Sharp pain in lower right leg - Any suggestions.

[tomx2]

Hi.

Ten years ago I had lower back surgery for a herniated disk. Since then I've had off/on discomfort in my lower back but nothing serious. Just before leaving for Thailand from New York, I had a severe back strain in my lower back. I then started getting a sharp pain in my right leg running from my butt to my calf.

It seems to occur when walking (but not to severe). However when I am standing idle for a few minutes in an air conditioned room the pain is more severe. From what read online this is known as

“Sciatica”. I come to the realization that after I get MRI (back in the States), I will probably need a 2^nd back surgery.

In the meantime, I will be here in Thailand (Pattaya) for 8 months. I would like to get through this with a minimal amt of discomfort as possible. For anyone who experienced this problem can I get some suggestions.

- Are there any over-the-counter strong pain medications that can minimize the pain till I return to

the United States?

- Do you suggest I see doctor? Any recommendation in Pattaya?

- Daily exercises I can perform that might help?

- Sleeping preference?

Any suggestion will be appreciated.

Thanks.

TC.

[johnatong]

The 'strongest' pain medication which could be accessed OTC would be Tramadol but not all pharmacies will stock/sell the medication.

Many cases of Sciatica will settle if you keep reasonably mobile and take a NSAID like Ibuprofen together with a simple analgesic such as Paracetamol(Acetaminophen)

If the pain is severe or if there is any disturbance of bladder/bowel function an urgent medical opinion should be sought.

[Jdietz]

Definitely Diclofenac as above. Sold as 'Subsyde CR' continuous release capsules everywhere, around 200B a box.

One capsule once a day at bedtime.

Works.

[Ghostnigel]

I had severe sciatica down both legs, tried everything, exercise, xrays, that stretching machine thing, pills.....then i went and had acupuncture with electric pulses, and suction cups and its great. I had 4 sessions, it was fine, then it came back slowly, so i went again for 5 or 6 sessions, haven't been back since. Its not expensive here, between 500-700 baht a time. I wish i had done it years ago.

[Ghostnigel]

Sorry, one more thing, if you go and have acupuncture, trust me, you need the full amount of sessions, even if you think you are ok, have maybe 5 or 6 to be sure.

[johnatong]

I had severe sciatica down both legs, tried everything, exercise, xrays, that stretching machine thing, pills.....then i went and had acupuncture with electric pulses, and suction cups and its great. I had 4 sessions, it was fine, then it came back slowly, so i went again for 5 or 6 sessions, haven't been back since. Its not expensive here, between 500-700 baht a time. I wish i had done it years ago.

Bilateral sciatica, represents a potential neuro-surgical emergency and urgent specialist advice should be sought.

The advice to seek a "cure" for such a condition via acupuncture is potentially dangerous

[Ghostnigel]

Ok sorry, but it worked for me...so diclofenac is ok then? As in posts 3 and 4, hmm!

Edited April 23, 2016 by Ghostnigel

[johnatong]

I had severe sciatica down both legs, tried everything, exercise, xrays, that stretching machine thing, pills.....then i went and had acupuncture with electric pulses, and suction cups and its great. I had 4 sessions, it was fine, then it came back slowly, so i went again for 5 or 6 sessions, haven't been back since. Its not expensive here, between 500-700 baht a time. I wish i had done it years ago.

Bilateral sciatica, represents a potential neuro-surgical emergency and urgent specialist advice should be sought.

The advice to seek a "cure" for such a condition via acupuncture is potentially dangerous

Ok sorry, but it worked for me...so diclofenac is ok then? As in posts 3 and 4, hmm

Posts three and four make no mention of Bilateral Sciatica.

[tomx2]

Thanks @Transam, @Jdietz, @Ghostingel

It appears Diclofenac is what I will need temporarily.

Can I get this at a local Pharmacy here in Pattaya i.e. Boots Pharmacy?

@Johnatong I tried Ibuprofen for 2 days but it didn't help. You suggest I should buy/take Paracetamol(Acetaminophen) along with Ibuprofen. Is Paracetamol readily stock in a local Thai Pharmacy? Keeping mobile, Should I walk 1-2 miles per day?

Thanks

TC.

[Ghostnigel]

I had severe sciatica down both legs, tried everything, exercise, xrays, that stretching machine thing, pills.....then i went and had acupuncture with electric pulses, and suction cups and its great. I had 4 sessions, it was fine, then it came back slowly, so i went again for 5 or 6 sessions, haven't been back since. Its not expensive here, between 500-700 baht a time. I wish i had done it years ago.

Bilateral sciatica, represents a potential neuro-surgical emergency and urgent specialist advice should be sought.

The advice to seek a "cure" for such a condition via acupuncture is potentially dangerous

Ok sorry, but it worked for me...so diclofenac is ok then? As in posts 3 and 4, hmm

Posts three and four make no mention of Bilateral Sciatica.

