HomeAnswersPhysiotherapysciaticaI had a minor herniated disc L4 or L5 but the sciatica is heavy. What is the underlying cause?

My sciatica is heavy after a minor herniated disc L4 or L5. Why?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Nithila. A

Published At June 2, 2019
Reviewed AtJune 30, 2023

Patient's Query

Hello,

I had a minor herniated disc L4 or L5 last year. (MRI confirmed nerve pinch, but no broken disc or liquid leaks) With heavy pain, I was hospitalized but recovered within two weeks. With Ibuprofen and muscle relaxants, I was able to walk and function pretty normally. Sciatica (leg nerve pain) came and go during the time now and when I was in the hospital last year.

Right now, I am experiencing almost no back pain, but the sciatica is heavy. Mostly on the back of my left upper leg, down to the end of the knee. I am doing stretching exercises, belly position, upper body up, or on the back, leg stretches towards the torso, plank training, etc. But I still have to sit a lot due to my job. I tried a standing desk, which resulted in foot pain and also more sciatica.

Though I am sitting straight, the fascinating thing is that heat and cold are influencing sciatica. As long as I apply heat to the leg (not the lower back), the pain disappears instantly to an almost level of no pain. A bit of cold and the pain becomes very heavy immediately as well. Can there be an underlining other issue causing it?

Hello,

Welcome to icliniq.com.

As it is a year-old injury now I will suggest doing some physical tests like the McKenzie maneuver to see if the radiating symptoms stop and the pain gets centralized to the lower back. The McKenzie maneuver is simple, and you can read about it and practice it. Now I think there is still a muscle weakness that is leading to nerve root entrapment like the lateral spinal muscles, paraspinal muscles, hip muscles, etc.

I advise you to not use cold therapy as it is aggravating the pain symptoms. Do proper exercise which will regain the strength in the muscles and avoid nerve root entrapment. In most cases, the pain is caused due to more muscle weakness, and it is common in most cases to have received the symptoms back. Doing proper exercise with proper guidance can resolve the matter.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Jay Indravadan Patel
Jay Indravadan Patel

Physiotherapy

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