question-icon

Suggest treatment for fatigue when suffering from sciatica pain

default
Posted on Wed, 30 Jul 2014
Question: I already wrote this.. it got lost,..so I'll try again. I am 60 yr old male, healthy, actually trying to build muscle tone and tighten stomach, and build UP my body. Although not full-time employed, I keep BUSY, active on a daily basis.Very health conscious. Have deteoriated disc disease, so sometimes bothers me,, Recently via sciatica, left leg.. Hurt more left leg later in day, evening. Went to DR. he confirmed it was sciatica.. More or less, come and goes, sometimes intense, especially at night. Been about a month. I have tried alive, (no good) excedrine, and advil. Advil seems to work OK, but not as well as I'd like. As of last week I have gotten short-winded and fatigue added to these systems,. The short-winded is occasional...not always. fatigue is horrible. I overcame a bout of low hemoglobin about 2 yrs ago, anemia..but git the numbers up from 7.7 to 13 (average range) within a year..Feel much better. Continue to take same iron supplement. I'm on wellbutrin, nexium, adderall (generic only 15 mg a day) synthroid (100 mcg. daily) and meloxicam. Need some help to get OVER this and get my life and energy level back.


I wanted to mention mainly , that my concern now is my leg pain seems to have become more frequently, generating down from hip level (sciatic nerve?) and more often during the day,as opposed to just occasionally to more severely in evening.. THAT accompanied with the fatigue (and occasional shortness of breath) is what is keeping me from having the level of activity I normally enjoy each day, plus
the fatigue makes me feel less productive, and I HATE that!

I also take supplements of vitamins, body building, and general wellness. I HAVE started doing waist and leg exercises to supposedly help "loosen" the sciatic nerve
from tightening on me, thus causing pain. Other than that my general health, upper and lower GI, is very good. All my stats on blood work were great as of Feb. this year
Edit Delete Posted By : Hutchguy
Know and appreciate that you are reviewing... before you answer--allow me to add a couple other observations...I mentioned the fatigue and evening pain in leg, but I didn't mention at times it causes a lot of "restlessness" in which I find it hard to sit on sofa or chair and find COMFORTABLE spot.. Also difficult to rest in bed..but generally- ultimately get a decent night's sleep..although not as good it it was prior to this.

Other observation.. I hate the heat.. It has been very hot here in NC these last 10 or so days. My thyroid condition makes me "heat intolerable' which I sure adds to the fatigue situation. Also, I am not motivated to eat as I need to during the day. I know I need to- especially the protein- and I usually end up eating several "small" meals or peanut butter just to keep my energy levels up.

I have flat feet and have experienced "tingling" in extremities off and on for past few years.. This doesn't HELP the situation-but I am aware enough to know that it hasn't CAUSED this situation, and realize part of it is age-related.
doctor
Answered by Dr. Chakravarthy Mazumdar (9 hours later)
Brief Answer:
Holistic approach

Detailed Answer:
Hi,

I read through your mail and would like to discuss the following issues put forward by you. A well built active health conscious 6o yr old man
1) Back pain diagnosed as sciatica does not completely help with common medications
2) Fatigue and restlessness increased in the evening. You feel good when you lie down and deteriorates in some postures esp sitting on a sofa
3) Tingling in the extremities

You wanted help for the fatigue and the back pain.

I have the following suggestions/ideas for you.

You were treated for anemia a couple of years ago. I would like to know the reason for anemia and what type of anemia. Remember anemia is recurring. It would be good to test the Hemoglobin again. The multitude of medications would nullify the oral absorption of iron supplements esp Nexium.

Drug interactions I found two or three areas where five of the current medications will nullify or enhance the mechanism of action of others. I suspect a depression element is not being treated properly leading to extreme fatigue.

Chronic fatigue syndrome comes to my mind. It needs to be ruled out. It is a clinical diagnosis. A Psychiatric evaluation is needed sooner. Nutritional deficiency cannot be ignored in an aged person esp Calcium, Thiamine and B12 deficiency.

The medical diagnosis of sciatica may be aggravated in such scenarios. Nerve pain alleviators can help esp Pregabalin / Gabapentin. Massage therapy would be worth a try at this stage.

Mind body relaxation, yoga, massage therapy are my choice along with the necessary medications which makes it a holistic approach to deal with the multitude of problems.

Hope this helps.


Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
default
Follow up: Dr. Chakravarthy Mazumdar (2 hours later)
I feel like since I had a hemoglobin test within last 4 months, it should be sufficient. The anemia is hereditary. It is fine now. I have NO bleeding in stomach or stool..NO need for gastroenterologist.. or "specialist" not EVEN a consideration!

I asked for an XXXXXXX DR. The one showed online was an XXXXXXX yet you answered my question????? Holistic??? NEVER EVER has worked for me.. So don't EVEN go there.

You MISSED my point completely by NOT throughly reading my questions.. I mentioned SPECIFIC… when I said LEG pain. --RADIATING from hip area, worsens at night...you wrote Back pain… It is NOT back pain. It is leg pain radiating down from my hip. sciatic nerve area, I mentioned I had been treated once before with same problem.. did you not catch that?

