Chronic Sciatica, Baker's Cyst, and an Unexpected Cardiovascular Response
Background
A 90-year-old patient with a history of high blood pressure, multiple past surgeries (C-sections, breast surgery, and a hysterectomy), and a right leg that measured 1.5 cm shorter than her left.
Presenting Complaint
The patient wasdiagnosed with chronic right-sided sciatica following the L5 dermatomal pattern down to the hallux (big toe), accompanied by a right Baker's cyst (knee swelling). She had been in constant, intense pain for eight months. Her pain was so severe she could no longer sleep on her right side and required a nurse to care for her feet and toe nails. She had already tried massage therapy and physiotherapy without success, and was managing her pain with Tylenol and morphine.
Treatment Course
After Treatment #1: The sharp, shooting pain had resolved into paraesthesia (numbness and tingling only) down the right leg, with only mild residual pain in the right knee.
After Treatment #2: The patient was completely pain-free for 3–4 days. Right leg pain returned after she caught the flu.
After Treatment #3: The patient reported no right leg or knee pain at all, and no longer needed a nurse's help caring for her feet - she could manage this on her own. Her sciatica recurred suddenly two months later but resolved after a single treatment, then recurred again nine months after that and again resolved fully with just one treatment.
A Year Later: An Unexpected Finding
The patient returned a year later with bilateral pitting edema in her legs. (a sign of underlying systemic issues like heart failure) As someone who weighed herself daily, she had noticed a 7-pound weight gain in water retention, from her usual 128 lbs up to 135 lbs, despite not taking the water pills (diuretics) her doctor had prescribed.
The night of her NRT treatment (April 16, 2021), She urinated frequently and lost the entire 7 pounds of water weight overnight, returning to her baseline weight without any medication.
Clinical Reflection
The pattern of pitting edema and sudden water retention is consistent with early signs of heart failure. It's my belief that the treatment supported an improvement in cardiovascular and kidney function, allowing her body to release the excess fluid it had been retaining.
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These case studies reflect individual patient experiences and outcomes. Results vary by patient and are not a guarantee of similar results for any other individual.