I don't suffer from it anymore, it worked for me...because the acupuncture cured it, i think i will stick with a thousand year old Chinese quack treatment if you don't mind....thanks for the concern all the same.

[Sheryl]

Diclofenac and paracetemol can both be found in any pharmacy. Like all NSAIDs, diclofenac may irritate the stomach. Take only with food and do not take if you have a history of gastric ulcers.

Avoid sitting as much as you can in favor of either lying down or ewalking, sitting puts maximum pressure onto the lower spine.

Physical therapy with lumbar traction can help. Pattaya International Hospital has a physical therapy department that several TV members have spoken highly of. http://www.pih-inter.com/department/14/physical-therapy-center.html

Suggest giving them a visit. In addition to lumbar traction, which requires use of their machine, the physio there may be able to prescribe some exercises.

[johnatong]

Thanks @Transam, @Jdietz, @Ghostingel

It appears Diclofenac is what I will need temporarily.

Can I get this at a local Pharmacy here in Pattaya i.e. Boots Pharmacy?

@Johnatong I tried Ibuprofen for 2 days but it didn't help. You suggest I should buy/take Paracetamol(Acetaminophen) along with Ibuprofen. Is Paracetamol readily stock in a local Thai Pharmacy? Keeping mobile, Should I walk 1-2 miles per day?

Thanks

TC.

You should try the Ibuprofen for longer than a couple of days ! You can safely take up to 1200mgm/day in divided doses(make sure you check for contra indications) and make sure to take the medication with food. Paracetamol is easily obtained and you can safely take up to 4G/day in divided doses.

As always follow the manufacturer's instruction when taking any medication.

Keep mobile within the constraints of your condition ---- do not exercise to a point where the problem is exacerbated.

[tomx2]

@Sheryl. Thanks for the tip. I've just sent an email to Pattaya International Hospital asking about their starting cost giving Physical Therapy for Sciatica. In regards to avoid sitting, i'll have to train myself more intently to keep walking when pain occurs. Sitting does relieves the pain, but as you stated, sitting can endure other consequences.

Also, I'll take a NSAID pill just before I eat to avoid any stomach disorders.

@johnatong. I still have a packet of 20 Ibuprofen on my dresser will use them in conjunction with Paracetamol.

Thanks.

TC.

[Sheryl]

In regards to avoid sitting, i'll have to train myself more intently to keep walking when pain occurs. Sitting does relieves the pain, but as you stated, sitting can endure other consequences....

If walking is painful, just lie down instead of sitting. That actually puts the least pressure on the lower spine of all provided you position properly i.e. if on your back, put 1-2 pillows under your knees so that they are slightly flexed; if on your side, place pillows under the upper leg to avoid overly twisting the spine. Head pillow as needed for comfort.

[Greenhill]

Definitely Diclofenac as above. Sold as 'Subsyde CR' continuous release capsules everywhere, around 200B a box.

One capsule once a day at bedtime.

Works.

I think a Doctor's consultation is required before taking these drugs as they can cause kidney/damage to those who might have existing weak function of these organs!!

[simple1]

OP: I had very similar symptoms as you describe. After going though the usual routine of exercise / pain medication for spinal stenosis it was actually diagnosed the pain in the lower legs was being caused by insufficient blood flow. The method for diagnosis was Doppler measurement of blood flow. To ease the symptoms recommended walking / cycling and 100mg aspirin a day. In severe cases, if the blood flow restriction is located in the upper leg, a surgical intervention by implanting a stent may be recommended.

Suggest you get a consultant to check out if the above is applicable to your situation; Sheryl would know of the best specialists in Thailand.

Edited April 23, 2016 by simple1

[Langsuan Man]

Same symptoms but no back surgery but did have a broken leg 7 months earlier

Went to Pattaya International Hospital and they correctly diagnosed a deep vein thrombosis (DVT) after an ultrasound

Put me on blood thinners and their correct diagnosis was confirmed by a Hematologist upon return to the US

[NancyL]

Someone with a history of cardiovascular problems may wish to consider another NSAID -- naproxen -- instead of dictlofenac for pain relief in this situation. It's available at pharmacies here without a prescription. It does irritate the stomach, so it should be taken after a meal.

[samuijimmy]

I have been going through the same sort of problem for several months...

Really one should see a doctor, and have an Xray..(less than a 1000 baht) to see what is going on. after doing that I found I have four collapsed discs in the lower back... no pain in back, but horrendous pain in left leg, from pinched nerves.

I've done traction at Samui Public hospital, helped some what... acupuncture and chiropractic sessions were useless.

It was suggested I have steroid injection, by my doctor that helped a lot...(6000 baht!) but took away most of the pain, except just above my left ankle.

