Lower Back Pain & Sciatica Pain In Right Leg

[syd barrett]

My initial idea was to self-treat using diclofenic sodium 50mg three times per day.

However, no pain relief after three days. I will continue because it might take some time to 'kick-in' with NSAID relief.

I have added an analgesic: Tramadol 50mg 3 times per day and am getting some pain relief with that.

My question to fellow sufferers or those with good ideas, what other drugs might help with the pain and relief from this condition?

Also, am I paying too much for my tramadol (150 baht for 10X50mg)?

Thanks, all suggestions gratefully received.

[ThommoPerth]

I have had this and a similar condidtion for over 30 years, the only relief I got was surgery of which I have 2 lots of 25 years apart. It is now manageable with accupuncture and light exercise. I have the accupuncture applied once a week by my local physiotherapist. works for me.

[Sheryl]

Drug wise you are already taking all that would be advisable.

Addition of heat (heating pad) may help.

Exercise also may be useful but imperative to see a specialist first and get at least an Xray of the spine in order to determine the nature of the problem and get advise on appropriate exercise from a qualified physiotherapist as the wrong exercise can make matters vastly worse.

Avoid being in a sitting position as much as you can in favor of standing or lying down.

If these measures don't bring relief, and especially as you have pain radiating down the leg (indicative of possible nerve root entrapment) then you may need surgery.

[newtronbom]

For Tramadol, try tramcap, which is the Thai generic brand and is exactly the same - for 30 baht per 10 x caps. Be careful with the NSAIDS as they can knock the hel_l out of your stomach. There is a new and better alternative to Tramadol, called Tapentadole.This is not yet available here in LOS, but should be soon. Same family as Tramadole, but much stronger. Half way between Tramadole and Morphine, without the tolerance, dependence side effects of Morphine - but be careful! Tramadole does have a hook if you have to use daily it for more than 2 x weeks!! Of course not as bad as Morphine, but nasty all the same. I got up to 10 x caps of Tramadole Daily, before I was put on Morphine. I just wish there was Tapentadole here, as that would have been the safer option.... good luck.

[Thongkorn]

In my experience over the last 20 years , of having sciatica , Exercise is the only way, It Will hurt if you do and will hurt more if you do not ,Pain killers only damage your kidneys over the years, There are some new treatments about , ultra sound is one , i have heard that it works quite well, Never use heat it will be good as long as you are hot but when you cool down it will hurt more , Cold is the best relief for short term. I use a frozen bag of peas , that molds to the shape where you use it ,

[PMNL]

Have you try the combination of B1-6-12 ( Neurobion, neubeeforte/LM) and nortyline/amitryptyline(25mg)?

You might want to discuss with your doc first how to take all these meds.

They work well with the NSAID, but try to get off the diclofenac if you can.

Long term side effects of kidney damage/elevated blood pressure and gastritis are common.

[edgarfriendly]

anyone know of a source of heat pads/mats? ef

[Comehome]

Hi!

Have you thought of going to see a chiropractor?

If the Sciatic nerve is giving you pain it is most probably because it is squeezed somehow inbetween the pelvis bones. Sorry for my bad explanation in english.

My Dad in europe works at the Operahouse and I know lots of proffessional ballet dancers there and chiropracors as well

Some of the dancers sometimes have problems with the Sciatic nerve and they say that the first step is to see a chriopractor who will put the sceletat bones right, so the nerve will be put free without any pressure on it.

After that is done, a training program is a good option, to make sure you learn the right exercises to prevent the bones to go back in the same location again. Most of the times the musclestrength is not in balance and that is why the there are too much pressure to the bones and the nerve will come inbetween and cause a lot of pain.

Look at how you stand and how you walk. If you have overflexible knee joints you most probably cringe in the lower back to compensate it.

That will put a lot of pressure on the lower back as well. If your abdomen is heavy the pressure on the lower back is even higher..

Perhaps you need some support in the shoes you are wearing.

Medication is a temporary solution but not a solution to the actual cause.

Depending on how bad the nerves is squeezed inbetween the bones, proper massage and stretch can help a bit but if the nerve is squeezed bad the best thing is to release it of the pressure first and then start to build up balance between the muscles that causes the problem.

Sorry to write so long, i hope you understand how I mean anyway?

Hope you will feel better soon.

Take care,

Comehome

[FBN]

Pain down the leg usually indicates some nerve root irritation; either from a bulging or ruptured disc or narrowing of the root canal with bony spikes or outgrowths due to degenerative changes.

If there is such a mechanical reason for the pain, medication will only offer mild or moderate relief.

The idea is to get off all medication, if possible, so a specific diagnosis is needed by X-ray, MRI after a full clinical examination.

If the reason is apparent and clear, surgery may be an only option.

Minimally invasive surgery for disc prolapses often yield good results.

