Expert: Scott F. Gillman, DC, DACBSP - 7/27/2008

Question
Good day
For the last five weeks I thought that I was experiencing sciatica.  I have had this before but this time I felt it was different because it wouldn't go away even after several visits to my chiropracter.  I went to my doctor a couple of weeks ago and had an xray taken of my lower back and the results showed that I have a slightly protruding disc that was causing the sharp pain to radiate along the left side of my lower back. Just a few days prior to starting physiotherapy last week I started to have a terrible ache in the back of my left leg (it's definitly not sharp) which goes from the just above the back of my knee to my ankle (it's mostly in the back of my knee and calf). At night I sleep with a pillow under my legs, however, just having my leg rest on the pillow causes my leg to ache more.  It almost feels like I have strained the muscles perhaps by favouring that leg while I was walking when I was having the sharp pain in my lower back.  I should, also, let you know that I do take 2mg coversyl (for 2 years now) and 1-200mg celebrex a day for my back (I've taken this before and have had no side effects).  I, also, walk on the treadmill 3 days a week (for the last 3 years) and swim twice a week though I have cut this back due to the protruding disc.

Would you by chance know what is causing the leg ache and if there are any exercises that would help alleviate it?  
Thank you for your help.

Bev


Answer
Bev,

First, you cannot assume anything from looking at an X-ray.  The research shows that Xray findings do not necessarily correlate with pain.   If the xrays show a worn-out disc space, meaning that the space between the bones where the disc sits is no longer, and you have one vertebral bone very close to another, then you can only assume that the pain is related to that worn out disc.   You cannot be completely sure.  To know if the disc is up against a nerve, causing sciatica, the only way to image it is with an MRI.   Exercises should be aimed at reducing the calf symptoms.  There is an approach of testing your trunk position in various extension positions to see if it takes your pain away from your calf.  The DC or PT should have tested you on this.   If you find, for example, that when you extend your trunk backwards and slightly to the left, your calf pain reduces, then that's the direction your exercises should go.   If you have not lost your knee or ankle reflexes, and you have no loss of strength to the muscles that allow you to heel or toe walk, then you simply must find the right procedures to help alleviate your pain.   If methods fail, you should get an MRI to see what's up against the nerve.  

'Hope this helps.

Dr. G