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    Suggest treatment for sciatica

Posted on Mon, 31 Jul 2017 in Back Pain
Question: Im a 28yo white male, athletic, fit (5'11" 175lbs), no health problems whatsoever, except constant lower back pain and associated pains. As seen in the attached xray, my right leg is about 22mm shorter than my left (measured in the xray viewer tool by a spinal orthopedic doctor). I sometimes have sciatica like leg pain shooting down my right leg, initiating deep within my hip. I have constant back pain of about a 2-4/10 pain scale. I cant remeber a weekend or a week without back pain in the last 2-3 years. I can only wear hard soled supportive shoes or its 5x worse that day. Sitting at a desk or in the car makes it worse, but so does standing and walking all day. Weekends feel the best when I can lay down and relax often. For 2 years I have been wearing a 3/8in adjust-a-lift heel insert in my right shoe consistently. My doctor reviewed MRI results today from a lumbar MRI scan that was conducted yesterday. He said there was no fractures, breaks, nerve damage, herniated discs or other issues he saw, besides a little bit of arthritis that is in my lower back. Also, while I still quite flexible, my flexibility in my right hip is about 20% worse than my left hip. My doctor has said there isnt really a solution besides wearing the heel inserts (which I've done with little to no improved results). He has referred me to see a physical therapist. He assumes this is a structural issue of my leg being shorter rather than a functional. I did have back pain dating all the way back to when i was at least sixteen or earlier when a chiropractor adjusted me and said visually I had about a 1/2 inch discrepency between my leg lengths that he was able to adjust to about 1/4inch. Is there anything else I can do? This is starting to affect my motivation at work, my enegery and overall quality of life and I am only 28. Any help is greatly appreciated!
Answered by Dr. Praveen Tayal 2 hours later
Brief Answer:
Muscular pain likely.

Detailed Answer:
Thanks for posting your query.
The low back pain and hip pain that you have is likely to be related to posture as it is relieved with rest. This can improve only after improvsation of posture or with regular physiotherapy that can tone up the muscles. For symptomatic relief you can do a hot compress and apply local analgesic gel in the area. Taking an oral muscle relaxant will also help.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Praveen Tayal 5 minutes later
I work out very frequently and often try and correct poor posture. Will this be something that the PT will help correct? Do you have any other suggestions? I care much more about the long term solution than any temporary pain relief. Also while resting helps in most positions, laying flat on my back makes my lower back burn (i assume this is inflamation). Would the custom orthotics also help, since i have severe over pronation in the longer leg?
Answered by Dr. Praveen Tayal 3 hours later
Brief Answer:
PT will help in long term.

Detailed Answer:
Thanks for writing again.
Physiotherapy will help in toning of the weak muscles thus providing a better support. The burning sensation in the lower back can be due to a mild nerve root irritation. Taking methylcobalamin supplements will help.
Custom orthotics will also help in improving the posture.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Praveen Tayal 1 hour later
What about an alignment such as chiropractic manipulation to help realign my hips. As i have mentioned this supposedly corrected it by 1/4 of an inch years ago. Is that a common or accepteable appraoch, combined with physiotherapy, orthodics and other advice?
Answered by Dr. Praveen Tayal 7 hours later
Brief Answer:
Chiropractic adjustment will help.

Detailed Answer:
Chiropractic adjustment can help in decreasing the disparity between the limbs. You can get it done in addition to physiotherapy and orthotics.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12072 Questions


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