Sciatica anyone?

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CaraOC

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I am post op total hip replacement on September 1st and although my hip is healing great I've had a big flare up of sciatica pain in the operative side. Internet research has turned up info on neuropathy issues post op THR. Anyone with some wisdom on addressing this would be appreciated. My surgeon insists its the back and not the hip so I'm thinking he's not going to do anything. This is very annoying. Pain down my butt to my ankle with a constricted pain around my ankle.
 
I don't have anything to offer other than you probably need to see an ortho or neurosurgeon who specializes in the area of spinal cord/disc issues. He/she should be able to determine if it is spinal cord nerve compression or general neuropathy. Pain injections for that disc level might be one option.
 
It's called referred pain. It's very possible it is the back being pinched. It is also possible he irritated it during your THR. OR it could be due to inflammation.

The sciatica nerves go from your lower spine (L5 on the spine is where the nerve root starts) down each leg to your feet. But since it travels thru your butt, it is possible that during surgery it was pinched or compressed.

I agree with a neuro/ortho spine surgeon consult just to figure out if it is due to L5/S1 (mine was) or just due to the THR.
http://www.spine-health.com/conditions/spine-anatomy/sciatic-nerve-anatomy (for an overview)

Studies on hip replacement and sciatica:
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0089154
http://newsnetwork.mayoclinic.org/d...after-hip-surgery-may-be-due-to-inflammation/
http://www.wheelessonline.com/ortho/nerve_injuries_in_thr
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3928432/
 
I can most definitely relate to this, Cara. My continued foot and thigh numbness, tight calf and nerve pain is coming from some kind of damage to the sciatic nerve from my THR revision. EMG test confirmed this (sciatic neuropathy) so you might want to start there.
I woke up from surgery with it, so hopefully yours is not as severe and is a result of inflammation and swelling. My revision was on 8/7 and my foot still swells. I am having two MRIs today to better see what's going on. One is of thoracic and lumbar spine, the other of pelvis. I'll keep you posted. Yes, doctors seem to just brush it off as if it's imagined. So frustrating. I am sorry you are enduring this.
 
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I broke my femur near my hip on July 1 and needed surgery to put in a nail and screws. I had the shooting butt-to-toe pain when I walked, diagnosed as sciatic nerve inflammation. The physical therapist worked on it with exercises, cold packs and massage for several visits and it went away. I still have inner thigh pain and foot numbness on occasion, but not the shooting pain. I also have narrowing of L1-3 in the spine, but it didn't cause pain before the surgery and when the inflammation went away, so did the pain. One lesson I learned, which doesn't make sense, is that Advil, Aleve, ibuprofen etc should not be used because they inhibit healing after bone surgery. So extra strength Tylenol was all that was allowed, with a single aspirin for blood clot prevention per day. Don't use an anti-inflammatory for inflammation? Not sure why, but it worked in my case. I swear by physical therapy and think that did the most good in recovery.

Cara, glad to hear you are getting more tests to figure out what is the cause. Hope someone figures it out soon. I was told that any MRI would be harder to read because of the hardware, so you might want to ask if that is part of the problem. An independent orthopedist might tell you if it was a surgical injury that could be related to poor technique on the part of your surgeon. I am seeing a second opinion because the physical therapist feels a screw protruding farther than it should into the inner thigh where the pain is. Not that I am suing for malpractice, just that I want to find the cause of the pain and get it fixed.
 
I am seeing a second opinion because the physical therapist feels a screw protruding farther than it should into the inner thigh where the pain is. Not that I am suing for malpractice, just that I want to find the cause of the pain and get it fixed.
Unfortunately screws will move slightly sometimes. I know that is what happened to my jaw hardware. Nothing the surgeon did was wrong...my body did it. But it's also why I had two other surgeries 2 and 21/2 years later to remove the hardware.
 
i hope removal surgery isn't the only way to fix it! You can hear a click-click-click when I walk sometimes and she can make it click with pushing it in the right place. She thinks one of the 4 screws is broken. I am 12 weeks out now and I made an appointment at another hospital. Hope it is a simple remove and replace 1 screw?

Sorry about the jaw hardware woes!
 
i hope removal surgery isn't the only way to fix it! You can hear a click-click-click when I walk sometimes and she can make it click with pushing it in the right place. She thinks one of the 4 screws is broken. I am 12 weeks out now and I made an appointment at another hospital. Hope it is a simple remove and replace 1 screw?

Sorry about the jaw hardware woes!
I hope yours is an easy fix as well.
 
I had sciatica off and on for years after pushing for 4 hours with a bored L&D nurse contorting my knee behind my ear (and still had a cesarian). Two to three weeks after the DS I was damn near paralyzed with pain. The chiropractor said that simply the act of lying on the OR table in positions you wouldn;t keep while awake can aggravate lower back and sciatica. And, yes, he said it often doesn;t appear for a couple weeks after the surgery. It took 3 months of PT and meloxicam. Still on meloxicam. (If it happens again, though, I would do acupuncture as recent data suggest it is more effective than PT on lower back/sciatica.)

Hope it is just a positioning issue on the OR table and not a pinched nerve, and that it passes on its own.

BTW When my sciatica used to act up (always at night when trying to sleep) it helped to roll on my side and curl up with knees under chin.
 

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