How do you know if sciatica is something more serious

[morningtrain]

DH has been in agony with sciatica for months now. Finally went to docs & now needs 6 and physio before they even consider a referral for MRI. He does all the exercise and stretching religiously, massage, acupuncture etc.. It's not improving whatever he does. You hear awful stories of sciatica turning out to be something else more serious & im aware I'm a bit more health paranoid than usual at the moment due to other ongoing situations, but how can we be sure this is not something worse without an mri scan- considered private but guessing it's ££££. Any others experiences of sciatica here where it did not improve??

If you can pay for a private MRI, then do that. I would not let a physio loose on a spinal problem without a definitive diagnosis.

It's serious if he loses control of his bladder or bowels, in which case call an ambulance/ go straight to A&E. Otherwise swimming (backstroke) is good and if that's too painful just walk up and down the pool.

Yea the doc told him this - what if it's a tumour pressing on the nerve though? That wouldn't cause the loss of bladder/bowel control necessarily would it? That would just cause pain, right?

My physio treated me for 3 sessions then said she wasn't touching me without an MRI any further as something was really wrong
She sent me for an MRI and found I had a severely herniated disc and I was referred for surgery. 48hrs before the op I developed cauda equina
I had a 5hr discectomy and laminectomy and sciatica gone

No idea what those things are but sounds traumatic. Are you ok now?! I think we do need to look into mri costs as he is really not one to be ill/ complain and it's clear he's in severe pain

Well yes it could be a tumour, of course but much more likely to be a herniated disc. Unfortunately I have suffered for years on and off. I was once unable to get out of bed for about 3 weeks. I believe private MRIs are silly money. I have a brilliant osteopath who is very gentle but gets everything moving.

Having had sciatica for 9 months only to discover 2 crushed discs, wake up one morning with no feeling below my waist and be rushed in for surgery I would suggest you go private if you can afford it. The surgery was a success but I have been left with bladder issues and a paralysed leg. I'm am an extreme case but I wish I had paid to go private

My physio refused to guess what the cause was and wouldn't treat until I had MRI. It took 4 months on the NHS and it was two slipped discs and a trapped nerve. Physio then sorted it out very well.

Cauda Equina is the condition that the doctor is talking about - loss of bladder and bowel function and numbness in the saddle area. This is a medical emergency and you must go to an A&E without delay otherwise you risk paralysis.

I was diagnosed with sciatica 20 years ago and an MRI revealed a prolapsed (slipped) disc at L4/5 level. I had three steroid epidural injections for pain relief (two worked and one didn’t), and an operation, and years of physio on/off. However, the cause of your DH’s could be far simpler so don’t assume worst case scenario, however he really needs an MRI for a definitive idea of what’s going on. Sciatica can be very painful but I don’t believe it’s usually because of anything nasty like a tumour.

Do note that MRI results can take around 8 weeks via the NHS depending on where you live, so don’t think this is a quick option either. I recently had a brain scan and waited 9 weeks for results (chased twice), and was told there is a severe shortage of radiologists. Go private if you can (I did for the sciatica).

Also look up Piriformis Syndrome; I was also unlucky to have a nerve running through the piriformis muscle rather than under it so when the muscle spasmed/clenched then the nerve caused pain. Exercise and physio cured that.

Also, others may differ but avoid a chiropractor like the plague. You do not want to be clicked about until you know what you are dealing with. Anyone who says a chiro fixed them probably had a very simple issue.

Yes I'm fine now, some residual numbness/loss of feeling in my foot and leg

If he gets any change in bowel or bladder, loss of sensation in saddle area or (my symptom) it felt like warm water running down my legs then go straight to a&e

I think I paid about £300 for my MRI and the results were back in 24 hours. I had a microdiscectomy which sorted tings out to the point where I could walk and things have very gradually improved since, although I am still in pain.

Agreed. My mum has had operations for sciatica but the thing that probably helped the most was acupuncture. She had to wait months for a MRI as well with the GP trying to block her from having one due to cost, so if you can afford to go privately do. I think we all need small at home machines we can use ;)

She went to a chiropractor first and it didn't help at all (probably made it a bit worse in fact).

Depending on how old your DH is - it is not uncommon to get pain from either hip/knee/spine and it is difficult to diagnose as sciatica is the nerve pain and treatment depends on what is affecting the nerve.

Months ago I had what I thought was sciatica which came on suddenly and I struggled to walk and the pain was intense.

Paid for a physio after the telephone physio on the NHS could not really help.

Paid to see an osteopath - and he diagnosed problems with hip and knee.

Finally after weeks of self-help via exercises etc. obtained a GP appt and sent eventually for an X-ray (not an MRI they are very rarely available unless you pay. )

Long story short - results show early onset arthritis in knee and hip (as I am 77 I suspect wear and tear). GP phone appointment to discuss booked for 3 weeks time!

IMO - the osteopath knew what he was doing and at £60 it was a big help. Avoid a chiropractor if possible.

I am sure an MRI would show the source of the problem but at £200+ I cannot afford it - and unless you follow through with the private medical route it may not speed you up the waiting list.

It could be serious but more likely there is a simpler diagnosis that can eventually be fixed. Good luck

You sound like you have quite bad health anxiety OP!

It’s not uncommon for sciatica to last for months or even years without treatment. Physio etc doesn’t work for everyone and some people do end up needing surgery to resolve things. My 19 year old DD was very unlucky, herniated a disc at 17 which despite doing all the right things as per consultant advice (physio, exercise, giving it time, taking nerve pain medications, having steroid injections to help the inflammation in her sciatic nerve) nothing really helped and she had very successful surgery for it last month, pain completely gone as soon as she woke up. Some cases are more stubborn than others, your husband might just fit into that category.

Given it’s been going on for months now I do think that an MRI is a good idea - DD’s was around £450 and then £200 for spinal consultant on top of that

I had severe sciatica, caused by a herniated disc. Surgery sorted it out.
I'd also suggest going private. Get the MRI done and get a consultation with a consultant who also does NHS work. Often you can then get onto the consultant's NHS list a lot quicker if you need surgery.

Has you DH had his PSA tested?

My FIL was fobbed off with a diagnosis of sciatica for months but things came to a head when the pain was so bad he couldn't walk and he went to A&E. It was prostrate cancer but as he had no bladder issues they hadn't checked for it (despite his age).

Everything I could say has already been said above, but I absolutely suggest you go private.
If I had listened to my GP I would now have a blue badge.
Private MRI (about £500, followed by spinal fusion £40k - worst case scenario) changed my life and I don't believe I'd still be here without it.

This is my concern. Thank you I am going to suggest it to him - tho he's not one to go to docs unless crucial.

Hello dear @morningtrain can you update us here .. I am having sever sciatica pain for 3 months now, schedueled for MRI tomorrow