sciatica pain for 10 months, meragia paresthesia for 4 months

by Ivana

It all started in January and february at 2011, when I felt some more intense pain in the lumbosacral region, but was functionaly active, ascribed everything to the cold weather in Sweden (where I live now).

In March I woke up and with complete absence of motor control in my left leg. They check MRI, found buldged disk but not herniated disk and I was diagnosed lumboischialgia and said that my problems will go over in 2-3 weeks. But they don't.

When I wanted to walk a bit longer with crutches the following day both legs were spastic and and couldn't even stand and was forced to lie down in bed the whole day. Anyway, I trained myself to go first 50m then 100m and finally come to 1km but I couldn't come back to my ordinarily movements ( make a promenade and go to bed that was my daily routine in May).

Since things didn't developed as they should I've got i.m injection of Diklofenak with corticosteroids but that resulted in the appearance of abcess and flegmonas I was suffering the whole summer. I developed intense burnning pain in the trochanter region, could not sit for 2 minutes it was awful.

In August I have tried to go back to work and pain which was mostly located in the gluteal region spread to the underside of the upper leg and I got the sensation of sitting on a barbed wire. Unfortunately there was no possibility to examine the condition of the pyriformis muscle and whether other gluteal muscles were damaged due to the infection and how this influenced the sciatic nerve.

I would like to hear your opinion whether this condition per se could evoke injury of the sciatic nerve which has a more permanent character and whether it is possible to examine this.

Q1: At that point I have pain in sciatica neuraxis and mostly suffered pain when I have to sit and have some moderate weakness in the legs.

Q2: I went to a chiropractor and he wanted to manipulate ( adjust leg length discrepancy. He adjusted one of the sacral segments and rotated my pelvis a bit. I didn’t feel any particular change in the days following manipulation.

However ten days afterwards I started to develop pain in the muscles of upper thigh, hip on the right side and buttocks. Very soon I developed nerve pain in the upper and lateral part of the right thigh which has a burning character and this burning pain from the upper an lower side of the thigh caused a spastic reaction of my body.

I am wondering whether inappropriate manipulation of pelvis could evoke pinching of the femoral and cutaneous femoral nerve and possibly pudendal nerve. This pain in upper thigh increases when I sit, walk down the stairs, when I try to stand and again does it reflect pinching of the femoral nerve?

Q3: When I walk my pain increases in sacral segments and I feel hip and groin pain. When I sit I feel pain also from the tailbone. All conditions are more than a nightmare for me. I am interested in your opinion where to start- to treat nerve pain or problems with the pelvis?

Sciatica pain is constant and was not relieved with epidural sacral injection of cortisone which I received once.

Could you please give me advice. My condition is getting worse from day to day. I am not satisfied with the orthopedic approach in Sweden. Unfortunately, in recent days I could not stand without opioids.

Thank you very much for all
With kind regards

Dr. Barrie Lewis Dr. Barrie Lewis

Hello Ivana,
Firstly, congratulations on your English. You write better than many of my English speaking correspondents.

It's time to see a neurologist. What you describe is not consistent with an orthopaedic condition. You twice use the word "spastic" and that means neurological.

Likewise the "complete lack of motor control", using crutches, both point to some neurological condition.

Frankly, I'm not sure at all, but I would be looking for changes in reflexes, sensory changes and which muscles have been affected. Do you they follow the myotomes associated with one nerve, or several. It's fairly unusual, though not impossible, for an orthopaedic condition to affect both the Sciatic and Femoral nerves.

I presume the abscess was in the buttock and the site of the injection. I'm not surprised you're not impressed with the orthopaedists! An abscess internally, lying along the psoas muscle however could affect both nerves. Are you in good health. No weight loss, no fevers?

A reaction to chiropractic manipulation is of course possible, but after so many days it was almost certainly unrelated.

Keep pushing, Ivana. All the doctors you have consulted are missing something, the question is what?

At C-H, go down the Navigation bar to "lower back exercises". Do them faithfully every day. Keep as active as possible. Sit less.

Please let me know once the correct diagnosis is made. I hope this has contributed.

Dr B

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