Hi, I am a 31 y/o white male, 6 feet, 145 lbs, no pre-existing conditions, no accidents or injuries. In mid-2011 I started getting diffuse pain and paresthesia in the buttocks and backs of my legs when sitting. It would go away if I stood up or laid down. The pain has gotten much worse and now comes on when I lay down and is interfering with my sleep. The pain still gets worse with sitting and goes away with physical activity. I have tried so many things and no one has even been able to tell me what the root cause of this is. I am worried about losing my job and my wife if I cannot manage this. The joy in my life is gone because there is so much pain everyday.

Does anyone have any ideas on how to get a diagnosis and some treatment options? Every test that has been run has come back normal. I went to the Mayo clinic and they had no ideas.

Here is what I have been through-

Doctors: internist, orthapedic surgeons, neurologists, physical medicine & rehabilitation, pain management

Imaging: x-rays spine and pelvic, MRIs of lumbar spine (both lying down and sitting), thoracic spine, pelvis, lumbosacral plexus

Diagnostics: 2 EMGs, blood work, HLA-B27 (negative), celiacs disease (negative)

Prescriptions: NSAIDs, hydrocodone, ultram, muscle relaxers, anti-epileptics, elavil, lidoderm and flector patches,

Steroid injections: lumbar back, piriformis, SI joint, facet joints L4-L5

Physical therapy, chiropractor, acupuncture, TENS unit

Hello and welcome to Neuro Talk. I really am sorry that you are going through so much. I read with astonishment, what you have been through and the lack of DX through Mayo Clinic. Of course they have been noted for being a DX center. Did nothing at all show on your MRI? No hint of nerve inpingment?
At 31 you are too young to give up. There has to be some solution, and or improvement.
Post where you live, and see if another NT member can recommend a good Neurologist in your area. Also, look into the branch of medicine called a physiatrist. They treat for pain, and also deal with the body at a cellular level. Pain has a source. I do not believe it just is there, with nothing that shows up. Keep a journal of all your symptoms. If you can get all your records from all these proceedures, that would be good to bring with you at your next appt. Have you had a scan of the brain? I know that all signals come through the spine to the brain. Please have faith, and I hope that your wife can stay supportive. What kind of work do you do for a living? you can post to me PM any time if you want to. There has to be an answer. I will keep you in my thoughts and prayers. ginnie

Hmm,
Maybe some other things to try acupuncture, bodywork, yoga, hypnosis or EFT ( you can find info or videos on most of those via Google or other web search tools)
did the PT or chiro find any trigger points or postural anomalies?
If they didn't check for those they didn't do the best job for you..IMO.

Did the injections work at all, or the pain always came back after a time?

Have you tried any Vitamins/supplements, no junk food etc..
Maybe a naturopathic dr might have ideas.

6 ft tall and 145lbs? Is that correct?

Has anyone suggested Piriformis Syndrome? This is where the sciatic nerve become compressed by the priformis muscle. This is VERY hard to diagnose, and from what i understand, they can't see it by an MRI. I don't know why. That's why it's so often overlooked. And I really don't know what the treatment is, unless it's physical therapy, to release the sciatic nerve.

You might ask your doctor about this, to see if it's a possibility. It sounds like it could be. It can't hurt to ask, since all other options have been looked at. Best of luck and God bless! Hugs, Lee

PS -- PLEASE LET US KNOW, OK???

I was getting outpatient PT with a gal who has this. They were doing heat, E-stim, various massages and one wild looking sciatica stretch. The patient was experiencing relief. Best wishes.

yup, clean up your diet, (no offense intended) good quality supplements, and celiac testing has ~ 30 false neg. I would wonder about your bone health with that weight and height. I don't see that on your list. Hormone testing, if not already done. Vitamin testing before supplementing if you can get them to do it
! good luck!

Yes I am 6 feet 145 lbs. Skinny guy.

My diet is clean. Rarely do I eat fried stuff, junk food, or sodas. Limited red meat.

Some have suggested piriformis syndrome, and initially I felt my symptoms matched it. However I did the piriformis stretches/massage religiously and had a piriformis steroid/anesthetic injection without any results.

Have had acupuncture, no effect.

Early bloodwork determined low vitamin D (doesn't half of the country have low vit D?) and so I took supplements for 2 months but no difference. Have also tried joint supplements (glucosamine/MSM and such) without any help.

Neither MRIs nor EMGs have shown nerve impingement. There is very slight bulging of a couple of discs but nothing that should be resulting in this much pain per the docs. They say my discs are well hydrated.

When this first started, the area under my glutes was really tender, but since then I have had only mild tenderness across there and have not been able to identify any trigger points that are sensitive.

One x-ray indicated I had very mild dextroscolosis but again nothing that should be resulting in this much pain every day.

I just don't know what I'm going to do. I can't face the prospect of waking up early to this much pain every day for the rest of my life.

With all due respect, I'd like to ask you a couple things.

1) Did you use the RX form of D from your doctor? If so there will be little if any improvement. That RX is D2 and we now know it does very little. You need D3 instead which is OTC and the active form. Do you know your actual numerical reading result?
Also it is now estimated that about 80% of Americans are low in D. We have had posters on PN forum here get good relief from nerve pain with fixing D levels correctly. And even with the proper form of D3, it would take longer than 2 months to effect.

2) Did you ever have your B12 tested? Low B12 will cause nerve damage. Lab ranges in US are outdated and low levels are often not flagged, so doctors say "normal" when in fact they are quite low. The new lowest norm is now 400 pg/ml.
This is our B12 thread:
http://neurotalk.psychcentral.com/thread85103.html
This thread is long, but it has all the current new clinical data on it to help people with this common problem. The surge of acid blocking drugs OTC and long term use has contributed to
a rising number of people with B12 problems. This is because stomach acid is necessary to break cobalamin out of food so it can be absorbed.