Sciatica - so worried about my DH

[BG2015]

My DH has always suffered with a bad back (he's 55) he works in construction so a manual job.

6 yrs ago he ended up with sciatica after a visit with a chiropractor (not sure if it's linked but it started after that )

It took him 10 months (didn't work at all during that time) for anyone to take him seriously- they gave him physio and drugs until eventually he went to A and E and had an MRI and they said sciatica (we had been saying this for months) they doctor referred him to a specialist and bingo!

He had a cortisone injection in his spine and for the past 5 years he's been great. No issues with the nerve in his leg, ankle, bum.

Last week he felt his back go, battled on at work but was sent home. He is now bedridden - he's struggling to get to the toilet and can't put his socks on, walking is agony. The sciatica is worse than ever.

GP won't see him, spine to a nurse on the phone who prescribed naproxen and omeprazole - neither have which have done anything. They've suggested physio which he's refused.

His referral has been rejected. He's in agony and I'm so worried.

Last year he had a kidney removed as it was cancerous. Praying it's not linked,

We just don't know what to do and it's so frustrating

*spoke

The omeprazole is to lessen the negative effects of naproxen on the gut, so that won't do anything for pain.
As for sciatica - codeine is a better pain killer, however short of seeing a chiropractor and physio, and doing exercises they can suggest, there is no long term fix. You can only have a very limited number of cortisone injections, and injecting into the spine is incredibly risky anyway. Sorry it's so rubbish x

Why has he refused physio? I've had disabling sciatica a number of times and it's a combination of codeine, physio and time that sorts it out.
He has my sympathy though....it can be agony.

I have found that an oesteopath sorted mine out over a course of a few weeks and although I do need to go back occassionally when it recurs it is now much better. The only downside was the cost but it was worth every penny to be out of pain.

Why did he refuse physio? I had a slipped disc last year and the physio got me upright and walking again within a day. My husband had to carry me, sobbing to the emergency appointment as I couldn’t walk. Depending on the physio they can be miracle workers. It was a long road of exercise and zoom Pilates but strengthening my core has returned me as close to normal as possible.

It feels unmanageable at first and I understand why he’s reluctant but back issues require active management. Good luck to him and I hope he gets appropriate treatment soon.

He's taking co-codomol too.

Physio did nothing last time. He was told that he could have another injection if it came back.

@WTF99

Why has he refused physio? I've had disabling sciatica a number of times and it's a combination of codeine, physio and time that sorts it out. He has my sympathy though....it can be agony.

Yes, I second this - sciatica is rubbish - I have only had in twice (am on my 40s) - once getting out the bath and 2 changing the duvet cover. I always think it would be easier to handle if I had got it doing something that I could just stop doing like bungee jumping! It really takes ages to sort out but why not the physio? Or a different one? One really effective thing that worked for me was lying on the floor on tummy (might need help getting up) and raising my upper body on my elbows - I even had to do this out and about! I was v v sceptical when the physio told me this but it really helped!

Tbh the only thing that sorts my sciatica is specific stretching exercises. I catch it now before the pain starts because I get a needlepoint pain in my spine and my bum cheek goes numb first.

He really should go back to the physio, do those exercises on a daily basis for ever. Not just until the pain stops and not rely on injections quick fix.

He's a very fit gym goer. He's got good core muscles and upper body strength which is helping.

He can't even lift his leg up to go up the stairs and has to crawl on his hands and knees. We live in a 3 storey house which isn't great. I'm frightened he's going to fall whilst I'm at work.

His experience of physio is very negative, it didn't help at all last time. It was 6 weeks of wasted time.

This time it's much, much worse.

Following the cancer diagnosis last year I would take back pain very seriously. Push very hard for him to be seen. Kidney cancer spreads to the spine and from family experience I know pain is a symptom of this happening.

@Angelica789

Following the cancer diagnosis last year I would take back pain very seriously. Push very hard for him to be seen. Kidney cancer spreads to the spine and from family experience I know pain is a symptom of this happening.

That's why I'm so worried

Keep an eye out for red flags any issues with going to the toilet straight to A&E. I personally would take him to A&E anyway as you don't know what's going on internally. My husband had surgery we refused the injections because they only mask the pain. As for physio it's not for everyone and can cause more issues.

@BG2015

He's taking co-codomol too.

Physio did nothing last time. He was told that he could have another injection if it came back.

You can get stronger cocodamol from the gp than over the counter and take them along side ibuprofen so maybe try that though I would check with gp or pharmacist first. I can imagine an injection is a pretty rapid solution and when I was in agony I might have been tempted had it been offered (it wasnt) But overall I would go for a good physio rather than a needle anywhere near my spine I have to say. I've had a mixture of hands on massage....not the relaxing sort!....and exercises to do, including front lying as described above, and lunges. All of this has helped.

