Is it the same? I have been 2 5 different Drs and gotten 5 different answers on my back.?

Question

fianlly one told me it was sciatica, that something was pushing on the nerve. And the Dr I see now agrees that the symtoms I describe sound like sciatica. But when they take an MRI all they come up with is degenerative disc disease. Are they the same thing? Otherwise I am confused.

Thank you so much Dr J. The first Dr I saw was a chiropractor who said that my hips had come out of joint. That one went one way and one went another.
The second time I had seen a Pysicians Assistant who said it was a pulled muscle - that was it.
3rd I was at a health clinic for a cough and the M.D. said that's where my sacroliliac is.(and to think I didn't even know that was real!)
next was an M.D.. It was an eval for a job. They had to make sure you could lift first - he didn't really give me an answer.
Then I saw an N.P. asked her to do x-rays. Nothing. Then she did an MRI - degenerative disc disease.Later she left the practice and the next N.P. agreed it sounded like sciatica but MRI said degenerative disc disease.

symptoms: my lower back is sore. I can't lie on it for more than a few min at a time,so sore I have to turn. Often feels like I was hit by a board. Hurts mostly to touch. Sometimes but seldom without touching it in some manner. Leg does go out on me at times.

Leg (con't): sometimes just while I am walking around the house, I feel like going down, it gets weak sort of. But not that often. (yes I am fat) I get sort of a wierd pain in my leg that can down to my ankle. It's sort of like a charlie horse in my leg. (make any sense?)

Heat helps a lot! So does sleeping on pillows so my lower back does not TOUCH the bed! Problem is I still get very uncomfortable and want to turn. If I get tired enough, something about heat relaxes me.

I take 2 different meds. Relafen and tylenol.

Did I miss anything?

ok I did forget one. Injury. approx 15 years ago we lived in Ga with lots of pecan trees. I would move my leg back and forth to find them on the ground. Soon my leg started to ache. I did not want to go to the Dr becuase my leg ached. soon the other one started to ache. then I couldn't sleep on my right side. Then I couldn't sleep on my left side. I let it go and let it go and let it go..
It is worse when I lift something. Normally when something touches it.. if I bump into something or lying in bed.

One more Dr J: the pain goes down my right leg - for some reason never my left.My feet burn on the bottoms and am seeing chiro now. I believe he said something like a nerve problem.. don't remember for sure.
I don't think I missed anything else did I?

one more thing Dr J: EMG was negative. Diabetes test was neagative. Heart is good. Thyroid is good.

Answer 1

I'm back. You gave me a lot of useful information. First, based on your history, negative EMG, and 'negative' MRI, it does not sound like you have a disc herniation. It also does not sound like you have a 'true' sciatica. Note: sciatica is a very general, not truly professional term that merely means some part of the sciatic nerve is causing pain. It is a little like saying your car is broken when it won't start. It doesn't say much about what is broken or why. It really is a term that is almost meaningless. Frankly, any health professional that uses it (other than in the context of trying to simplify for the patient the idea that leg pain is caused by a nerve problem in the lower back) is probably a professional that is not an expert in back pain. OK, enough on that!

I think your history from 15 years ago is very important. It sounds similar to your current condition and it suggests a muscle problem - specifically either the Quadratus Lumborum muscles (one on each side of the lower back) and/or the Ileo-psoas muscles (one on each side on the front of the spine. Your pain patterns being affected by lying on one side or the other and needing pillows under your back are consistent with problems in these muscles. Usually, when these muscles are contracted/painful, there will be associated spinal subluxations in the thoracolumbar spine area (T11 to L2) and in the pelvis/sacroiliac joints. Here are a couple of quotes about the Quadratus L. muscle from a book I consider the bible on these types of conditions: "The quadratus lumborum muscle is one of the most commonly overlooked muscular sources of low back pain and is often responsible, through satellite gluteus minimus trigger points, for the 'pseudo-disc syndrome' and the 'failed surgical back syndrome'." Here are descriptions of the pain patterns associated with tightness/spasms and triggerpoints in the Quadratus L.: "pain may extend to the groin, ... or in a sciatic distribution"; "rolling onto either side from the supine (lying on your back) position is painful and difficult"; "patients have reported heaviness of the hips, cramping of the calves, and burning sensations in the legs and feet". These symptoms sound a lot like you!

OK, so what can we do to help this problem???
First, talk to your Chiropractor about this. He/she is probably not familiar with this issue or it would have been already dealt with for you (and see the initial quote above). Hopefully, the doctor will be willing to study this and learn how to help evaluate and treat this condition. I strongly!!!! recommend the referenced book - no good doctor that deals with back pain should be without this 2 volume set on the book shelf (and read and studied - not just collecting dust!). If your doc is 'resistant' to learning (or has already tested for this condition - but I doubt it), then you may need to keep looking for a Chiropractor or even a physical therapist that has experience with this. You may also want to get a copy of this text and study it yourself. Because it is a medical textbook, it is not cheap, but it is available on Amazon.com and sometimes you can find a used copy there or at bookfinder.com.