I have read about the interaction of the five drugs I take.. I don't take Nexium until later in day by itself, because I don't want it nullified by other drugs.

The massage therapy may be worth a try…BUT YOU HAVE TO REMEMBER, IF YOU READ MY REPORT..THAT I WAS VERY HEALTHY AND ACTIVE…THIS PART of MY HEALTH ISSUER DID NOT OCCUR GRADUALLY….BUT WITH THE SUDDEN ONSET ON SCIATICA..

I also mentioned I DO take other vitamins/supplements.. and when you wrote, I may need calcium, or others supps… DID YOU NOT READ my original report when I mentioned I already take these supplements?????????????


A psychiatric evaluation?? What the hell??? That is completely absurd. Please get me a doctor in XXXXXXX accustomed in treating these issues without a holistic or alternative approach. I need responses ASAP, please.
Thank you..
PLEASE GO BACK and re-read my statements clearly
doctor
Answered by Dr. Chakravarthy Mazumdar (54 minutes later)
Brief Answer:
Pyriformis Syndrome

Detailed Answer:
I am sorry I missed certain history while answering you.

I could think of Pyriformis syndrome a muscle that crosses the sciatic nerve at the hip. This could be a sudden event. That fits the description ' find it hard to sit on sofa or chair'. It requires physical therapy and stretching exercises at home. Some may benefit by Ultrasonic therapy.

I do not mean to offend you by taking a Psychiatry opinion. At least I failed to understand why were you taking Wellbutrin and Adderall, the former is first line antidepressant.

It does not mention if you take Calcium or Vit B12 supplements. Anyway I wish an XXXXXXX Doctor picks up your query but there was none leaving me to lead.

You can write to YYYY@YYYY for a refund of the money you paid.

Wish you Good health.
Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
default
Follow up: Dr. Chakravarthy Mazumdar (2 days later)
my hip pain is somewhat relieved. However, I do have a question/Concern that seems to be even MORE pressing... With all this anxiety, I somehow have developed a shortness of breath, extreme, at times. Very scary I might add. Along with that an occasional dry cough. Not too frequent, but occasional. This , is in addition to the fatigue... These "spells" of anxiety/shortness of breath are really scaring me.. I have to lie down, take long slow breaths, and try to get some relief. I have looked up allergies, or other things that could cause this. No real answer. I had one or two similar symptoms when I had low hemoglobin about 2 years ago, but like I said earlier, that shouldn't be a problem since levels has come back and got a good report a few months ago, plus I don't think that would come on "suddenly".
Any help? please
doctor
Answered by Dr. Chakravarthy Mazumdar (9 hours later)
Brief Answer:
your description has the answer

Detailed Answer:
Hi,

You admit to be anxious. Anxiety has the potential to cause any simple to serious symptom. Slow and deep breath ins and slow breath outs will certainly reduce these symptoms by a long difference. With these actions parasympathetics sets its tone over the sympathetic drive that your symptoms. Most often these episodes are temporary during a physical pain. If they continue to bother you should see a Psychiatrist for temporary medication.

I do not see an organic disorder bothering you so much.

Keep breathing in very slowly and breath out similar. Start tightening each muscle of your body and release them after three seconds. This is another technique to ease your symptoms.
Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
Answered by
Dr.
Dr. Chakravarthy Mazumdar

General & Family Physician

Practicing since :2004

Answered : 1779 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest treatment for fatigue when suffering from sciatica pain

Brief Answer: Holistic approach Detailed Answer: Hi, I read through your mail and would like to discuss the following issues put forward by you. A well built active health conscious 6o yr old man 1) Back pain diagnosed as sciatica does not completely help with common medications 2) Fatigue and restlessness increased in the evening. You feel good when you lie down and deteriorates in some postures esp sitting on a sofa 3) Tingling in the extremities You wanted help for the fatigue and the back pain. I have the following suggestions/ideas for you. You were treated for anemia a couple of years ago. I would like to know the reason for anemia and what type of anemia. Remember anemia is recurring. It would be good to test the Hemoglobin again. The multitude of medications would nullify the oral absorption of iron supplements esp Nexium. Drug interactions I found two or three areas where five of the current medications will nullify or enhance the mechanism of action of others. I suspect a depression element is not being treated properly leading to extreme fatigue. Chronic fatigue syndrome comes to my mind. It needs to be ruled out. It is a clinical diagnosis. A Psychiatric evaluation is needed sooner. Nutritional deficiency cannot be ignored in an aged person esp Calcium, Thiamine and B12 deficiency. The medical diagnosis of sciatica may be aggravated in such scenarios. Nerve pain alleviators can help esp Pregabalin / Gabapentin. Massage therapy would be worth a try at this stage. Mind body relaxation, yoga, massage therapy are my choice along with the necessary medications which makes it a holistic approach to deal with the multitude of problems. Hope this helps.