Dealing with Sciatica pain

Does the MRI show nerve impingement from the discs? Are the discs in your lower back? If so, epidural steroid injections and PT might be helpful.
I speak from experience!

The MRI shows spinal stenosis and two bulging discs, but before I get an epidural I wanted to try a shot in the piriformis muscle and PT. I have no pain in the lower back, only on the left side of the thigh and groin with severe muscle cramping. So far I haven't had much relief. Am due for another shot next week. I am really scared to get an epidural b/c of the proximity of the spinal cord, so that will be my last resort. Thanks for responding.

Hello @junebug15, I am sorry to hear of your recent diagnoses.

I would like to invite @blindeyepug, @goodtime376, @pat3316, @jeriliz, and @jjwest to this discussion as they have all discussed having spinal stenosis as well and may be able to offer some insight regarding your concerns with treatment options and epidurals.

@junebug15, did your physician(s) mention or talk about how long the shots would take to start having an affect?

Hi Justin: My dr. said it would take 24-48 h. before I would feel any difference. I haven't felt much better. I am scheduled for another shot next week. Since I had problems with the piriformis muscle before I wanted to have a shot in that area before I had an epidural. That would be my last resort. I also want to start PT. Am interested in ART (active release therapy) which I heard can be very beneficial. I have absolutely no pain upon sitting but feel severe muscle cramping in my groin and lateral thigh upon standing. Was wondering if anyone else had the same problems. Am just not sure if this is from bulging discs or spinal stenosis.

Thanks for your input. I do have 2 bulging discs at L4-5 and spinal stenosis but I have also had this problem before which was cured by a shot into the piriformis muscle. If this muscle becomes inflamed it will cut off the sciatic nerve which runs underneath it. Am going to try PT before I go for the epidural. Thanks for your input.

I completely understand your caution when it comes to anything entering near your spinal cord and you cannot be faulted for trying everything else before you try an epidural if that is what makes you the most uncomfortable.

In regards to ART, I would like to invite @predictable to the conversation as he has done some research on this type of therapy and discussed it on Connect in the past.

Thanks Justin. Would love to hear what @predictable has to say about ART. Stay well.

Because Active Release Technique (ART) was unknown to me, I googled it and found many articles and other references. Members reading this discussion may find them informative. Here's one of a number of similar descriptions:

"ART is a patented, state of the art soft tissue system/movement based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART. These conditions all have one important thing in common: they are often a result of overused muscles."

I found nothing to explain how a massage technique that involves no special equipment could be patented or how much the owner of the patent is paid for leasing or licensing ART to a massage technician.

Here's a link to another reference: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4563290/ and an excerpt from this 2015 article:

"The active release technique (ART) is a manual therapy for the recovery of soft tissue function that involves the removal of scar tissue, which can cause pain, stiffness, muscle weakness, and abnormal sensations including mechanical dysfunction in the muscles, myofascia, and soft tissue. The effectiveness of ART has been reported for carpal tunnel syndrome, Achilles tendonitis, and tennis elbow, all of which involve soft tissue near joints in the distal parts of the body. ART is also effective at reducing pain and increasing ROM in patients with a partial tear of the supraspinatus tendon (in the shoulder). Most patients with chronic neck pain experience pain and movement limitation as a result of soft tissue impairment in the neck."

The unique factors in this description are "soft tissue function" and "removal of scar tissue" usually attributable to "mechanical dysfunction in the muscles." There is no mention of bone or skeletal injury or disformation as targets of ART massage therapy.

The lower back epidural injections for stenosis did nothing for me. The Hyalan type injections for my shoulders did nothing as well.Had this done by an anesthesiologist who now operates a "pain clinic" at a small hospital on L.I. N.Y. In my case, taking steroids that are not effective, is not worth the risk. So far I'm doing the best on Medical Marijuana and Ibuprofen twice or 3 times a day, Plus PT twice a week. Check out the latest issue of Consumer Reports for an extensive article on Back Pain. Good luck with your treatment choice and don't believe everything the doctor tells you. Check the treatments and drugs yourself, reading and talking to fellow sufferer's and ask tough questions, of the doctors.

(shortshot80) I have had two surgery's for spinal stenosis and both really helped. I'm 84 now and all is well as far as those go, I have other problems. Can't do much for them though. But I would do the surgeries again drather than a shot in a muscle or epidural. The surgery is a faster- less problems. (It was for me) just have to do as the doc says. I would do it again!