Looking for relief of Pinched nerve in L4: PT worked me too hard

Have u tried Voltaren Cream on the L4 area?
I so understand ur tiredness re chronic pain. I’ve been at it 22 Yrs. It steals muscle bc Cortisol stays elevated. You might want to talk to ur Dr about taking some Creatine powder. It helps build and preserve muscle.

Ask you doctor about epidural spine injections. That will be cortisone that will help decrease the inflammation and ease the pain. Call in your area a spine clinic. I live in southern Minnesota so I just called a Spine Clinic called Inspired Spine Clinic in Burnsville outside the Twin Citirs, They will know exactly how to help with this situation. Their phone number is 952-405-6714. Good luck. I had a recent MRI and showed Compression fracture T11 plus five(5) bulging disks in the Lumbar Spine. Lots of pain, so trying to get some epidural injections myself. Let me know how things work out.

You need a pain management doctor. A physiatrist may be able to help you.

Welcome @bazzinga1234, I'm sorry to hear that you have unresolved pain. I moved your message to the Spine Health Support Group

In addition to the helpful posts that you've received from @tyco @cookiegirl1944 and @irr4et, you may also be interested in this related discussion:
- Dealing with Sciatica pain: https://connect.mayoclinic.org/discussion/sciatica-pain/

Tyco, thank you for your suggestion. My orthopedist is a physiatrist. He’s prescribed 3 MRIs.
The lumbar MRI showed
A Pinched nerve in L4.
I’ve had cortisone shots in my spine a few months ago and got very little relief from it for about one day.
He’s now prescribed another series of MRIs...
One for the femur, and (thoracic and lumbar again to see if any change).

Thank you for your advice. I’ll check out these remedies.

@bazzinga1234 I understand your frustration with physical therapy. There could be a couple of things adding to your pain, the nerve compression in the foramen of the nerve root at L4, and if a muscle spasm has caused your pelvis to shift, that might also further compress the foramen (space between vertebrae at L4) putting more pressure on an already compressed nerve. When the pelvis is out of alignmenet it adds to back pain and can cause sciatic nerve pain even when there are no spine issues. If your disc at L4 is OK, and the problem is only at the nerve root, there is a less invasive procedure called a foraminotomy that could open up that space and it may be able to be done as a minimally invasive surgery. This isn't extensive back surgery.

Here is some information about a foraminotomy:
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/foraminotomy
You mentioned you are 73 and have trouble walking because of this pain and loss of normal function. This can create a risk of falling that would be significant and that could lead injuries that would further decrease your quality of life. I don't know if you have osteoporosis, but that would substantially increase the risk of breaking bones if you fall. This is something to think about because you may not be a candidate for a surgical procedure later at an advanced age. That is something only a specialist can answer, and it might be worth your time to get an opinion as to what is best in your situation. My mom has severe osteoporosis and fell because when she was walking, a bone in her foot just broke causing a fall that also broke her pelvis. That was a very long recovery and because she didn't walk on her foot, the tendons shortened and she could no longer put her foot flat on the floor. That lead to another surgery on her foot and life in a wheelchair. When you are older, a fall risk can be serious.

Another suggestion I can make is to look at myofascial release therapy. A specially trained physical therapist can do this, and basically it is a hands on manual technique where the therapist stretches your overly tight tissue. You would not be doing exercises; this is more like a massage or like kneading bread dough in slow motion. The therapist will press into your skin with their hands and push it in a direction against the tightness and just hold the pressure and wait for the tissue to release. Doing this can realign the spine a bit if a muscle spasm has caused a shift. The pelvis is connected to the spine by muscles and can pull on the spine causing pain. This might be something to try to see if it helps. It won't change the compression in the foramen, but it gets the body better aligned.

Here is the discussion that you may want to read through and meet other members who have used MFR. I have done this therapy for over 10 years and it has helped me a lot. I am also a cervical spine surgery patient.

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

Would you please come back and share what you learn from the new MRI's that you will be having and what your doctors suggest? I just noticed your member name Bazzinga..... and I think that you probably like a TV show that I like too.

The rehab center overworked me and caused a pinched nerve in my L4. My
leg is disabled and I live with chronic excruciating pain. My leg feels like a
50 pound weight is attached to it and feels like a tight heavy rope is pulling my thigh causing lack of mobility. It is numb and I’ve gotten neuropathy from it too. Every time I sit or lie down I feel like I’m sitting on a pile of rocks. I cannot sleep on my sides.
I can barely lift myself out of my bed. My orthopedist has prescribed muscle relaxers and pain meds like gabapentin, cymbalta and none of them work. If I stand while preparing meals for more than 10 mins, it creates terrible pain in leg and back.
I am crippled in my left leg. I’m afraid of having surgery because there’s a 50% chance it can make me worse. Has anyone experienced pain like this? The only thing that gives me some relief is Excedrin Extra Strength

Hi @bazzinga1234, I'm sorry to hear that you are still dealing with such pain. I moved your recent post to the discussion you started on this topic previously. I wonder if you saw the post that @jenniferhunter shared with you?

Jennifer,
Thank you so much for your input to my post.
Sorry that I’ve been remiss in responding to you.
It’s been a year and my pain and mobility is getting worse. My orthopedist recently told me “Don’t let anyone convince you to have surgery” I asked him why he said that and his response was “surgery may not help and I can be worse off.
He said it’s a 50/50 chance.
He is not a surgeon. He
is a physiatrist.
He suggested that I see a spine specialist, who are usually surgeons , and most likely he’ll want to do surgery. It’s a catch 22.
Three years ago, He diagnosed me with spinal stenosis which affects my back. But, the stenosis pain is nothing like the nerve pain and complications from my pinched nerve in my L4.
At times it’s excruciating.
Thank you for your suggestions and your concern about my age and falling.
Give your mom a hug from me. I’m sorry what she’s going through. I hope she has someone to care for her.
Take care.
And yes, we watch the same show. Lol.