Debilitating Back Pain

If you are experiencing intense radiating pain down either leg, commonly referred to as sciatica, here is what I believe is the most efficient way to handle the injury.  Often times, the pain will subside and you will be able to go about your normal life after a week on some Advil or Tylenol.  But what happens when it doesn’t go away?  Generally speaking, you will be thrown into a gauntlet of doctors, specialists, chiropractors, physical therapists, and anyone else that you believe has the answer to your problem.

I have been there.  I know the pain you are in.  Unless someone has been through this experience there is no way to properly describe the pain.  Here is my best effort.  An electrical sharp shooting pain that radiates down the leg, generally stopping behind the knee, but sometimes shooting down to the outside of the ankle.  This pain pathway is consistent with L5-S1 herniation with nerve compression.  9/10 on the pain scale… with a 10/10 being burnt by a welding torch or boiling oil.  See picture below for other pain pathways.

So if you are in this pain, how can you effectively and efficiently resolve it.  Generally speaking, the herniation will need to be removed; however doctors will exhaust all options before opening you up.  The microdiscectomy is an outpatient procedure that makes about a 4 cm incision, where the surgeon removes a portion of the disc where the herniation or bulge has occurred.  This procedure will hopefully improve your condition by removing the disc material off of the nerve sending the pain signals throughout your body.  So why did it take 5 years to get to this procedure.

I went to many world renowned specialists in Chicago, deducing that if I went to the “best” doctor I would get the best treatment.  Wrong.  I was moved through Rush and Northwestern like a Ford on an assembly line only to be dismissed and handed a script for some oral steroids or PT.  Frustrated, I just gave up and tried to do core strengthening exercises, which helped sometimes.  Then the pain progressed to the point where I could barely get out of bed, sit, or walk.  It was a nightmare.  I then went to a pain doctor that used epidural steroid injections combined with a potpourri of narcotics to help mitigate the pain.  Still no help.

I then found a great pain doctor that understood my level of distress and fast tracked me to surgery.  He tried a combination of injections and medications, and when that failed, I was under the knife within a month.  So here are the cliff notes on how to get out of immense unrepairable nerve pain stemming from a herniated disc in the most efficient manner:

1.  Go get an MRI

All doctors will need to see what is going on internally.  Getting this done first will help save multiple unneeded visits to various doctors that will say that can’t do anything until there is an MRI to look at.  Carry around a copy of that CD like it is your driver’s license.

2.  Go to a Pain Specialist with strong credentials

Explain your level of pain and emphasize that you want to be fast tracked to a microdiscectomy procedure if he/she cannot provide relief.

3.  Get multiple referrals of neurosurgeons and orthopedic surgeons from the Pain Specialist.

Line up appointments, don’t wait until after each appointment to move to the next doctor.  I believe it is always best to get multiple opinions.  I lined up multiple doctors in case any of the docs were dismissive like the ones that I encountered over my 5 year battle and would not proceed with the surgery.

4.  Once comfortable with a doctor and you feel the procedure is right for you…  Consider the benefits of getting it done.  Studies show 90-95% effectiveness from the procedure.  The microdiscectomy is minimally invasive, and you are pain free and walking the same day generally speaking.

I personally felt comfortable after the first Ortho I visited, and was in surgery within days.  The recovery time is 10 weeks (no lifting, bending, or twisting) and PT begins at week 6.  Listen to your body and take it easy.

The procedure does not fix back pain, dullness, or achyness.  This procedure is used to get that sharp radiation nerve pain down the leg gone.

I am not a doctor, but I know there are thousands of people out there today that are going through that immense pain.  If I can help one person get out of pain one day quicker… this post will have served its purpose.

In no way is this post any medical advice, it simply serves to help patients move through the process more efficiently.  Only you and your selected doctors can make the determination of what treatment options are right for you.  Hope this helps.

Patrick Draut

I also like young doctors from good schools.  They are on top of their game, understand technology, and generally carry a more suitable bedside manner for those under 50.

Understanding these pain pathways is a good start towards resolution.