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Sciatica Foot Pain, What To Expect?

Started by luvdodo on 07/09/2010 10:42pm

Hi everyone,

I've been on this forum for a few months now and thanks to all the advice and motivation!

Like I've mentioned to some of you in the past, I've had a diskectomy in 2003, painless until last month when I had a re-herniation at the same spot L5S1. Woke up with pain, landed in ER for a day followed by the ward for a week. Pain in hip and foot did now allow me to even take a step. Got 2 ESI shots within 4 weeks and am now back on my foot.

My back is ok. My foot was OK until last week; not sure what went wrong and woke up with a worse foot.

There is tremendous paresthesia/formication in the sole of my foot (arch) and severe burning sensation on the skin on top of the foot. Hurts to touch, unable to wear socks too! Its that sensitive. Today the foot , upon touch, is clearly much hotter than the other foot and is slightly inflamed.

Warm water feeling like boiling water, putting on shoes feels like the foot is inside a 400 deg hot oven.

Met my doc today and he asked me to take neurontin 100mg/thrice daily. Said if this does not work, come back and get the fusion done!

Any one gone through this? Please tell me what helps! Struggling with this and need to get back to work.

Thanks a ton.

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luvdodo

Have you read about something called Complex Regional Pain Syndrome (CRPS) which used to be referred to as Reflex Sympathetic Dystrophy (RSD)? Some of the more classic symptoms are
* severe burning pain
* pathological changes in bone and skin
* excessive sweating
* tissue swelling
* extreme sensitivity to touch

Are you now taking the Neurontin 3 times a day? Any side effects? In the grand scheme of things, that is a very low dose trying to chase what sounds like some very brutal symptoms. How long have you been taking the Neurontin consistently? It can take a couple of weeks to build up in your system.

Wow, I hope you are able to find some relief soon. Keep us posted.

Bacaumi

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Hi Bacaumi,

Things were great until last week when the new PT asked me to include hamstring stretches in my schedule and I woke up with this pain. Well, it was always there on 1/10 but not its at 7/10.

I just started taking neurontin yesterday? No side effects yet but I realized I fall asleep early and wake up late :( and I hate to sleep that much. And I know in sleep, I am moving my leg in pain.

I haven't read about those things, I'll have a look shortly.

Thanks much.

Dodz.

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Hi Bacaumi,

Things were great until last week when the new PT asked me to include hamstring stretches in my schedule and I woke up with this pain. Well, it was always there on 1/10 but not its at 7/10.

I just started taking neurontin yesterday? No side effects yet but I realized I fall asleep early and wake up late :( and I hate to sleep that much. And I know in sleep, I am moving my leg in pain.

I haven't read about those things, I'll have a look shortly.

Thanks much.

Dodz.

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luvdodo

It takes a week to two weeks to start building up the Neurontin's effectiveness and to start getting past the initial side effects. When I first started it at 100mg 3 times a day, it made me a bit drowsy, but passed in about a week. After the initial start up dose, I was then able to increase the dosage in fairly large chunks without any side effects. I eventually reached a level where it dramatically reduced my pain and it has been a wonderful part of my pain management recipe for many years now.

Bacaumi

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Thanks Bacaumi, this doc upon pleading gave me a prescription of 100mg/thrice daily saying he's not a neurologist and said its best to perform the fusion.

I gladly took the prescription and walked out. Hoping the neurontin kicks in soon.

He also said the long term neurontin effect on my nerves will be severe. Any word on what? Does it mean the nerve continues to get damaged and we don't feel it?

Thanks.

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Bacaumi, Got the book :) Good information. Grocery time this weekend!

Update - Meeting up with a good combo ortho/neuro surgeon tomorrow. Good reviews on him and has passed our out from Cleveland and John Hopkins. Not that there's a a lot of hope.

Spoke to the pain doc and he also recommended I save up the 3rd shot for the last since I've had 2 in 40 days. He's taking a look at me tomorrow and giving me an evaluation/ prescription tomorrow.

Any pointers on what should asked?

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luvdodo,

Glad you got the book. It has some really great info in it. It's one of those "take what you need" out of it and leave the rest. If even one thing from it makes a difference, then it's worth it.

Question for you. So I understand that you herniated L5-S1 twice. Do you have any instability issues that go along with it that you are aware of? In other words, if they remove the disc and fuse you, is it absolutely necessary to prevent further nerve damage? Or is it just in hopes of helping resolve the pain issues?

The reason I ask, is because if there's no structural instability issue, then why not take a chance and possibly pursue another diskectomy and possible laminectomy to open things up and make some breathing room for your spinal cord and nerve roots.