[tomahawk]

Syd, I have same problem. herniated disks and sciatica pain in right leg. Only thing helped me is exercise and therapeutic massage. I walk and ride bike every day and also do exercises called hindu squats and planks. I go to Thai massage almost every day but must advise that you go to qualified masseuse or will not help and can even make worse. Although massage is somewhat painful it has done miracles for my condition and before I began could not walk without stick or get in and out of car and now can do everything physically I did before. I tried tramadol but did nothing for pain, and I now take no medication at all.

[Pattayatony]

Syd,

Please try this>>>>>

I have suffered from Sciatica pain for over 30 years, spent a fortune on Chiropractors. A few weeks ago out of desperation with pain I decided to google Sciatica pain & came onto the above on U Tube and it works for me but I think the secret is doing it 3 times a day. I hope it works for you.

Cheers Tony

[filingaccount]

I'm surprised nobody has said that easy walking (focus on elongating your step) and light stretching of the legs, lower back and hip work, because it does help both medium and long term. The longer you stretch and walk, the better the end results.

Adding chemicals to your body doesn't do anything except maybe relieve the pain momentarily. It doesn't help solve the problem at all.

(In terms of numbing your nerves, you'd be better off punching the affected areas until numb. yes that's how bad it is)

Get off the meds as much as possible and start moving around.

(this should not be taken as medical advice, and consultation with a medical and/or sports injury rehab professional is advised.)

[grumpyoldman]

Hi Syd,

I feel for ya man, back pain is no fun, I went about a year battling it after herniating a disc.

Full sciatica to the point that my leg would go numb. No position sleeping felt good, so lack of sleep, or being woken up in pain made things bad also. Couldn't do any of the sports I liked to do.

Doctors of course recommended surgery, then prescribed a pretty powerful NSAID, I cannot remember the name of the drug, beige pill, that made me so constipated I wouldn't crap for three days. I figured that couldn't be good for my kidneys.

Saw a couple chiros. One told me to stop all activity until the frazzled nerves started to calm down. Another built me a machine where I could hang by my knees upside down. I'd get home from work, club a Norgesic and half a bottle of wine (o.k., maybe a full bottle) and then I'd flip upside down on the machine. When I first started this the separation "boom" or "pop" would make my whole body shudder and I would practically pass out. After awhile the "pops" became less violent and now a year later my back is perfect, I'm back to all of my sports, am trying to keep my abs and hamstrings tighter (running and situps).

My advice, work on the structure problem in your body instead of trying to kill it with pills. I think there are a few good chiro clinics in Bangkok, if you need an upside down machine, PM me and I'll put you in touch with the guy that makes it, he charges 18,000thb for it. Best of luck, I know where you are at.

[PPG]

I've been stuck, totally immobile in my Bangkok apartment for 6 weeks with same thing. This is probably the 5th episode in the last 10 years, but this time is much worse. Before I've always self-healed after maybe 3-4 weeks, but not this time.

I'm basically crippled and unless I'm lying down, I'm in indescribable pain... which seems to shift around. I was getting massage on the frazzled nerves and knots in my left leg down to my ankle, which was like a game of 'endurance'... that did seem to help for a while. Then after a trip to extend my visa last week at Chaeng Wattana the pain moved back to my lower back again. Now the last 3 days I'm losing feeling in my fingertips on both hands. That's reassuring. lol

I've been to BNH 3 times and have been on various meds all mentioned here and codeine as well - this actually worked but the fact that it gave me a bit of a buzz and is an opiate I thought it best to stop.

I've been told it could be a herniated disk, degenerated disk or a slipped disk. The thing is, you may as well save your cash on getting an x-ray, because this tells doctors nothing. I got 4 x-rays of my lower back done at B4,000. After looking at them, the doctor said "maybe you have something going on, but I can't tell from this x-ray - you need an MRI for B10,000". Jeez, thanks Doc - I can't afford that now having just paid B5,000 for this visit. That was about 5 weeks ago.

Anyway... rambling on here. But I'm trying to face the fact that I really do need an MRI and quite possibly surgery. Of course I have no Health Insurance. What are your opinions on having this done in Thailand..or anywhere else for that matter? Scares the beejeezers outta me. But then I faint at the sight of a needle..

Cheers.

[lopburi3]

Not cheap at about 33 baht per pill (per day) my wife has had good luck from Neurontin (Gabapentin) 300mg. She has had two previous operations to clear calcium deposits pressing on nerve and has/had same left leg problem you appear to mention. Doctor has advised to use this medication until it stops helping.

As said the MRI will likely be needed to pinpoint cause or operation path.

[Sheryl]

Yes, you really do need an MRI. Only then can a specialist give you an idea of what your chances are of being able to avoid surgery.

Depending on the findings, a course of physical therapy might work.

But a reputable physical therapist isn't going to touch you without seeing an MRI, either. There are good reasons for that.