I can understand why you're concerned given his previous diagnosis. Do you still have access to the oncologist or surgeon? I had breast cancer, now treated, but can contact them directly if I'm concerned about anything and don't have to go via gp
Chances are its not related especially as he's had sciatica before, and it's not unusual for it to be worse sometimes than others, but natural to be concerned. If you can't speak to previous specialist it would make sense to mention it to GP, or to the nurse practitioner who will probably refer you to the gp as its likely to be outside her remit

@glitterelf

Keep an eye out for red flags any issues with going to the toilet straight to A&E. I personally would take him to A&E anyway as you don't know what's going on internally. My husband had surgery we refused the injections because they only mask the pain. As for physio it's not for everyone and can cause more issues.

He really tried with the physio, did exercises at home etc but it really made no difference to the pain at all.

He really needs to try the physio again

My dp has been diagnosed with sciatica and even a year of private physio made no difference at all so it’s definitely not some golden bullet for the issue. It was nice going and having someone to talk to about it but it really did nothing to help the pain.

I agree that the previous cancer diagnosis is a bit worrying. Mets in renal carcinoma tend to spread to the bones. Speak to your gp and mention your concern about bone secondaries in his spine following his previous diagnosis. You are absolutely justified in being worried. Good luck

I think he really needs to be seen by a GP again and he needs to mention his worry about the cancer. That’s the very first thing to do imo.

Re sciatica, the NICE guidelines have changed and people should be told to get acupuncture.
They also should NOT be given painkiller, esp of the opioid type (codein, co codamol etc...). Tbh all the research on that shows that those painkillers work in the very short term but after than have no effect in the pain.
I’d that something you could get privately?

@Undeuxdrei

I agree that the previous cancer diagnosis is a bit worrying. Mets in renal carcinoma tend to spread to the bones. Speak to your gp and mention your concern about bone secondaries in his spine following his previous diagnosis. You are absolutely justified in being worried. Good luck

Yes to getting reassurance on this OP but do remember though that 'common things commonly happen' as my breast surgeon used to say to me, and recurrence of sciatica is the most common and likely issue here. Hope he gets sorted.

A couple of thoughts...
Just because physio hasn’t worked before doesn’t mean it definitely wouldn’t work this time. It would also mean seeing a real life physio who could actually assess him and consider whether it looks like simple sciatica or something more worrying. As pp said, common things are common, and if he’s had sciatica before and this feels the same then it probably is ‘just’ sciatica.

It may be worth chatting to his urologist/oncologist/cancer nurse specialist though and asking the question ‘could this be anything more concerning’, particularly if this episode feels different to the last. And perhaps most importantly they could advise about how appropriate they think naproxen is - it can cause renal problems and they may have strong feelings about someone with a solitary kidney taking it.... Hopefully the nurse that prescribed the naproxen is aware of his history?

Hi OP my husband had this, but not with the back ground of cancer. I can imagine how worried you are. The two things that have helped were the iamcomfi sciatica cushion off Amazon and really pushing for a microdiscetomy. Previous to this he was completely immobile and taking handfuls of pills. He says the cushion is the next thing he has ever bought and buys them for anyone he knows with sciatica.
Can you contact Pals or the patients association to get advice about getting a referral as it sounds like you really need some treatment. Physio did very little as the pain is often coming from a disk touching a nerve.
If you have any money to go private would recommend. That’s when things really got moving for us. Sending it’s a nightmare seeing someone in so much pain and a stress on you too.

Thank you everyone for your advice and kind words.

I'm frustrated, as is often the case men fail to tell medics relevant and important information, don't ask the right questions and don't push for things! I don't know if he told the nurse about his kidney or if she's aware of it.

He says he's going to ring his GP again tomorrow

Definitely ring the GP again
Thermacare lower hip and back wraps
Codeine, naproxen and paracetamol
Try not to sit. Standing or lying is better, pillow under knees if lay down and pillow between knees if on side, think keeping the spine straight so not loads of pillows under head either
Any saddle numbness, bowel or bladder issues then straight to a&e

I would recommend the physio, only because mine stopped treatment after watching me walk in for a session, refused to touch me and sent me for an MRI. I had a massive herniated disc, developed cauda equina and had spinal surgery and I owe that physio a LOT

He needs an MRI to ensure this is not cancer related OP. Talk to Gp this morning and if nothing forthcoming take him to A+E this afternoon. It’s probably return of sciatica but this needs to be ruled out as the first step, then can think about physio etc.