Dealing with Sciatica pain

@travelinman
Have you had a recent MRI ? What does it show? What spinal nerves are being compressed that are causing your leg/foot symptoms? Is your spinal cord being compressed (do you have spinal stenosis/neurogenic claudication)? What was your surgery supposed to address? Are you better or worse after the fusion? Did they injure a nerve?

Have you been to a neurologist for EMG/nerve conduction studies and seen other spine specialists for 2nd and 3rd opinions? Have you ever had a MRI of your pelvis/hips to see what nerves or blood vessels may be compressed? Have you ever had MRI or ultrasound of your calf/ankle to see if a nerve or blood vessel is pinched, blocked or damaged? Have you ever seen a vascular specialist? Have you ever had an ankle brachial test?
https://www.mayoclinic.org/tests-procedures/ankle-brachial-index/about/pac-20392934

Thank you for your reply. I will answer your questions, and I hope and pray you can give me further direction.
I've had two MRIs, 1 - May 2022, before surgeries, and 2 - May 2024, both of which these of the Lumbar region and pelvis area. With the MRI’s, no mention of nerves/blood vessels being compressed. The spinal nerve being affected is.L5-S1. Not sure if the spinal cord is being compressed.
1st Surgery - August 2022 - Was for fusion at L5-S1 and “clean out” of L3-L5. The first surgery was done by a neurosurgeon who was a second opinion. The first opinion was from an orthopedic surgeon who was only going to do a “clean out” of L3-S5. (Same hospital)
2nd Surgery- October 2022 - The screws came out of my fusion, very painful and ended in emergency room at direction of my nerosurgeon who did both of these surgeries. I am being treated for my bone density situation with supplements and an infusion, followed by X-rays.
3rd Surgery - November 28, 2024 - Another neurosurgeon, different hospital network. He did a microdiscectomy to clean out around the nerve. My first neurosurgeon told me he would not do this surgery. It's only been 4 months, but this neurosurgeon said it could take at least six months for the nerve to recover, after being affected for more than 3 years. This neurosurgeon was referred to me by my first neurosurgeon.
Pain started in my lower back in February of 2022, then moved down into my leg by April of 2022. My pain is basically the same as before my fusion, the only difference is that after my first surgery, my right foot around the ball and toes became numb, as it is today. My PCP claims that possibly the neurosurgeon damaged my nerve, though the neurosurgeon who did the surgeries 1 & 2 has never admitted to that.
I have seen 2 neurologists, EMG Studies - which showed nerve problems at.L5-S1. They tried me on 6 different alternative medications as a substitute for the oxycodone, none of which worked, and the Side effects were as bad as the pain.
Right Calf/Ankle - December 2022. Saw a podiatrist who examined this area, no arthritis, said my ankle looked like a 40-year-old, though I am older. I've walked a lot and still do through the pain. No mention of nerve or blood vessel problems in this area. Have not seen a vascular specialist or had an ankle test.
I do appreciate your guidance as I am at wit's end with the pain, and taking the medication. My PCP is going to increase the dosage once again due to my tolerance with the effect of the medication on my pain. Let me know if you need any further information, and if it would be helpful to discuss by phone. Let me know what you feel would be my next steps.
Again, thank you for all the help! I am taking it seriously and will follow through.

Thank you for your reply. I will answer your questions, and I hope and pray you can give me further direction.
I've had two MRIs, 1 - May 2022, before surgeries, and 2 - May 2024, both of which these of the Lumbar region and pelvis area. With the MRI’s, no mention of nerves/blood vessels being compressed. The spinal nerve being affected is.L5-S1. Not sure if the spinal cord is being compressed.
1st Surgery - August 2022 - Was for fusion at L5-S1 and “clean out” of L3-L5. The first surgery was done by a neurosurgeon who was a second opinion. The first opinion was from an orthopedic surgeon who was only going to do a “clean out” of L3-S5. (Same hospital)
2nd Surgery- October 2022 - The screws came out of my fusion, very painful and ended in emergency room at direction of my nerosurgeon who did both of these surgeries. I am being treated for my bone density situation with supplements and an infusion, followed by X-rays.
3rd Surgery - November 28, 2024 - Another neurosurgeon, different hospital network. He did a microdiscectomy to clean out around the nerve. My first neurosurgeon told me he would not do this surgery. It's only been 4 months, but this neurosurgeon said it could take at least six months for the nerve to recover, after being affected for more than 3 years. This neurosurgeon was referred to me by my first neurosurgeon.
Pain started in my lower back in February of 2022, then moved down into my leg by April of 2022. My pain is basically the same as before my fusion, the only difference is that after my first surgery, my right foot around the ball and toes became numb, as it is today. My PCP claims that possibly the neurosurgeon damaged my nerve, though the neurosurgeon who did the surgeries 1 & 2 has never admitted to that.
I have seen 2 neurologists, EMG Studies - which showed nerve problems at.L5-S1. They tried me on 6 different alternative medications as a substitute for the oxycodone, none of which worked, and the Side effects were as bad as the pain.
Right Calf/Ankle - December 2022. Saw a podiatrist who examined this area, no arthritis, said my ankle looked like a 40-year-old, though I am older. I've walked a lot and still do through the pain. No mention of nerve or blood vessel problems in this area. Have not seen a vascular specialist or had an ankle test.
I do appreciate your guidance as I am at wit's end with the pain, and taking the medication. My PCP is going to increase the dosage once again due to my tolerance with the effect of the medication on my pain. Let me know if you need any further information, and if it would be helpful to discuss by phone. Let me know what you feel would be my next steps.
Again, thank you for all the help! I am taking it seriously and will follow through.

