Question

Dear Dr. Newhart,

I am nineteen years old and was recently diagnosed with Sciatica by my doctor (general doctor, not Chiropractor).

She prescribed me Lodine, an anti-imflammatory I'm sure you have heard of.  However, after evaluating the side effects, I decided it was something I wasn't comfortable with taking.

For pain, which was been severe, I've been taking Hydrocodone left over from when I had my wisdom teeth out back in September.  It has really helped take the edge off and has also helped me sleep when the pain would normally be so bad, I can't.  To be honest, I can't remember a time when I have been in this much pain.  It has driven me to tears on several occasions because it hurts so bad.

As far as medication goes, I'm on 5mg of Lisinopril, 2.5mg of Lexapro (for Anxiety, which I no longer have, so I'm being weened off of it, just as I was weened off of Klonopin), and birth control.

Also, my doctor said if Lodine didn't work for me, she was going to try a steroid treatment of sorts.  I saw her last Thursday.  I called her yesterday and left her a message stating how I didn't want to take Lodine and asking her if she could possible prescribe me Hydrocodone for pain.  I've tried every over-the-counter pain medicine there is and nothing is strong enough.  I even had prescription-dose Naproxen (I don't know if I spelled that right).

Basically, my question to you is, what is the best way to go about treating my pain?  When I say that it is severe, I'm very serious.  I can usually tolerate pain very well, but this is horrible.  Also, should I actually see a Chiropractor?  My doctor diagnosed me based on one office visit and no tests of any kind.  I told her my symptoms and she had me lay different ways while she lifted my legs, and had me touch me toes.  That's about it.  I'm not saying that I don't think I have Sciatica, but I'm just not 100% sure.  If horrible, shooting pain in your lower back, hips and legs is Sciatica, I definitely have it.

I know you cannot diagnose me over the internet, but any advice about pain medication and/or management you can give me would be fantastic.  I definitely don't want to be on pain medicine forever, but I think that now is one of those times that I truly need it.  I know Hydrocodone is not meant for people to stay on long-term, but I'm hoping that my "Sciatica" isn't long-term, either.

Thank you for listening,
Laura

Answer
Laura, I can sympathize with you.  Even chiropractors get pain, and sciatica and low back pain happen to be 2 that I get , and have had since I was young (I am 38 now, and can remember back to 9 or 10 years old having sciatic symptoms).  It is possible to narrow down sciatica with a few tests that you mentioned, but to truly diagnose it, you want to find a good chiropractor.  They would take xrays, and address any muscle issues that may be contributing.  Medicinal management is only a "band-aid":  it will mask the symptoms.  I am not faulting your doctor; they just aren't trained to fix the problem from a mechanical point of view.  Anti-inflammatories and muscle relaxants are their first line of defense.  Physical therapy next.  Steroid injections, stronger meds, and surgery are the next in line.  All have their place, but a good chiropractor should be able to help you, and if they cannot, they should be able to refer to someone that can.  Hope that this helps