You can get an MRI done for a lot less $ at a government hospital but it would take days of red tape and waiting which given the pain you are in may not be worth it.

You can also shave several thousand baht off the BNH cost by going to a less costly private hospital. I've used Phayathai2 for this in the past. Just say that you need only the film, as you already have a doctor. (To be tactful, maybe say a doctor back in your home country). Or if you like, go ahead and consult an ortho specialist there. Won't increase the cost by that much and no harm in getting more than 1 opinion.

Be sure to get the film to take with you to show the docs at BNH though. Not just the report, the actual film.

As to having spinal surgery in Thailand -- should it come to that in your case -- given what is at stake I personally would be very fussy about the qualifications and experience of anyone I let near my spinal column with a scalpel. There are doctors in Thailand that I'd be fine with, but not many, and you may already be seeing these. They do cost significantly more than surgeons of less eminence. But IMO this is something you should do with the best or not at all. If you cannot afford the cost of having a top notch surgeon do it here then you would be better off going home for it if your country has free health care.

[lopburi3]

I am not so sure about cost saving in a government hospital for procedures such as MRI as believe the cost at Chula five or six years ago was about the same as top private hospital. I know it was a huge amount more than the 10k being asked in above post.

[PPG]

Thanks very much for the replies.

I found an MRI Center in Chatujak that charges B8,000, not a huge difference to BNH which charges B10,000. Do you know if PhayaThai2 is cheaper than that?

The Doctor at BNH has put me on LYRICA (pregabalin) 75mg. These are fairly heavy drugs and since taking them I've started to get evening shivers and what I think is a fever (I say 'think' because I don't have a thermometer), I've also woken-up soaked in sweat for the last 3 nights. I can't be sure that this is related to this drug or not, but I do know the pain has subsided since taking it, so I don't mind these side effects if it gives me a break from the pain.

Sheryl, I've read some of your other very helpful posts related to back problems, and I saw you recommend Dr Wicharn. I actually went to see him at BNH but he only works evenings and I've not made it to Bangkok Christian on a Saturday yet. I'm woundering if he does surgery at Bangkok Christian, which I presume would be cheaper than BNH.

[tutsiwarrior]

FWIW, I just re-read this thread and got to thinkin': why is it that every time that I come home on leave that I have lower back pain/sciatica symptoms? Diet? activity level?..Aha! when I come home I'm totally sedentary and don't move much except to mix another drink or to change the DVD in the player as I don't have to move otherwise as everything is taken care of...

sure enough this time at home after 2 days or so I got the dreaded twinge around my hips that developed into severe pain a day later...after re-reading this thread I noted that daily exercise is recommended as therapy so I got myself up yesterday evening and hobbled to the barber about 30 min walk away...he was closed but when I returned home I felt a lot better and last night was able to sleep all night horizontally without pain...the two previous nights I had no sleep as only a semi-sitting position would minimize the pain...

try that daily exercise, folks; you'll be glad you did

[Sheryl]

Thanks very much for the replies.

I found an MRI Center in Chatujak that charges B8,000, not a huge difference to BNH which charges B10,000. Do you know if PhayaThai2 is cheaper than that?

The Doctor at BNH has put me on LYRICA (pregabalin) 75mg. These are fairly heavy drugs and since taking them I've started to get evening shivers and what I think is a fever (I say 'think' because I don't have a thermometer), I've also woken-up soaked in sweat for the last 3 nights. I can't be sure that this is related to this drug or not, but I do know the pain has subsided since taking it, so I don't mind these side effects if it gives me a break from the pain.

Sheryl, I've read some of your other very helpful posts related to back problems, and I saw you recommend Dr Wicharn. I actually went to see him at BNH but he only works evenings and I've not made it to Bangkok Christian on a Saturday yet. I'm woundering if he does surgery at Bangkok Christian, which I presume would be cheaper than BNH.

I believe it was when last I did this but is was a while ago so call and check. Costs everywhere have gone up in past year.

I'd be hesitant with an MRI Center, some of them do not produce good quality films in which case you'd end up having to repeat it at BNH and actually losing money.

Dr. Wicharn does sometimes operate at Bkk Christian and it does save on the hosp costs but not on his fee which is considerable - and well worth it IMO.

Since the hospital stay is not that long, the savings don't add up to all that much. And the English speaking is much less. What I'd suggest you do is contact both hospitals and ask for a quote sparate from surgeon's fee then see how much difference there is.

If you are going to ask hom to do the surgery at Bkk Chrisitian best to consult him there as I think BNH frowns on docs using their consultation facilities to schedule surgery elsewhere (as most private hosps would).

[syd barrett]

UPDATE

My condition is cured. Since I was the O.P. of this topic I might add that getting a rock-hard mattress at Home-Pro improved the condition very quickly.