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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8796
Experience:  Doctor of Medicine
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I have had a bad back and sciatica down my left leg for

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Hi - I have had a bad back and sciatica down my left leg for several years. I do exercises daily to help, and attend a gym, and was managing the pain OK. Then I bought an adjustable desk as I was conscious my job was quite sedentary. When I started using the standing desk my sciatic leg pain went away (hurrah) but was replaced almost immediately with a different pain in the same leg. If anything this is worse, as nothing I do seems to shift it. It's like a dull, throbbing ache deep in the bone, and sometimes if I'm standing up my left knee just kind of gives out, and I have to massage away the pain for a few moments to be able to walk around properly. I think it's relevant to say that there is a problem with that leg anyway - it doesn't rotate properly at the hip and the problem (and the pain) seems to stem from there. But it runs right down the leg and feels more bone-related than the sciatica did, which was more in the buttock. The throbbing keeps me awake for hours unless I take a strong painkiller. The doctor just says it's sciatica and tells me to be more active, but I know it's a different feeling - quite different - to what I had before. However, he won't offer imaging or anything like that - which I understand if it IS sciatica, but I'm not sure it is. I cycle at the gym at least 10kms 3-4 times a week and walk daily. I'm a fairly active person and am within healthy BMI range (though am currently on a diet just in case this helps). I get up, move about, do things during the day. I've now run out of ways to try to get rid of this pain and I'm worried it's something more sinister. I can feel it now, sitting typing this - a dull, burning ache from my groin right down the middle of my left leg. Sometimes it feels as though someone has taken my leg and twisted it. The floor exercises I do each day don't seem to help the leg at all, though they help with the back. Do you have any thoughts on whether this is just a form of sciatica or something else?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. SH replied 1 year ago.
Thank you for your question.Actually, from my experience I can tell you that in the majority of cases when the sharp pain of sciatica improves it is followed by dull burning type of ache that you are having at the moment.This is a very common followup kind of a pain that one experiences after the sharp shooting pain of sciatica.I still think that this pain is related to your nerve(s) being pinched at the back and will improve in few more weeks or even months.In the meanwhile though, I would have referred you to a pain medicine doctor, reason being, that epidural blocks or methylprednisolone injections in the back can help tremendously, at times, in relieving such kind of a pain.I would have also repeated a lower back scan.I would have also done a doppler ultrasound of your arteries to rule out any blockage in the arteries of your legs as blockage in arteries of the legs can also, at times cause such kind of a pain (which seems unlikely in your case because you are able to exercise and walk around fine but I would still rule it out to be on the safe side).Let me know if you have more questions.Please rate me by clicking on one of the rating options (stars) at the top right hand corner when you are done asking.Kindest regards
Expert:  DrRussMD replied 1 year ago.
HelloThe solution here is not "more activity" as your doctor says, and it is not injections.Simply pain relief will allow the disc disease to progress.You have not stated that you have had an MRI of the lower back.This is required, as well as an EMG/NCS, which will show if there is nerve damage and help explain the leg giving out.In fact, you need to see a specialist MD of physical medicine and rehabilitation. These doctors are now plentiful in the us and are the doctors most trained to help reverse your disc disease.There are also called physiatrists.A physiatrist is an MD or DO doctor of physical medicine and rehabilitation, who will tailor a physical therapy to you and your tests, and can do the tests, and who will also use novel electronic and traction therapies, and can handle pain control or work with your pain control doctor and your other doctors.The reason physical therapy often does not help is because it is not individualized.This doctor will do that as well.These doctors...physiatrists are oriented to improving the situation to the point that you don't need surgery or medications. Again, standard physio, and injections is not enough, and, you have two different types of pain, indicating, in most cases , a chronic and slowly progressive problem.That needs to be stopped.A surgical assessment also needs to be done, as you have not responded to conservative therapy, but that will also be based on the PM&R doctors assessment. The PM&R doctor can do the EMG/ NCS right in the office.I am a double board certified US doctor.Find me here by request in medical to safe time for safe and correct yet comprehensive answers.I am here daily.Please click a positive on the scale at the top of this answer page. That is how we are paid.Find me any time.
Expert:  Dr. SH replied 1 year ago.
This session is open for any number of further questions that you may have.Please rate me by clicking on one of the rating options at your end as that is the only way I am credited on here for helping you out.Kindest regards
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8796
Experience: Doctor of Medicine
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