Pain in the butt - Can't sit down

I would like a copy as well if possible.

I too have low back pain that follows the track of Sciatica; low back through butt, down leg and into feet (mostly on left side). I do have issues with L4, L5, and S1 as seen via MRI (degenerative discs). Radiologist has not seen any nerve compression, but I sure feel it; especially when sitting. I’ve been through PT many times, have had cortico steroids in those areas plus piriformis and sacroiliac joint. I’ve been through rolfing, myofacial release, laser therapy, chiropractic and acpuncture. Nothing seemed to help except the last two modalities. Just this past Wednesday, I went to the chiropractor. He adjusted me and asked if I had some time. He took me to the room Nextdoor and he had a new machine I believe called Stim Wave. It sounds a bit like an MRI when it’s pulsing. They apply gel to the area, and move the wand back and forth over the area - which for me was the lower back and side of hip. After one treatment (and he’s offering 5 for free since the laser didn’t work), I felt immediate relief in my lower back. The hip pain was down, but not gone. I’m going back for two more treatments this week. I live in hope that I’ve found the magic bullet. He said that if after five treatments I don’t feel any better, then more won’t help. If this does work, I plan to be on maintenance for quite a while. Good luck to all of you, as I know how hard it is to get a good diagnosis and treatment. It feels as if you must advocate and do your own research since doctors just don’t seem to know what you think they should about the nerves and skeletal interfaces. By the way, there’s an article on “the war on chronic pain” it’s the big story on the cover of the June AARP Bulletin. Might be worth a read for some.

Thanks Karen and I truly hope you find an answer. Pinched nerves are probably impossible to see on an MRI, but they can certainly be implied from vertebra and disc degeneration, stenosis, scoliosis, and on.

I had this problem about 10 years ago when I was 60 y/o. First Dr. would only do a fusion at S1, L4 and probably L5. Second surgeon did a laminotomy, removing a minimal amount from the affected vertebrae and releasing pressure on the sciatic nerve.

Life changing and an easy recovery. Now I do work very hard to stay in shape, keep my weight appropriate for my height and build, and do a lot of core strength exercises. The core is not just the abs, but rather a collection of 30 muscles around the lower spine.

My current surgeon tells me that if I experience sciatica-caused pain again he will need to fuse, but probably won't be necessary as long as I stay fit.

But damn, before that lamitomy, I couldn't stand for more than a minute. I also had a ruptured disc at S1/L5 - ruptured, not herniated - that was removed. So there is next to nothing as far as cushioning between S1/L5. But I do a spin class 4 times a week, use a rowing machine once or twice a week - all for cardio and to maintain weight. And then do resistance/strength training 3 days/week with a trainer. And I consider stretching and core exercises to be "table stakes"meaning I do them everyday.

All the best to you Karen! Joe

Have you had a sacral MRI ( not pelvic)? They would be looking for nerve compression from a Tarlov cyst. Many radiologists do not report them or say incidental as most doctors believe they are asymptomatic. However, they can cause symptoms like you describe. Go to Tarlov Cyst Foundation and look up Tarlov Cyst symptoms; see if they match.

Look up piriformis syndrome. This is the muscle that leads from your butt cheek, down to your leg. There are good PTs that help you. Online, I go to Dr Jo, who is a PT and the "pretzel" stretch is just the thing. Also, tight hamstrings make the matter worse. I have degenerative back disease and these stretches make the difference. I have not had a shot in several years.

I almost thought this was a post I had posted a few weeks ago at first. I had L4-S1 fusion my L5 was loose biggest mistake 3 weeks later a neighbor came up behind me and twisted me while I was sitting. The surgeon refuses to leave me in pain and says everything is healed , no pinched nerves , no scar tissue. The front and sides of my left leg are numb it comes and goes on the right. My left leg is on fire from what feels like nerves being ripped apart. Now my right leg is starting too, I use a cane and Walker. Waiting on a pain stimulator since I’ve went to 4 surgeons who have said nothing is wrong . 4th surgeon sent me to a hip specialist who laughed and said it wasn’t my hip. I seen someone mentioned falling they should see a pelvic therapist there’s not many that do men . It’s beginning to help but the nerve pain hasn’t slowed down yet but I can now tell when the tailbone gets out of alignment, bowels won’t move right.

I'm so sorry plumber.

Damn, fusion surgery just terrifies me because of these stories. I don't think this is representative of the majority of spinal fusions- that doesn't make it any easier for you or any less scary.

Any orthopedic surgery is gonna involve touching some nerves. And when the spine is involved, well almost all of the body's nerves track through the spinal column. I had laminotomies at S1, L5, and L4 - the least invasive type of back surgery to relieve nerve pain. It worked great, but for the first week after surgery, my leg was weak and it hurt like hell to sit down - I had to lower myself onto a chair.

Next in complexity/nerve involvement is a laminectomy, where a larger portion of the vertebra is removed. And finally, fusion - where the space between fused vertebra is removed and filled with a patient's bone or cadaver bone, and then screws and pins, sometimes rods, are used to make two or more vertebra into one. It even sound awful.

My lumbar spine is held together by a strong core. I've got lumbar stenosis, scoliosis, and degenerative/arthritic disc and vertebra disease. I'm motivated to stay in shape, including keeping my weight normal because I so want to avoid any fusion.

I hope you find an answer and get rid of that pain plumber. All the best friend. Joe

I have to carry a gel cushion to set on anywhere I go. Can’t sleep in bed it hurts to bad to put pressure on the back and can’t sleep on my side because of sciatic nerves irritating my hips! I have spinal stenosis, I was already fused in 2002 at L3-L4. Even the nurse was shocked when I told her the Neurosurgeon never got me out of he wheelchair the last 4 visits to even look at my back . You could literally rub the fused area and pain goes straight to the testicle. My inner thigh(saddle nerves)was numb now tender and burning I asked about the Cauda Equina nerve after reading on her it’s considered an emergency once again without touching me he said NO you do not have that! 13 months since the surgery I’m no longer able to walk 20’ without pain. Before the surgery I would about fall when raising back up every time I bent over! 52 and now disabled, was told at the last visit I’m sorry it didn’t help but everything is healed and he recommends no more surgeries, I can go play football (I think he forgot to say arcade football ) . I’ve seen 3 other surgeons all they do is say it’s good using the same Mri he looked at . I’m trying to get a new MRI since the pain has got worse since the last one.

Could it be your sacrum? I had pain misiagnosed as sciatica and a lumbar MRI which did not show anything. After an MRI of the pelvis and sacrum, they found a chordoma. I just finished 7 weeks of proton radiation and can finally sit for awhile without pain. Although I still use a cushion and a lumbar pillow.

I just spoke to the pain Doc that’s doing the stimulator insurance won’t approve another MRI luckily I had the Psych televisit last Friday so it could be anywhere from 2 weeks to 2 months to get the pain stimulator