Interesting that your doc mentioned a long term Neurontin effect on your nerves. I've been on it for at least 10 years and just two days ago was sent some information on Neurontin dependency and withdrawal. I thought Neurontin had been around for many many years, but it has only been approved since the beginning of the 90's. None of my docs are even aware of the withdrawal issue. I doubt many are. All I know is I take a ton of it 3 times a day and have for a long time. It is one of the few things that helps with the neuropathic pain in my legs. So I plan to discuss this with my new PM doc and see what his take is on it. As far as it actually damaging the nerves ... haven't seen or heard anything about that.

Well keep me posted on what you find out tomorrow.

Bacaumi

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Bacaumi,

My bad. I meant to say neurontin helps you relieve pain but the impingement of nerve carries on. Which means you get rid of the symptom but not the cause and as time goes by you are allowing the impingement to permanently damage the nerve.

The more I delay the surgery lesser the hopes of recovering the nerve from damage. Did I say it better this time?

I was also speaking to a Friend of mine who is also a doc, he spoke about scar tissues acting up later after a fusion that might cause the nerve irritation and there's no guarantee. That worries me too.

Boy we have endless things worry now!

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Hi Bacaumi,

The new neuro/ortho doc seemed good. Spent time looking at the MRI carefully and then explained whats going on in terms of the herniation.

But the foot pain (and sole) seems pretty too high against the level of compression in the MRI. So he's asked me to get an EMG done first to ensure all "assumptions" are clarified before we decide on the knife.

He also have me robaxin and vicodin for a few days to see how that helps.

The pain doc also upped the neurontin from 100mg to 300m.

Let see which ones help. curious to see what the EMG shows.

Thanks,

Sanjesh

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Neurontin
I have been on Neurontion for 9 years. I am on the maximum dose. It helps tremendously with the nerve pain. I have severe peripheal neuropathy of the feet.
2 years ago I had a 3 level laminectomy. Now I have an instability. My L3 nerve is being crushed. Fusion has been suggested.
Pt is extremely painful

Nights are the toughest
Nan

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Yes, but I'm sorry it sounds like we both are wondering what the heck is going on? I am having almost the same symtoms as you. I'm sorry but I was excited to see your post. I feel like this is crazy. My foot looks and feels like the my arch went flat. I'm not flat footed.
From what I'm reading, I'm wondering if it's L-5? I had a fusion on 4-5 many years ago. Didn't help with my low back pain. As I get older, well so does my low back! I had that down, with pain management. This foot has taken over and is out doing the rest. I couldn't even swim very well. Painfull to do anything. The top of my foot is painfull to the touch. And yes warm. Heat won't help. Nor Ice. I had to go buy really soft slippers yesterday to get to the docters today. I have been hooked on Sketchers. Sneaks and flip flops, but it is getting to painfull for them.

I had an E.M.G today. Not that I think it told them anything. I didn't get to see my docter last month. His PA ordered the test. .
Anyway I hope WE find some answers and relief. I'm sorry about my writing. I'm lacking sleep due to this foot.
Please keep me posted, and I will the same.

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Becker,

I am much better now. I found this medicated oil that i apply top-bottom with a lot of force on the foot every night before sleeping. I am not able to find a link to them online - sankalp oil or samartho oil. Both work fine.

I also have stopped all meds and am on indian herbal treatment now.

I am not 100% cured but there are days with a pain of 1/10 and I'd like to see more of those days is all I hope for.

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I'm glad to here you found something that helps. I'm going to the Dr. on Friday. I will ask about your oil. But I really want to know what this could be?

Thanks for your advice

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It's probably the same nerve - L5 neuropathy..I exactly know what you mean, its painfully painful!

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Hi All,

I had spinal fusion (L4, L5 & S1) in Mar 09 and still have herniated L3 disc - still have pain. I've discovered, very recently, that neurontin has been a major blessing. So, my vote is to try neurontin, and quite frankly move up to 300 or 400 mg three times a day to see if that works, if not move up a little more. I agree w/the other person who said they stopped other med's - I still take hydrocodone but no longer on a daily basis. Also, I still wake up due to pain to, as the med's wear off - - sleep is very challenging and sadly not as good as I'd like. I mentioned in another thread that one thing I've learned, just last month, is that I need to wear heavy cushioned soled shoes / flops ALL the time. Meaning I realized I need to put them on as soon as I get out of bed and wear them in my house too. It's made a radical improvement on my leg and back pain!

Question - I'm taking 2500 - 3000 mg a day and curious what you folks consider the "maximum" dose as someone posted they were on the "max" amount?

Hope this helps

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