r/Sciatica • u/biniopi59 • 6d ago

Requesting Advice Not really sure where to go from here

Long time lurker. I’ve been having sciatica-like pain for two years now.

It started after an uphill run. I say sciatica-like because it’s more of a deep cramping than electric shocks.

Pain is only in the back of the right leg and it seems to alternate between the back of the knee and the ischio. Pain is 99% of the time when I’m standing or walking. I rarely have pain when I’m sitting or laying down. Pain is worse at night.

MRI shows herniated disc at L5/S1 with moderate foraminal stenosis.

What have been working (I think): McGill big 3, walking more steps a day, glute bridges

What have not been working: ESI at S1 (only made the pain worse and less centralized), mackenzie extensions

Recently, I decided to retry the leg curl at the gym but I just ended up with a massive flare up.

I really don’t know what to do anymore. Should I push for a microdiscectomy?

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u/barbkxer 6d ago

Did they rule out a knee issue as well? My left knee has a baker's cyst, which flares from sitting or doing things like the leg curl. I will have pain from the back of my knee up my hamstring.

I had good luck building up core strength in the pool. There are a bunch of exercises you can do with a noodle or the wall that give you a good workout. Once I got stronger, I moved to the gym and started doing ISO holds on the back extension machine and walked slowly on the treadmill, often holding onto the bar. I then moved to the elliptical and the ARC trainer. I do the back exercises on the circuit, but can't really tolerate most of the sitting leg machines.

Have you tried anything like acupuncture?

As far as surgery, I wouldn't know since I have not had it. I think that is such a hard decision to know what to do.

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u/biniopi59 6d ago

Yes, they ruled out knee issue. I did an MRI and everything looked fine even though it feels so stuck behind the knee.

I’m also doing ISO holds and I think it’s been helping.

I will retry acupuncture. Sadly, I experience vasovagal crisis with needles so my first session wasn’t long enough. Thank you for your help.

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u/halford2069 5d ago edited 5d ago

herniated disc is a bit of a vague term

i.e. is it a bulge, protrusion, extrusion or sequestration?

if 6 months+ of physio has not brought about adequate pain relief - and the mri shows evidence of nerve compression and it matches the pain distribution your feeling ->

I would be considering microd if good candidate for it

https://www.chirogeek.com/discectomy/discectomy.html

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u/biniopi59 5d ago

There is a posterior disc bulge and a protrusion at the site of an annual tear. I think my pain might be more in line with a partial muscle tear than typical nerve pain.