:Have you tried this as well?
Doctor:Let me tell you, ultimately, you need to learn the pain management yourself based on the level of pain you are in
User:Let me share that I'm well educated...MS immunology. There are times when I need to get things done, I'm sure you understand that
Doctor:Surgical corrections do not always relieve the pain by 100%
User:Yes, I agree
Doctor:Yes, I do understand
Doctor:That is good to know that you are well educated
Doctor:Glad about it
Doctor:So, you must have learnt how to deal with the pain
Doctor:I am sure, you know all the non invasive and invasive pain management techniiques
User:I believe so. There are still times when life gets in the way and one must move on.
Doctor:With the existing knowledge that you have, you can use different pain management techniques as and when required
Doctor:Yes, that is right
Doctor:You should move on and the pain should not come in the way of your progress in life
User:That' a great thought. It isn't always reality
Doctor:yes, but we could try to do our best for ourselves
Doctor:Now, how do you think you are managing your pain?
User:Anyway, I appreciate your time and effort. I'm sure you're busy.
Doctor:Not really
Doctor:would be glad to help you
Doctor:If there are no more queries from your end, we can end the chat
Doctor:Would you like to end the chat now?
User:The only way I 'manage' my pain is when I'm pushed to the limit and I've tried all other options, is to take vicodin
Doctor:I understand
User:I know that isnt the optimal answer.
Doctor:But, yes, Vicodin can be best in moderate to severe pain at times
Doctor:You can take it on occasions
Doctor:The ultimate aim would be to get relief from pain especially when it is severe
Doctor:Also, you must rest adequately at those times
User:Thats good to hear. my issue is not having insurance. To try to get an RX at an ER I wait 2 hours and 'maybe' get 20. My last visit the admitting dr said "oh, we used to have an attending with that last name....I said, "yes, he is my x-husband".
Doctor:I see
User:I'm feeling a bit silly at this point, I'm not sure what an online consult can help me with but I appreciate your conversation.
User:feeling a bit lost in what to do
Doctor:Online consult can be relieving in educating you, we could discuss health concerns here
Doctor:perhaps about the treatment and other medical guidance
Doctor:yes, I am sorry, I cannot treat your pain sitting online
Doctor:sorry about that
Doctor:I can reassure you not to feel lost
Doctor:But, you are already well educated with your pain
Doctor:So, you must know what treatment you should take when
Doctor:Since, your pain is at level 4, you probably need some bed rest and a tylenol to help you
Doctor:This should suffice for now
Doctor:You should feel better tomorrow
User:Yes, but it seems as if I look like a 'frequent flyer'
User:Thanks for your time and effort and I wish you the best in your future practice in medicine
Doctor:Thank you too
Doctor:Your wishes matter the most
Doctor:Good health and good wishes to you as well
Doctor:Get well soon
User:take care
Doctor:my regards
Doctor:you too
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