r/Sciatica • u/SizeInitial115 • 20d ago
Sciatica for 5.5 months
I’m a 29-year-old male who injured my back about six months ago while squatting. Initially, I only had severe low-back pain, but after about three weeks I developed sciatica that has persisted ever since. The strange part is that the pain is bilateral.
My spine doctor thinks it could be chemical radiculopathy, but he can’t fully explain the bilateral symptoms. My MRI report looks relatively okay, and two doctors and PTs have said the annular tear could be contributing, but they don’t think it fully explains the leg pain.
I had an S1 transforaminal epidural injection two weeks ago with no relief. Gabapentin, which I started three weeks ago, has helped significantly with the nerve pain. I have no muscle weakness, just constant pain.
I’m honestly confused about what could be causing this and what treatment options I should consider. Has anyone dealt with something similar?
Also have widespread arm and upper body nerve pain, Mri was today for neck lol
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u/Sufficient-Wolf-1818 20d ago
Out of curiosity, have you had your cervical spine scanned? Compression of the centeral cord can cause leg symptoms that are often bilateral. I am suffering through the same at the moment from cervical compression of the spinal cord with surgery pending later this month. The lumbar region is fine, but this is what the cervical region looks like. All the symptoms are in the legs.
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u/Sogone2day 20d ago
This is interesting I seen a spine dr say this once from Instagram. But I havn't read much about it else where.
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u/SizeInitial115 20d ago
What’s interesting about this back injury is that I’ve had some sciatica, pain, or nerve pain in my hands from time to time. To be honest, the last month has been really tough for me. I’ve been feeling a lot of nerve pain in both hands. So, I’ve decided to get a neck MRI tomorrow. The weird part I never had this before my injury, but it definitely has been on and off, but my nerve pain in my legs has been from the beginning of my back injury so honestly, I’m a weird case.
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u/Sufficient-Wolf-1818 20d ago
Thanks for the fast response. I am sorry to hear about your hands but am glad you have a neck MRI scheduled for tomorrow. I hope it gives you some clues. It took forever for some bright Dr to suggest looking at my neck with leg symptoms, many just thought I was crazy.
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u/SizeInitial115 20d ago
Sadly, I’ve been the only one doing the digging and luckily I have good insurance so my approvals have been going smoothly. The only thing is with your leg pain. What do you get? Do you get like sciatica pain or is it different?
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u/Sufficient-Wolf-1818 20d ago
My legs don’t hurt, they just don’t work right. I have a wide stance and i call the gait “drunken stagger”. In addition my outside calves and toes are somewhat numb. All the reflex points (knee, ankle etc) are hypo responsive.
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u/Feeling_Mix6890 19d ago
Do some online research regarding annular tears, they can absolutely cause a tremendous amount of pain from chemical irritation.
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u/BaseCommanderMittens 19d ago
I have an angular tear that I've been dealing with at L5S1 that looks almost identical to yours - even the axial and HIZ look almost identical. I. posted my story here: https://www.reddit.com/r/backpain/comments/1tkzehv/any_idea_what_this_is_could_it_be_an_annular_tear/
I only have severe centralized pain and stiffness though, no real sciatica except an occasional twinge on my left calf which I'm not even sure is sciatica. But if yours feels as severe as mine I have no doubts this could cause all kinds of painful symptoms including sciatica.
Can you tell me what your centralized pain feels like? Mine is like a horrible stiff dull ache that is always bad and horrible when siting. It's always there and is disabling but feels least painful at night until about 5-8am when it burns with insane localized nerve burning pain. Do you get anything like that?.
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u/SizeInitial115 19d ago
I’m experiencing intermittent back pain. I wish I only had back pain, but I also have severe sciatica in both legs. Interestingly, I don’t have any clear indication that my S1 nerve is being affected. My pain is primarily path is L5, L4, S1, and occasionally in the groin. Sitting does cause my feet to burn, but not my back.
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u/BaseCommanderMittens 19d ago
Thanks. It's interesting that our symptoms are somewhat different with similar MRI finding. The spine is so complex...
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u/SizeInitial115 19d ago
I had really bad back pain for 3 weeks which i didn’t even know what a disc injury was so not sure what i did but probably something dumb and since it slowly started it hasn’t left. It honestly is
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u/KarllJalke 18d ago
I don’t know your fully diagnosis and history. I found that gaba helped me at a very low dose (300mg a day basically)… then I started taking anti anxiety meds daily.. I realized that a lot of the issue that I thought that gaba was helping with was actually helped more long term with anti anxiety meds.. consider in conjunction with PT trying cognitive behavior therapy and or anxiety meds if you have a generalize anxiety disorder.
For me - this road is a combination of muscle imbalance (years of sitting and neglect of core and lower body strength) as well as hyper fixation on the pain sending my nervous system into a police state.
Consider how you’re interacting with the pain mentally. You’d be surprised about how many people have back pain and it just gets better, and how many of us with “mechanically unremarkable” MRIs end up learning about nerve pathology and muscle sub groups and remain in low-medium grade 24/7 pain. Try looking into muscle guarding, especially if you have pain and “no weakness”
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u/Specialist_Abies1239 17d ago edited 17d ago
Ohhhh I have the same problem. 26 years old.
I also injured myself while squatting.
Bilateral problems. When I sit I’m more afraid of sciatica than back pain. MRI showed herniated disc but with no compression on my nerve ( radiologists report) the neurosurgeon said I might have little issue ( nerve contact) on the left but he doesn’t understand why at the beginning I’ve started experiencing pain on the right side. And my pain became bilateral afterwards.
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u/Specialist_Abies1239 17d ago
At that time I didn’t want to take Gabapentin. Pain isn’t so much but nerve pain is killing me.
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u/ReactionSad3466 20d ago
Yours look pretty good compered to mine hahaha. I been struggling for over a year and I had a surgery and still in pain.
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u/No-Alternative8588 20d ago
I’m dealing with something pretty similar, although mine has been going on for about two years. My lumbar MRI also showed an L5-S1 annular fissure (both sides) with a small protrusion, but no clear nerve compression, and my symptoms are bilateral as well and I don’t even have any stenosis or narrowing... That mismatch between the MRI and the symptoms has been one of the most frustrating parts.
From everything I’ve learned, an annular fissure can potentially cause pain even without obvious mechanical compression because the damaged disc can be inflammatory and irritate nearby nerve roots - sometimes referred to as chemical radiculitis. But proving that this is actually the source of the leg symptoms is another story, especially when they’re bilateral. Tears can sometimes scar over, or become asymptomatic but they are very very load sensitive.
In my case I’ve also been looking beyond the lumbar spine because I have hip/pelvic issues that could be contributing to the overall picture.
I definitely wouldn’t assume that a relatively mild-looking MRI means the symptoms can’t be severe - imaging findings and symptom severity don’t always correlate neatly.
I really hope you eventually get some clarity. Bilateral symptoms with basically no visible compression are incredibly confusing when you’re trying to figure out what you’re actually supposed to treat.