Hello Doctor, how are you? Thank you in advance for taking the time to help me. I’ve been dealing with low back pain and right leg sciatica (down back of thigh and calf and all over foot) for 2 years. I have a left paracentral disc herniation measuring 3mm AP by 6mm transverse dimension without any compression. I also have mild-moderate inflammation in my facet joint. I have a positive emg at the s1 nerve root. I’ve tested negative for autoimmune diseases and lyme’s. When this initially started my doctor thought an annular tear on the right side was causing my pain and gave me 2 epidurals on the right side. It gave me about 75% relief for my sciatica and 50% for my back pain. I was able to exercise during a whole pregnancy just a couple of months later with some back pain but no returning sciatica. Right after birth I was completely pain free for 4 months then out of nowhere I leaned in to kiss my baby and my back completely spasmed and went out. Since then, it’s been a spiral. 1 epidural on the left side of l5-s1 and 2 on the right with 0 relief from any of them. 2 facet injections with about 2 weeks of relief both times for back pain only. Sciatic pain hasn’t been relieved at all (I should note I only get sciatic pain when sitting and for a few hours after standing up). I’ve been to several doctors all with varying opinions. Some say to live with it and never operate. Some say to do miscrodisectomy as there must be painful fragments causing a chemical inflammatory response leaking onto the nerve root. Others say to do ablation or prp in my facet since facet block worked (this wouldn’t take care of sciatic portion though).Another wants to try SI joint injection just to see. At this point I have no idea which route to go and am at a loss. Any advice would be be greatly appreciated. Thank you.