Here is a simple 'test' you can perform on yourself that may help to confirm that the Quad. L. is a part of your problem. To gently 'stretch' this muscle (and reduce the tension and pain it is causing) lie on your side on a firm bed. If you lie on your left side (left side on the bed) you will be testing the right Quad. L. Place a rolled-up towel (you may need to try several sizes/thicknesses) under your waist (between you and the bed) so that your right lower back is being arched/stretched. You can increase the stretch by placing your right arm over your head. If this is not painful, you can add even more stretch by letting your right leg hand slightly over the side of the bed. I hope this makes sense to you. Give it a try, holding the position for a few minutes to see if you feel improvement. If it helps, do this stretch several times during the day. This is not a cure-all, but it may help confirm the source of your pains. Do this stretch on both sides - it sounds like you have problems with both of the muscles, even though one may be more dominant at this time.

Again, I will check back later to hear your feedback. Good luck!



Hi helpme. A lot more information is needed to even begin to intelligently discuss the possible causes of your pain. If you answer these questions, I will check back with this question and try to give you some reasonable advice.

1) What type of doctors have you seen? Each type of practitioner has his/her own bias about causes and treatment of back and leg pains.
a) M.D.s? - family physicians, Orthopedic surgeons, Neurosurgeons? Neurologists? Physical Medicine specialists? etc.
b) Chiropractors?
c) Osteopathic Physicians?
d) Other?

2) Describe your pain.
a) back pain?
b) leg pain? - what part of the leg?
c) both?
d) any numbness or weakness?
e) how did the pain start? suddenly? gradually? was there an injury? any history of old injuries?
f) describe the pain, is it a deep ache? burning? pins and needles? throbbing? sharp? dull? constant? comes and goes? etc.
g) what makes the pain worse? coughing? sneezing? sitting down? standing? bending over? going up or down stairs? etc.
h) what helps the pain? lying down? sitting? standing a certain way? ice? heat? pain killers? wearing a back brace? etc.

It is important to understand that diagnosing the cause of back pain and/or leg pain is based on a thorough and knowledgeable history and physical examination by a competent doctor. You CAN NOT SEE PAIN on an X-ray, Cat-scan, MRI, or any other commonly used diagnostic test. These tests give valuable information about ANATOMY and changes in anatomy, but they are only valuable when this information is combined with the information the doctor collects from the history and examination. Other common tests may include an EMG and/or nerve conduction study which give information about nerve function.

There are many, many causes of back and leg pain. Most doctors only know a few; e.g. disc herniation, osteoarthritis, and the ever popular 'sprain/strain'. However, a knowledgeable doctor will also know about and evaluate for things like: Piriformis syndrome, Lumbar Facet syndrome, Sacroiliac Joint syndrome. Segmental dysfunction / subluxations of the lumbar spine, numerous Myofascial/trigger point pain syndromes, and a whole lot more.

I have given you a lot of info. here. If you are still with me, answer the questions with as much detail as you can, and I will check back later and try to give you some useful feedback.

Best wishes and good luck.

P.S. - MY BIAS on back problems comes from my perspective as a Chiropractor for the last 24 years. I am now retired and primarily do research and occassionally teach (e.g. other physicians).

Answer 2

I have been through that and 3 or 4 back surgeries. It is not unusual to get these varied answers when it comes to back problems. You have degenerative disc disease and this could be causing the sciatic area some problems, so yes it is tied together. Nerve problems don't show up usually on an MRI. You could have some nerve damage to the sciatic nerve or even have SI joint problems which has the same symptoms as sciatica. I would ask about the SI joint area. Injections can give you some temporary relief but not lomg term.

Answer 3

The sciatic nerve runs from your spinal cord, through the discs in the lumbar area. If you have degenerative disc disease, you could have sciatic nerve problems. The disc is getting smaller, there is less room for the nerves, they get pinched and you get pain. I think they use the term "sciatica" in reference to the locality of the pain, in the buttocks, hip, down the leg, etc.

Answer 4

No. They are not the same thing. I have degenerative disc. problems. I also had sciatica a while ago. With the disc problem, your lower back wil hurt. Sciatica usually goes down the nerve in the leg.

Answer 5

The reason it looks inadequate to you is that you're looking down at it from an angle. In perspective terms, that's called foreshortening. If you could see it at eye level, you wouldn't think it was as small as you seem to think. AND it's likely to grow some more anyway - not that it needs to, but it probably will. Body image issues are hard to shake. I can tell you that you're fine, and so can a hundred other people. That still won't take it out of your head. Sometimes it takes a leap of faith - you'll just have to trust us. Alternatively, find something about the same size as your penis in length and width (probably a banana of some length). And then hold that up to your eyes. See? It's plenty big enough.