Jerry’s back started to hurt after he returned home from a three-day car trip which involved sitting behind the wheel for long hours with infrequent stops. By the end of the week, his lower back was extremely painful, making it hard for him to sit or stand for more than a few minutes. During the second week of the attack, his left leg began to hurt, and before long, the leg pain was worse than the pain in his back. Now the leg pain is constant, much more intense than the back pain and gets worse with any movement or whenever Jerry tries to straighten his left knee.
My pattern of symptoms is similar to Jerry’s. Tell me more.
Jerry’s pain is leg dominant, radicular pain. It is true “sciatica”, pain produced by direct irritation of a nerve root in the spine. Given the preceding back pain there is a good chance that the irritation is caused by the herniation of a disc in the low back. The symptoms started in his back, but now they are worse in the leg because now a nerve root is involved. The constant pain is aggravated by anything that tugs on the nerve, like bending forward or straightening the knee on the affected side.
While studies show that Jerry’s leg pain has better than an 80% chance of subsiding with time, the symptoms can be unbearable and he may decide to see his doctor about immediate treatment. If surgery is an option the doctor may recommend a CT or MRI scan (see What to Expect from Your Assessment). The decision for surgery depends primarily on the nature of Jerry’s pain but it also depends on the results of the investigations and finally by Jerry’s decision and his ability to tolerate the pain. Many people with similar symptoms choose not to undergo an operation.
If Jerry doesn’t seek surgery, he should follow a program of frequent scheduled rest breaks in positions that provide the greatest reduction in his constant leg pain. He should try and remain as active as possible but he will probably require substantial pain medication. He’ll know he’s getting better when the leg symptoms become intermittent and he is able to move about without disabling pain. There will certainly be bad days.
If his leg symptoms do not start to subside even slightly within a week or two or become more intense over time Jerry should consult his family doctor.