I have endured Sciatica Nerve Pain for over 3 years now. Pain is coming from L5-S1, primarily S1. The Pain manifests itself in the lower calf of my right leg into my ankle. My right foot is always numb, but I can live with that. I have been through 3 surgeries, a fusion at L5-S1, shots, PT, and every pain medication there is. I have been on opioids for almost 3 years to endure the pain, with increases in dosage as I become more tolerant. Nothing has worked. I want to get off the opioids.
Other than a Spinal Cord Implant, I was told because of the location, I could not do an ablation. Are there other options for me?

I have endured Sciatica Nerve Pain for over 3 years now. Pain is coming from L5-S1, primarily S1. The Pain manifests itself in the lower calf of my right leg into my ankle. My right foot is always numb, but I can live with that. I have been through 3 surgeries, a fusion at L5-S1, shots, PT, and every pain medication there is. I have been on opioids for almost 3 years to endure the pain, with increases in dosage as I become more tolerant. Nothing has worked. I want to get off the opioids.
Other than a Spinal Cord Implant, I was told because of the location, I could not do an ablation. Are there other options for me?

I had L5-S1 ablations bilaterally multiple times. Don't understand why your doctor said that, but I have not had lumbar spine surgery. Ask again and get an answer.

@travelinman I wanted to share some information with you about myofascial release. MFR can be used to stretch tight fascia and surgical scar tissue. If your pain or nerve compression is being generated by scar tissue, perhaps MFR with an expert level provider may bring some relief. I don' t know if it will help you, but it may be something to try as it can help a lot of conditions and may be worth asking a provider about your situation. I have done MFR for many years and it has helped me a lot. There is a provider search at http://mfrtherapists.com/

Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Was hospitalized with severe back pains and then sciatic pain of the foot. No surgery was directed by my doctor and I was treated with traction. Took years to recover with my own traction inversion table. Now just need the table once in a while if my toe starts to hurt

FDA JUST APPROVED NON OPOID PAIN PILL ------JOURNAVX HAVE YOU TRIED IT?

@travelinman
I am not a doctor but someone who has experienced many spine issues, injections, surgeries, etc.

It does seem like your nerve(s) was(were) injured in your first 2 surgeries. Why did you decide not to work with the first orthopedic spine specialist who did not suggest fusion? Why did the neurosurgeon suggest fusion of L5-S1? Do you know why your hardware failed?

Do you have the 2024 MRI report that details what was seen L1-L5 and L5-S1? What level was worked on in November 2024 and did the surgeon say the source of your pain was due to a disc bulge/herniated disc and the surgery would relieve it? Do you know why the neurosurgeon that did surgery 1 and 2 would not do the 3rd surgery?

It definitely can take a long time for spinal nerves to heal. I had moderate to severe compression of L4-L5 spinal cord/nerve roots for 12 years and had decompression and fusion surgery on L3-L5 in August 2024. I had numbness in my right foot after surgery but it has improved some. I had a lot of pain for the first 3-5 months and started to get some relief in the 6th month.

Have you ever tried Cymbalta for nerve pain or Tramadol? Have you ever tried Salonpas lidocaine pain patches or acupuncture? I do feel for you and I know how bad nerve pain can be.

I have read that nerve ablation is possible for L5-S1. Who told you it was not possible? Are you working with an orthopedic spine pain specialist to review all options? A stimulator may be a good option to consider for your type of pain.