Question
Hi Lawrence and thank you for your time.
In 2001, I had a multi injury resulting in rotator cuff tears bi-lateral, torn bladder and herniations to L 2-3, L 3-4, and L 4-5, ending up having a shoulder resection in 2002 and a lumbar fusion in 2003. Funny thing, the shoulder without the surgery feels great...the one with the surgery still bothers me quite a bit. Also, I still have sciatica pretty bad and back pain. It seems that the surgery didn't really help at all. I have heard that a fusion weakens the surrounding disks and if they are healthy they will wear down from the stress of the fusion. So, if mine were not healthy, as indicated...what additional damage is being done and can this be the cause of my continued pain?The pain is in the lumbar area, occassionaly jolts down my legs to my feet. It doesn't help that I am also now in treatment for cancer and the chemo is causing nerve damage to my feet ant hands, but I can tell the difference between the sciatica and the chemo pain.
I am uable to sit,walk or stand very long.  I am prescribed Norco for the pain, which does help...so well in fact that I tend to over due myself and then pay dearly when the pill wears off. I do not see an orthopedic any more as he said there was nothing more he could do outside of pain management...is that it? the end of the line? Nothing to be done except downing pills?

Answer
Dear Lisa,

I think that you have a good option available to you, other than pills or the usual medical pain management.

First, understand:  Sciatica is a nerve impingement condition usually resulting from tight back muscles overcompressing discs; sometimes (more rarely) it's the piriformis (buttock) muscle(s) that contract and cause the impingement.  Accidents and surgery cause muscles to contract in a trauma-reaction.

Some training to learn how to relax those muscles (somatic education) may solve the problem (and usually does).  Surgery, on the other hand, is usually the wrong approach to sciatica, and if your orthopedist says there is nothing more to do, then yours is not a surgical situation any more.

The resected shoulder muscles are probably also very contracted.

A physical examination of your muscular system is called for to say anything definitive.  I would be looking for areas of your muscular system that are very contracted when you are otherwise at rest.

Somatic education is a new discipline in the field of health care and is not the same as physical therapy, strengthening or stretching.  In my opinion, you would probably get great relief from sessions with a somatic education practitioner.  I would suggest you learn about it and then get evaluated.  Visit somatics.com|articles.

with regard,
Lawrence Gold