New and confused - Facet joints vs. lumbar radiculopathy
 

So, I have been having sciatic pain off and on for probably five or six years. I had PT in 2009 and got stabilized to the point where I only rarely had a bad day. I had to give up yoga and bicycling, two of my main exercises, at that point to avoid re-triggering the symptoms.

After a concussion this past January, I got deconditioned and the sciatica came back with a vengeance. I've tried most of the conservative treatments including oral steroids, anti-inflammatories, active PT, and passive PT.

All along, my main areas of pain have been my right buttock/hip and right hamstring, with occasional pain into my calf and right foot. Everybody has said that they suspect bulging and/or herniated disc. In my 2009 MRI, I had "minimal lateral bulging" at L4-L5.

After a major rehab effort this summer, my leg pain briefly subsided and then came back worse than ever. It is now almost constant, even in postures that theoretically shouldn't put strain on the leg muscles. I had to give up even gentle walking on a flat surface for any considerable distance. Now I don't feel that there's any exercise I can do and it's very frustrating.

Just a few weeks ago, I started feeling pain in my back. This is unusual for me. The PT said it was a good thing because the pain was centralizing.

I had another MRI. This one showed no disc problems but some deterioration in the facet joints.

Yesterday I had a diagnostic spinal block which did help my back pain but not my leg pain. The doctor said I may need to consider epidural injections.

I am very confused. How can facet joint pain cause sciatica going all down my leg? If there is nothing wrong with the disc, where is the sciatica coming from, and how will this other type of injection help when the first one didn't? :confused:

Would love to hear from anyone with similar experiences. I'm well past ready to find a solution.

The sciatic nerve runs from the spine down the entire length of the leg into the heel:
http://www.sciaticnervetreatments.or...etreatment.jpg
and as pain can sometimes "telegraph" (pain felt at a location distant from the actual source), a problem in the spine can be felt anywhere/all along the nerve.

Sciatica can come from problems with discs, facet joints, and other sources.
Google: facet joint sciatica

The diagnostic spinal block was just that - diagnostic. It is used to help figure out the source of your pain.

The epidural injections are therapeutic injections. In this case, aimed at reducing inflamation by use of steroids.
http://www.spine-health.com/treatmen...n-and-sciatica

HTH,

Doc