Question
I'm experiencing lower back and leg pain (right side).  The pain in the leg seems to stem from some general "achiness" in lower (right) back, just above the buttocks.  Leg pain is mostly numbness, tingly (electric-like) sensations; it also sometimes includes sharper pain on the bottom of my foot (various spots).  Sitting and driving are hell for me regardless of how I modify each.  Standing isn't too bad.  Not much in the way of sharp pains overall.  

Had back pain 5 yrs ago and underwent neurologist exams, MRI, EMG and approx 1 month of physical therapy (core strengthening and balance work); also prescribed muscle relaxants and anti-inflams.  Situation improved after therapy.  MRI revealed mild/minor spinal stenosis in L4 or L5 (I think).  

Turning 50 in 2 weeks, slightly overweight.  Recent pain began almost 4 weeks ago and home medication (ice/heat packs, Advil, anti-inflams, warm baths) helps but only very moderately.  Pain and numbing begin quickly after an hour of sitting.  I'm scheduled to see a neurologist on July 7.  

Your thoughts, please.  Any opinion or advice would be very appreciated.  I can't miss more work, and the thought of having to sit for 7 hours (dang desk job) makes me kind of anxious.  This seems to be a herniated disk.  If that's the case, should I get medical help immediately (emergency room)?  I've checked with my insurance provider, but that's not been much help.  

Thanks very much for your time -
Len

Answer
len,
good questions. yes, this is a flare up of your old injury causing sciatica (nerve) impingement. When you sit you compress that disc even more.
a few approaches here.
1. pain management/medical/neurologist approach: it's fairly obvious what the neurologist will do for you, prescribe muscle relaxers and pain killers or anti-inflams and run another expensive EMG on you. In 3 years you will be right back to where you started from and in worse shape.
2: physical therapy: i never understood why doctors refer sciatica or any pinched nerve to a Physical therapist right away. PT's deal with the muscular system only, not pinched nerves. physical therapy will be helpful in your rehab after nerve pressure is removed.
3: chiropractic: chiropractors specialize in the spine by removing nerve interference through various techniques. One being the "adjustment" which removes pressure on that nerve. now, if you have spinal stenosis, there are two types; foraminal or central canal stenosis. either way the dr. needs to be gentle and i would suggest using a chiropractor with cold laser. laser will speed your recovery 10 fold and get you back to work faster when mixed with chiropractic care.

after about 4-10 weeks (based on injury,person and individual recovery avg's) when symptomatically improved you start physical therapy or get a rehab specialist personal trainer(special certification) and build your core. pilates is the best in my opinion. The extra weight you carry is worst enemy ( you need to lose it) you need to take care of your back. that means exercise for life, watch what you eat(weight management), and stretching a lot of stretching. you can also get a home traction unit for about $350 (only get it if your Dr. approves of traction)
what you can do now: you can get a cushion called a "sacral wedge." relax-o-bak has the best ones i have seen. we carry them in our office in nyc. call kristin to find out there phone # if you want to order one from the company or us. 212-533-4900.

i hope that is helpful