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Suggest treatment for sciatica pain in hips and tailbone

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Orthopaedic Surgeon
Practicing since : 1999
Answered : 705 Questions
Question
had been fighting sciatica pain for 4 months. Pain was almost entirely gone and i went running. Now pain is back in hips abd tailbone and feels like im almost at square one again. Aside from physical therapy is there anything else I can do? See a chiropractor?
Posted Sat, 16 Aug 2014 in Bones, Muscles and Joints
 
 
Answered by Dr. Karl Logan 1 hour later
Brief Answer:
Disc prolapse, nerve root compression

Detailed Answer:
Hi Thanks for your question.

If your sciatica, by this I assume you mean pain from your back radiating down the back of your leg to your foot, has returned after 4 months of improvement then I would suggest that you have an MRI scan of your spine to identify the likely disc prolapse and see if there is ongoing nerve root compression.

If there is then you have some options. Start physiotherapy and manage the pain medically with analgesics and pain modifying drugs. Have a CT guided nerve root injection with local anaesthetic and steroid to reduce inflammation around the compressed nerve root and hopefully relieve your symptoms. Have spinal surgery to remove the prolapsed intervertebral disc and decompress the nerve root.

I hope this answers your question.

Best wishes
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for sciatica pain in hips and tailbone 3 hours later
I am a very active individual. I love sports and lifting and running. I want to be able to do these things again. Is surgery my best bet?
 
 
Answered by Dr. Karl Logan 16 hours later
Brief Answer:
Surgery would depend on investigative findings

Detailed Answer:
Hi,

Thanks for your question.

Surgery is an excellent solution to sciatic pain caused by nerve root compression. I can vouch for this professionally and personally, however whether or not you proceed to surgery will depend on what your MRI scan shows and whether your symptoms do not improve with non-operative methods.

I would hope that you could return to full health.

Best wishes
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for sciatica pain in hips and tailbone 1 hour later
Ok i will have to get the MRI. Just to give you a background...i stretched the wrong way playing hockey and noticed some tightness in my hips and lower back. So i decided to run instead of lift to give myself a break. Pain got worse and physical therapist told me the running probably therew something out of whack after the stretch tweaked something
 
 
Answered by Dr. Karl Logan 12 hours later
Brief Answer:
Twisting often precipitating factor

Detailed Answer:
hi thanks for you follow up question.

an awkward twist or stretch is often the precipitating factor in a disc prolapse.

I hope you find a solution to your problem soon.

best wishes

Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for sciatica pain in hips and tailbone 27 hours later
Do prolapsed discs heal themselves over time? If so how will i know when it is safe to resume lifting/running
 
 
Answered by Dr. Karl Logan 9 hours later
Brief Answer:
90 percent chance of improvement

Detailed Answer:
hi,

thanks for your further question.

over 90 percent of first time disc prolapses will spontaneously improve.

second time disc prolapses this reduces to around 60 percent.

the reccomended approach in the abscence of weakness and numbness is to observe for 6-8 weeks treating only the pain. if symptoms then persist or recur the. further investigation and consideration of surgey are suggested.

when you are completely symptom free you can slowly reintroduce your sporting and lifting routine.

I hope this further answers yor question.

best wishes
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for sciatica pain in hips and tailbone 14 hours later
Ok i will continue going to PT and performing a series of stretches for the hips, glutes and lower back. I hope i do not require surgery, this nagging injury is very frustrating
 
 
Answered by Dr. Karl Logan 24 hours later
Brief Answer:
Best wishes

Detailed Answer:
I understand. I hope you find relief soon.

beset wishes
Above answer was peer-reviewed by
 
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