Dr. Vivek Chail
General Practitioner
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I have sciatica on the left side. I have pain when walking or standing for a long period of time. I have no pain when sitting. Bending over to stretch and inversion help take the pain away. I had a problem for multiple years. Physical therapy and weight loss have helped, but there is still pain when walking more than a mile. I am currently taking Advil when needed, Indomethacin 50 mg, when there is pain (usually one tablet at night is sufficient to feel good the next morning). I need reading of magnetic resonance imaging (MRI).
Hi,
Welcome to cliniq.com. Thanks for writing to us. I hope you are not in much discomfort. Your MRI (magnetic resonance imaging) lumbar spine shows degenerative vertebral and disc changes in multiple levels, and there is acute edema in the endplates of L5 to S1 vertebral levels. Disc bulges are causing moderate to severe bilateral neural foraminal compromise in L4 to L5 disc level and severe left neural foraminal compromise in L5 to S1 disc level. Your severe pain is understandable, and it is possible that the L5 to S1 left lateral disc bulge might need surgical treatment if there is a limitation of daily activities. Regards.
Patient's Query
Thank you, doctor, for your reply.
Can walking or jogging to the point of causing pain to accelerate or further advance structural damage? The pain from this is fully managed by hanging upside down on the inversion table and NSAID (Nonsteroidal anti-inflammatory drugs). I want to continue this activity to help with weight loss and general health, but do not want to cause or accelerate additional damage.
Hi,
Welcome back to icliniq.com. Thanks for writing to us. The pain is due to the intermittent nerve pinching at the level of the discs. When there is a position causing the disc to inflict pressure on the exiting nerves, then you experience the pain. Now, the pain can get intensified due to continuous and persistent nerve pinching due to sudden stress on the disc, like weight lifting or heavy physical activity, or it can slowly progress with the continuation of mild daily physical activities. So the acceleration to the point of causing additional damage persists in both situations, but the acceleration due to mild, regular activities might go unnoticed in the beginning and suddenly intensify. In your case, you might like to continue your regular jogging with an alert to control your physical activities beyond your physical abilities. If you feel that the pain is starting to intensify on any particular day, please take a rest from your routine physical exercises for a few days and start again once you feel better. This is a very subjective situation, and if needed, please take guidance from your physiotherapist or sports medicine specialist.
Regards.
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General Practitioner
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