I was prescribed and helps more than any other pain killer I have used... about all I think

Soproxen 1 after breakfast and one after dinner... and then before bed, Rontin 300...(neither cause upset stomach or plug things up!) Both available at my pharmacy... but really see a doctor first... but those work for me...

A fellow forum member I meet the other day, a qualified massage therapist from the States. He suggested weights on ankles (Big C has) and an inner tube around the upper body, and float in water for 20 to 30 minutes a day..... I am still looking for an inner tube that fits or I will get that sinking feeling!

Had to laugh at Sheryl's comment avoid sitting, too much, that's almost impossible being a fellow Mod....

[Pinot]

A great deal of misinformation above. Acupuncture and chiropractic have no scientific basis for effectiveness.

I would consult the best experts you can find.

I'm a Gabapentin guy.

http://www.kamalala.com/gaba-is-the-drug-for-chronic-pain/

[tomx2]

Hi.

This is the OP again. Was browsing at a local Pharmacy today and inquired about Diclofenac.

They showed me a box “Voltaren SR 100” Diclofenac sodium. I did not purchase. Wanted to get more info from the forum.

(Q) Is this a generic version of Diclofenac? Is it worth purchasing (250 baht) 100mg 10 pills.

(Q) Should the box to purchase clearly state “Diclofenac” on the front?

My Plan of action:

1. Will be going to Tony's Gym tomorrow beginning a 3 day(per week) use of their facilities.

Exercise to facilitate more mobility as some suggested.

Mainly Bicycle, StairMaster, and WalkMaster(not sure of the proper name).

2. Diclofenac, or Ibuprofen will be my main NSAID source of pain relief for now.

Will see if they help.

If no reduction in pain after 2 weeks, will see a doctor at Pattaya International Hospital for further evaluation.

To answer a couple of inquires raised.

- I do not have a history of cardiovascular problems.

- There was an issue (I thought) having insufficient blood flow last year with my toe getting numb. After having some blood test done by my Doctor. My blood flow is normal.

However my right toe is still slightly numb and possibly(doctor's assumption) the T1 (thoracic vertebrae) may be causing the numbness & possibly a pinch nerve in my leg. This will be evaluated further by a neurologist when I return home.

Will keep you updated on my progress.

Thanks.

TC.

[simple1]

Hi.

This is the OP again. Was browsing at a local Pharmacy today and inquired about Diclofenac.

They showed me a box “Voltaren SR 100” Diclofenac sodium. I did not purchase. Wanted to get more info from the forum.

(Q) Is this a generic version of Diclofenac? Is it worth purchasing (250 baht) 100mg 10 pills.

(Q) Should the box to purchase clearly state “Diclofenac” on the front?

My Plan of action:

1. Will be going to Tony's Gym tomorrow beginning a 3 day(per week) use of their facilities.

Exercise to facilitate more mobility as some suggested.

Mainly Bicycle, StairMaster, and WalkMaster(not sure of the proper name).

2. Diclofenac, or Ibuprofen will be my main NSAID source of pain relief for now.

Will see if they help.

If no reduction in pain after 2 weeks, will see a doctor at Pattaya International Hospital for further evaluation.

To answer a couple of inquires raised.

- I do not have a history of cardiovascular problems.

- There was an issue (I thought) having insufficient blood flow last year with my toe getting numb. After having some blood test done by my Doctor. My blood flow is normal.

However my right toe is still slightly numb and possibly(doctor's assumption) the T1 (thoracic vertebrae) may be causing the numbness & possibly a pinch nerve in my leg. This will be evaluated further by a neurologist when I return home.

Will keep you updated on my progress.

Thanks.

TC.

Again your symptoms are very similar to mine. Did your doctor assess blood flow using Doppler ultrasound technology?

Edited April 25, 2016 by simple1

[Rob13]

Celebrex with a Mydocalm are good too. Both are OTC in Thailand.

Edited April 25, 2016 by Rob13

[Sheryl]

DICLOFENAC is the generic name. Voltaren is one of the brand names for it.

[bkk6060]

Sorry.

To all: Never have back surgery. I have never spoken to a single person who says they are better long term after surgery.

Just ask Tiger Woods.

The Doctors want to do it for the money.

[johnatong]

Sorry.

To all: Never have back surgery. I have never spoken to a single person who says they are better long term after surgery.

Just ask Tiger Woods.

The Doctors want to do it for the money.

Nonsense !

[Sheryl]

Indeed. I can introduce you to quite a few people who got great results from back surgery, starting with my sister...and to ortho surgeons who refuse to operate unless it is both indicated and likely to yield a good result.

Can also introduce to people -- starting with my brother-- who put off back surgery too long and paid a permant price for it. Surgery can relieve nerve compression but it cannot undo any nerve damage that has already occurred.